RESUMO
Ventilator-associated pneumonia (VAP) is common with mechanical ventilation. VAP bundles have improved outcomes in acute care and long-term acute care hospitals. This article reports on an implementation of a VAP bundle designed for a skilled nursing facility (SNF). The primary goal was to improve oral health, a significant factor for VAP, and improve SNF nurse adherence to the bundle. Improvements in oral health and adherence were demonstrated. Nurses had difficulty with adhering to maintaining the tracheostomy cuff seal.
Assuntos
Fidelidade a Diretrizes , Saúde Bucal/normas , Pacotes de Assistência ao Paciente/métodos , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Respiração Artificial , Instituições de Cuidados Especializados de Enfermagem , Humanos , Melhoria de Qualidade , Respiração Artificial/efeitos adversos , Respiração Artificial/enfermagemRESUMO
Delirium is a common cause of morbidity and mortality in hospitalized older adults often superimposed on dementia. Older patients with delirium are more likely than other populations to develop hospital-acquired infections, pressure ulcers, and immobility and nutritional issues, as well as to have increased health care costs, longer hospital stays, and long-term care following discharge. Interventions that prevent or mitigate the effects of delirium while promoting recovery are essential for caring for hospitalized older patients. This article is a summary of an evidence-based guideline that includes a framework for addressing delirium that focuses on predisposing and precipitating factors for delirium. In addition, the guideline includes evidence-based assessment and intervention principles, along with a review of reliable and valid assessment instruments. The guideline also identifies measurable outcomes for managing delirium and a quality improvement approach for improving outcomes. [Journal of Gerontological Nursing, 44(2), 14-24.].
