MANAGEMENT FOR PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA AT ICU PANTI RAPIH HOSPITAL: A CLINICAL CASE STUDY
ABSTRACT:
Ventilator-Associated Pneumonia (VAP) is one kind of nosocomial infection that
happens to patients who use mechanical ventilator and tracheostomy. Patients who
are hospitalized in Intensive Care Unit (ICU) would have high risk onsuffering
from Pneumonia.
Objective: This paper aims to describe the interventions of nurses and to
give recommendations for managing the VAP prevention using case study method.
Methods: The data were collected from a patient who used mechanical
ventilator and continued by observing and interviewing the nurses who took care
of the patient.
Results: The development of late onset of VAP was noticed after 96 hours.
The observation result showed that there were fungi appeared after conducting a
sputum culture from the patient. There was an increase of White Blood Cells on
72 hours after the intubation and the temperature increased until 37o C while
the patient was using ventilator. Unfortunately, the nurses were not aware of
the tendency of late onset VAP development in the patient.
Discussion: Fungi are microorganism which causes VAP. The fungi were not
proliferating because the patient had received early antibiotics for treatment.
Early administration of antibiotics will prevent the development of VAP, but
late VAP is associated with antibiotic-resistant organism. The significant
increase of WBC count and the tendency of temperature while the patient was
using ventilator were signs for developing infection. VAP can be prevented by
conducting good oral hygiene every 2 hours using chlorhexidine 0.12% and using
orogastric tube and ETT with sub glotticport to patients who use mechanical
ventilator. Furthermore, positioning the patient’s head with 35o - 45o bed
elevation is intended to prevent aspiration as well as checkingadequate
endotracheal tube cuff of at least 20 cm H2.
Conclusion: Awareness, responsibility, knowledge, skills of nurses are
basis forinfection control especially for preventing VAP incidents.
KEYWORDS: Ventilator
Associated Pneumonia (VAP); Intensive Care Unit (ICU); management of
prevention; nurses
Author: Siwi Ikaristi Maria
Theresia
Journal Code: jpkeperawatangg160004