RESPONSE 1 BERNIS

Seeing my patients suffer as a result of poor infection control was the force that drove me into chosen my topic (Nosocomial infections). A few incidents left me paralyzed at work because I was afraid to stand up to a superior staff, reminding them to either put on an isolation grown, or not to sit on patient’s bed of a patient who was immunocompromised after sitting on the bed on a patient who tested positive for C.def. My research reminded me of the tools I need to not only practice safe bedside care but to understand my role in the fight against hospital acquired infections.

I understand that the actions of any nurse who provides first hand bedside care has a direct role in positive patient outcome which can be imparted by control and prevention of infection. The nursing staff has the responsibility to be proactive and control nosocomial infections especially when performing invasive procedures such as placing a catheter. Studies have shown that although we know about hospital acquired infections, we are not doing everything we were taught to prevent it, we don’t perform the right techniques and procedures, our Knowledge in sterilization and disinfection procedures is becoming increasing low (Chandak, R. J et al 2016). I put this to test at work today asking a few coworkers for the steps to change a central line dressing and 4 out of 5 directed me to the hospital policy, this got me worried because in the case of emergency, there might not be time to print out one and that might put a patient in danger of acquiring an infection. As nurses it is therefore important for us to stay educated on this issue, work with other healthcare team members, stay informed on the topic and apply new evidence-based research (Dutra, G. et al 2015) on our daily routines so we can reduce and eradicate the amount of infections.

RESPONSE 2 PIERRE

Each year, an estimated $ 9.8 billion is spent in treating nosocomial infection. Of the top 5 HAIs (Hospital Acquired Infection), surgical site infections contributed the most to overall costs (33.7%), followed by ventilator-associated pneumonia (31.6%), central line–associated bloodstream infections (CLABSIs; 18.9%), Clostridium difficile infections (15.4%), and catheter-associated urinary tract infection (Waknine, 2013). As a nurse working in the ICU, I see firsthand the burden of nosocomial infection in the community. Hospitals all over the country are striving to reduce the number of cases of nosocomial infection. The topic of my literature review will focus on evidence-based bundles to prevent ventilator associated pneumonia. The artificial airway of the ventilator or the endotracheal (ET) tube can transmit microorganisms to the lungs. Ventilator associated pneumonia has significant consequences in the healthcare with increased mortality and length of ICU and hospital stay.

Nurses are the first line of defense in preventing ventilator associated pneumonia. Simple tasks such as elevating the head of the bed and mouth care can make a substantial difference in preventing ventilator associated pneumonia. Although many studies have shown that head-of-bed elevation and mouth care help prevent VAP, these interventions are implemented inconsistently. In the hospital where I practice, there are bundle of cares set as protocol to care for patients that are ventilated. These bundles are evidence-based practice that are grouped together to encourage the consistent delivery of these cares. Those interventions that have been shown to have a clinical impact include the following: 1) maintaining ET-tube cuff pressure 2) sedation and weaning protocols for those patients who do require mechanical ventilation 3) mechanical ventilation protocols including head of bed elevation above 30 degrees and oral care, and 4) removal of subglottic secretions ( Keyt, Faverio, & Restrepo, 2014).