By Linda Childers
As part of a multidisciplinary team at HonorHealth Scottsdale Osborn Medical Center in Arizona, nurses are conducting research on ventilator-associated pneumonia.
While the Institute for Healthcare Improvement issued a how-to guide in 2012 that describes evidence-based care components that have been linked to reductions in VAP, IHI notes VAP remains the leading cause of death among hospital-acquired infections.
In November, researchers at the medical center were awarded a $200,000 grant from the Flinn Foundation, a Phoenix-based privately owned philanthropic organization.
“The funding will help us to take a closer look at genetic and molecular interactions during the early development of VAP,” said Lori Wood, BSN, RN, CCRP, a trauma research nurse at the medical center. “We are examining why some ICU patients get VAP and others don’t, and we hope that our research will help us to detect VAP in its earliest stages and improve patient outcomes.”
Risk of VAP
Wood says severely ill patients who can’t breathe on their own often are placed on ventilators, which poses a risk for VAP. The risk of VAP increases about 1% to 3% for each day on a ventilator, and afflicts an estimated 250,000 patients annually. In addition, patients who develop VAP have significantly more ventilator days, hospital and antibiotic days, and a higher hospital mortality rate.
“We hope our work will help lead to a more rapid diagnosis of VAP and better treatment for resistant pathogens that will improve patient outcomes,” Wood said.
Nurses aid researchTina Sheppard, RN
The medical center’s nurses are aiding in the research with ICU nurses working to identify patients who have suffered trauma, and helping to collect blood samples that would examine genetic and molecular interactions. The research involves a multidisciplinary team of ICU nurses, physicians, researchers and respiratory staff who work with patients and their families to identify potential VAP patients. Staff also can work with patients and their families to obtain blood and respiratory cultures. Some studies have found that gene expression profiles of lipopolysaccharide-stimulated blood cells were different in patients who did not develop VAP from those who did.
“We are still in the very early stages of our pilot study,” Wood said. “Our goal is to analyze blood samples, measuring tracheal aspiration and other medical information from 30 patients that will help us to enable the identification of the main players of pathology, which may represent novel therapeutic targets or biomarker candidates.”
Tina Sheppard, BSN, RN, trauma program manager at HonorHealth Scottsdale, said nurses find the research rewarding since it benefits their patients and results in better outcomes. “We’re incorporating research into trauma services,” Sheppard said. “As frontline caregivers, our ICU nurses are working to help ventilated patients to avoid VAP, by understanding how it develops.”
[accordion title=”How bedside nurses help drive research” load=”hide”]While Lori Wood, BSN, RN, CCRP, works as a full-time research nurse at HonorHealth Scottsdale Osborn Medical Center in Arizona, Tina Sheppard, BSN, RN, trauma program manager, and other nurses who work in the hospital’s ICU and ED are assisting with research while also caring for patients.
“The bedside nurse does not identify the patients to be part of the study. The clinical research nurse identifies the patients, obtains consents from the families and retrieves the specimens,” said Jill Lemma, MBA, CCRC, director of operations, clinical research with HonorHealth Scottsdale.
“The bedside nurse works collaboratively with the research nurse and the respiratory therapist in retrieving the specimens,” Lemma said.
“In order to implement a successful program where bedside nurses are engaged in research, you need to be genuine,” Wood said. “You can’t just walk in and say, ‘This is what we’re going to do.’ You have to foster a sense of teamwork and collaboration that allows nurses to understand how important their participation is to the overall research project.”
Wood also conducts inservices where nurses learn the definition of research, what it means to patient care and how the research plans to move forward, plus offers step-by-step guidance to nurses participating in the research.
“This also gives us a chance to brainstorm ideas on ways that nurses feel they can add to the research and to address any perceived barriers such as resources or lack of time,” Wood said. “Our goal is to help nurses integrate the research into their daily practice, and to ultimately integrate our findings into their clinical decisions to improve patient care.”
Linda Childers is a freelance writer.