The guidelines include decontaminating hands by washing them with antimicrobial soap and water or by using an alcohol-based, waterless antiseptic agent if hands are not visibly contaminated. In addition, gloves should be worn when handling respiratory secretions or objects contaminated with the respiratory secretions of any patient.
Grap have substantiated the need to standardize oral care for a variety of reasons, the most compelling of which is to prevent or lower VAP rates in mechanically ventilated patients. Oral care is not only part of a standard of care that lowers infection rates by removing plaque-harboring organisms, but is also a comfort care issue.Using evidence-based outcomes and research, the CDC and its Hospital Infection Control Practices Advisory Committee have developed a set of guidelines for VAP prevention that are beneficial for any institution. The guidelines include preferential use of orotracheal tubes over nasotracheal tubes, use of endotracheal tubes with a dorsal lumen to allow drainage, elevating the head of the bed to 30˚or 40˚, routinely verifying placement of feeding tubes, and preventing or modulating oropharyngeal colonization with implementation of a comprehensive oral hygiene program.
The VAP bundle was implemented over a period of 2 years and included (b) use of sequential compression devices or anticoagulation, (c) administering gastric acid histamine2 (H2) blockers, (e) initiating early mobilization, and Other precautions also were initiated and include the following: (a) the practice ofuniversal gloving was observed (i.e., as staff in all hard-wire units enter a patient’s room [after having meticulously washed their hands], they put on gloves. At the bedside, they used hand sanitizer.), (b) in-services regarding VAP and its consequences were held on all shifts and weekends, and (c) dual lumen endotracheal tubes were implemented.
When the head of the bed is flat,more secretions can pool in the back of the airway,become colonized,and then aspirate into the lungs.In conjunction with in-services about VAP,posters with a picture of a 30度角 showing what the height of the head of the bed should be were put up at patients’bedsides.
The next pieces of the bundle that were put into place were hand washing and gloving.Universal gloving requires any staff member walking into a patient’s room to put on gloves as they enter.Sinks are available in the front of every room in critical care,
so in-services were held on all shifts to encourage universal gloving,as well as frequent hand washing before and after putting on gloves,before and after suctioning,and before and after touching ventilator equipment or coming into contact with patients’ respiratory secretions.
- 7 年前最佳解答
VAP束在一個為期2年，並實施包括（b）使用順序壓縮設備或抗凝， （三）管理胃酸組胺H2受體阻滯劑（ H2 ） ， （五）發起早動員，和其他注意事項還發起和包括以下內容： （一）實踐ofuniversal配戴手套的觀察（例如，為所有硬線單位工作人員進入病人的房間[經精心洗他們的手後] ，他們把手套。在床邊，他們用洗手液）， （b）在服務VAP和所有的輪班和週末舉行，其後果及（c）雙腔氣管插管實施。
- 7 年前
- 羅莉Lv 77 年前