Running Head: PREVENTION OF NOSOCOMIAL PNEUMONIA

Prevention of Nosocomial Pneumonia Amy Gifford Lewis-Clark State College

2 PREVENTION OF NOSOCOMIAL PNEUMONIA

Prevention of Nosocomial Pneumonia Hospital-acquired pneumonia (HAP) or nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 4872 hours after being admitted. Mikolai, J. (2009). It is usually caused by a bacterial infection, rather than a virus and is the second most common nosocomial infection, following urinary tract infections, in the United States. It is the most common cause of death among nosocomial infections and is the primary cause of death in intensive care units. Nurses play an important role when it comes to the prevention of nosocomial pneumonia. By taking the proper steps during the assessment, planning and taking appropriate interventions and providing patient education we can continue to prevent the spread of this infectious disease. According to the American Nursing Association (ANA) Standard of Care 1: Assessment, nurses need to collect quality patient health data. Performing a quality initial assessment as well as ongoing reassessments for a patients risk of hospital acquired pneumonia is critical in the prevention of this illness. Upon initial assessment the nurse should take risk factors for infection into consideration. Patients at higher risk for developing nosocomial pneumonia include: infants, young children, and persons greater than 65 years of age; persons who have severe underlying disease, immunosuppression, or cardiopulmonary disease; and patients who have had abdominal surgery. Mikolai, J. (2009) Assessments should include at minimum vital signs, pulse oximetry, cardiopulmonary physical examination, WBC count and a CURB 65 or another mortality prediction score. Lai, Huang, Liao, Hsueh, Tan, Chou, Hsu. (2010). Many patients with pneumonia may have flushed cheeks, bright eyes, and have an anxious demeanor. In patients at high risk for development of

3 PREVENTION OF NOSOCOMIAL PNEUMONIA pneumonia it important to include a focused respiratory assessment. The nurse should observe the patients pattern of breathing, position of comfort to breath and use of any accessory muscles. Upon auscultation of the lungs make notes of any crackles which would indicate fluid in the lungs and wheezing that could mean the airways are inflamed or have exudate in the airways. Ignatavicius, D. D., & Workman (2013) The 5th ANA Standard of Care is Implementation, as a provider of care it is imperative that the nurse develop proper nursing diagnosis and interventions for patients that are at high risk for nosocomial pneumonia. Traditional preventive measures for nosocomial pneumonia include decreasing aspiration by the patient. Aspiration pneumonia occurs when foreign materials (usually food, liquids, vomit, or fluids from the mouth) are breathed into the lungs or airways leading to the lungs. This leads lung infection and accounts for a large number of nosocomial pneumonia cases. Ignatavicius, D. D., & Workman (2013) Other interventions include; preventing cross-contamination or colonization via hands of health care workers, appropriate disinfection or sterilization of respiratory-therapy devices, use of available vaccines to protect against particular infections, and education of hospital staff and patients. Lai, Huang, Liao, Hsueh, Tan, Chou, Hsu. (2010) Lastly, patient education is an important factor in the prevention of nosocomial pneumonia. The nurse should make sure that the patient understands the signs and symptoms of infection and knows when to alert the health care provider of these problems. The patients family should also be educated of proper hand washing techniques and not having contact with the patient of they have a cold, flu or have had an increased exposure to irritants such as smoke.

4 PREVENTION OF NOSOCOMIAL PNEUMONIA Mikolai, J. (2009). The nurse should also stress the importance of vaccinations against both influenza and the flu. In conclusion, health care providers play a huge role in the prevention of nosocomial pneumonia. By obtaining a proper assessment of the patient, identifying risk factors for the infection and providing proper nursing interventions, nurses can continue to make a positive impact on the reduction of nosocomial pneumonia.

5 PREVENTION OF NOSOCOMIAL PNEUMONIA References Ignatavicius, D. D., & Workman, M. L. (2013). Medical-surgical nursing: Patient-centered collaborative care. St. Louis: Elsevier Saunders. Lai, C. C., Huang, Y. T., Liao, C. H., Hsueh, P. R., Tan, C. K., Chou, C. H., & Hsu, H. L. (2010). Hospital-Acquired Pneumonia and Bacteremia Caused by Legionella pneumophila in an Immunocompromised Patient [electronic resource]. Infection, 38(2), 135-137. Mikolai, J. (2012). Integrative Management of Respiratory Illnesses. Townsend Letter, (353), 51-59.