Mentally Ventilated ICU Patients PICOT Question

Table of Contents

Introduction

Intensive Care Unit patients suffer the risk of losing their lives due to the critical illnesses they suffer from and ventilator-associated infections contracted while under special care, such as nosocomial pneumonia. The infection affects 27% of the patients and medical experts rate it as one of the most common pneumonia infections (Marti & Ewig, 2009). Over eighty-six percent of ICU related pneumonia cases are as a result of mechanical ventilation. The cases are, usually, higher in different populations, for example, those reported in United States range from 250,000 to 300,000 per year.

Picot question

The picot question is “In mechanically ventilated ICU patients, does positioning of the patient in semi-fowlers position result in a lower incidence of nosocomial pneumonia when compared to the supine position?”

Nosocomial pneumonia being a secondary process infects intubated patients under mechanical ventilation and occurs after a period of 48hours. Measures to counter the infection include respiratory secretions analysis, high levels of clinical supervision and patient bedside examination (Baughman, 2009). Through the study of the pathogens, clinical experts have known more about the infection how to manage it. The infections diagnosis includes; clinical, radiologic and microbiologic analysis.

Overtreatment and under treatment cases are experienced when dealing with the infection. Poor positive predictive value and specificity are some of the factors that lead to overtreatment while under-treatment results from over-reliance on clinical diagnosis (MacIntyre & Branson, 2009). Bed rest positions, for example, semi-fowler and supine are also associated with nosocomial pneumonia. Comparing the two bed rest techniques, semi- fowlers result in a lower infection incidence than the supine position.

Semi-fowlers position involves resting the patients head between a 45 to 60 degrees angle. The position enables proper breathing by allowing maximum chest expansion and abdominal muscle relaxation. Supine position involves the ill patient lying with the face up (Marti & Ewig, 2011). Such patients tend to experience less ventilation and perfusion in the anterior parts of their lungs compared to the dependent parts.

Picot statement

PICOT refers to acronym for the elements that make up the clinical question. The elements are population (p), intervention (I), comparison (C), outcome (O), and time (T). In this case the elements represented below match the picot format as follows:

  • P: mechanically ventilated ICU patients
  • I: semi-fowlers position
  • C: supine position
  • O: lower nosocomial pneumonia incidence
  • T: Duration at the ICU
  1. Population: Over eighty-six percent of ICU related pneumonia cases are linked to mechanical ventilation (MacIntyre & Branson, 2009). In the United States, a thousand hospital patient admissions register incidence rates of between 5 to 10 cases with 250,000 to 300,000 reported cases annually. The infection also has a 0 to 50% mortality rates.
  2. Intervention: Practices done to reduce the infection rates include; raising the patients head to a 30 degrees semi-upright position, oral hygiene, early mobilization and daily neurologic evaluations (Baughman, 2009).
  3. Comparison: Between supine and semi-fowlers, patients in semi-fowlers position have a lower incidence of nosocomial pneumonia. Supine position interferes with the patients perfusion and ventilation.
  4. Outcome: Semi-fowler bed rest position is recommended for the patients with necessary restrictions even though the trial results do not fully prove it to be effective or harmful (Marti & Ewig, 2011).
  5. Time: Nosomial pneumonia contraction occurs after 48hours of hospitalization and the results for intervention practices used can be acquired after 24hours.

Conclusion

Patients found to be suffering from nosocomial pneumonia should immediately receive antibiotics. In instances where a patient is already using antibiotics, the nurse should immediately change them and administer another (Baughman, 2009). More supervision should be conducted to patients with deteriorating health conditions to determine if they are suffering from mechanically ventilated nosocomial pneumonia.

References

Baughman, R. (2009). Contemporary diagnosis and management of nosocomial pneumonia (2nd ed.). Newtown, Pa: Handbooks in Health Care Co.

Macintyre, R., & Branson, R. (2009). Mechanical ventilation (2nd ed.). St. Louis, MO: Saunders Elsevier.

Marti, T., & Ewig, S. (2011). Nosocomial and ventilator-associated pneumonia. Sheffield, United Kingdom: European Respiratory Respiratory Society.

Calculate the price
Make an order in advance and get the best price
Pages (550 words)
$0.00
*Price with a welcome 15% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
How it works
Receive a 100% original paper that will pass Turnitin from a top essay writing service
step 1
Upload your instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
Pro service tips
How to get the most out of your experience with My Homework Geeks
One writer throughout the entire course
If you like the writer, you can hire them again. Just copy & paste their ID on the order form ("Preferred Writer's ID" field). This way, your vocabulary will be uniform, and the writer will be aware of your needs.
The same paper from different writers
You can order essay or any other work from two different writers to choose the best one or give another version to a friend. This can be done through the add-on "Same paper from another writer."
Copy of sources used by the writer
Our college essay writers work with ScienceDirect and other databases. They can send you articles or materials used in PDF or through screenshots. Just tick the "Copy of sources" field on the order form.
Testimonials
See why 20k+ students have chosen us as their sole writing assistance provider
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
11,595
Customer reviews in total
96%
Current satisfaction rate
3 pages
Average paper length
37%
Customers referred by a friend
OUR GIFT TO YOU
15% OFF your first order
Use a coupon FIRST15 and enjoy expert help with any task at the most affordable price.
Claim my 15% OFF Order in Chat
Live ChatWhatsApp