産業医学および健康問題

抽象的な

Ventilator Associated Pneumonia: Reducing the Risk during Covid-19 Pandemic

Karen L. Hoblet1 *, Heidi Shank2 and Mackenzie Maltese3

Novel corona virus, known as COVID-19, was identified in the United States (U.S.) in January 2020. Within two months, patients testing positive for COVID-19 were overwhelming U.S. hospitals in major cities. Many of these patients were presenting with severe acute respiratory syndrome (SARS) requiring critical care and mechanical ventilation to support respiratory function. A complication of mechanical ventilation is ventilator associated pneumonia (VAP). Orem’s, 2001, theories and the American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care, 2000, provide information that explains the need for and how to individualize nursing care to achieve quality outcomes. Evidence of effective strategies to prevent VAP is available. Planning and executing implementation must include inter professional team which should be led by an expert nurse familiar with critical care and VAP prevention. Bedside nurses are the change agents who will be most affected by this planned change, thus should be proportionally involved in the process. Change and process theory and evidence suggest that a process be mapped out including thorough assessment, goal setting, planning, implementation, and evaluation to facilitate quality improvement. Education, policy and protocol development, incorporation of the VAP bundle (a combination of care techniques demonstrated to prevent or reduce the incidence VAP), “ventilator care kit”, monitoring, and evaluation are key to successful sustainability of this initiative. Implementation of a VAP prevention program for care of mechanically ventilated patients has never been more important than during the current COVID-19 pandemic when patients assaulted with this viral infection fight for their lives.