VAP Prevention Knowledge in the Emergency Department

Abstract

Introduction: Ventilator associated pneumonia (VAP) is a prevalent hospital acquired infection that patients have a risk of developing after being intubated. The mortality rate of intubated patients is estimated between 30-50 percent. Furthermore, it is estimated that VAP occurs in 10-30 percent of all intubated patients. Numerous studies have linked VAP protocols and evidence based guidelines initiated in the intensive care unit (ICU) to a decrease in the prevalence of VAP. However, limited research exists on VAP prevention protocols implemented in the emergency department (ED). Early implementation of VAP bundles and protocols are linked to a decrease in the prevalence of VAP. Purpose: Evaluate the knowledge of interdisciplinary staff members on VAP, and the VAP prevention protocol in the emergency department. Setting: The setting of the DNP project is a 61-bed level one trauma emergency department at a Banner University Medical Center, serving approximately 77,000 patients a year. Results: The average score VAP survey was a 71.6%, with majority of the respondents unable to identify the correct patient diagnosed with VAP. The major barriers identified by the survey included lack of education, availability of the necessary supplies, proper orders to be imputed by providers, patient availability, lack of time and/or supplies, and RN ratios. Discussion: The results of the survey show majority of the registered nurses are not familiar with the protocol, but suggest they do implement the protocol on those patients who are intubated in the ED. Thus, there are still gaps in the full implementation of the VAP protocol and there is a need further improvement in the care of patients who are intubated in the ED.