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I will pay for the following article Ventilator Acquired Pneumonia: Literature Review and Theory Application. The work is to be 5 pages with three to five sources, with in-text citations and a reference page. Most health care givers consider it the leading cause of mortality among the nosocomial diseases. The presented articles strive to elaborate on VAP and the effective strategy in addressing this problem. One of the studies done pertaining to the subject matter elaborates a multidisciplinary approach that is aimed at reducing the incidence of VAP. The study was published in 2009 and was carried out by Arroliga et al. The aim of the study was to describe a multifaceted approach of evidence based practices geared at decreasing the rates of VAP in Intensive Care Units. The study also sought to describe the implementation of these evidence based practices within the same setup. Arroliga undertook the study in a teaching institution offering tertiary care. It employed a prospective surveillance system in identifying the cases emerging in the five ICUs. Cases included were confirmed by microbiology and used mini-BAL methods. A multidisciplinary approach was instituted in 2007 in the institution (Arroliga, 2009). The approach included education and awareness, use of standardized diagnosis and the direct confirmation of the adoption of VAP preventive and management measures. Pertaining to these measures, Nurses implemented oral care. Respiratory Therapists also assumed Oral care, and the Chlorhexidine was adopted in Oral care. Silver coated endotracheal tubes were also introduced. The rates of VAP before the implementation of these measures were compared to the rates after the implementation of the measures. The rate of VAP before the measures was approximately 5 cases per 1,000 ventilator/days. After the multipronged approach, the rate dropped to approximately 0.5 cases per 1,000 ventilator/days (Arroliga, 2009). This study objectifies the imperativeness of a multidisciplinary approach in tackling VAP. For effective management and preventive strategy, one needs to approach the disease from several angles. Another study was conducted by Keeley in 2007 sought to identify whether the occurrence of ventilator acquired pneumonia can be reduced by elevating the head of the patient to 45 degrees. This study was carried out in the Royal Sussex County Hospital in the Critical Care department. The study utilized 30 patients. The treatment group had 17 patients and the control 13 patients. The study implemented a randomized control trial to carry out the research. The bed of the patients in the treatment group was elevated at 45 degrees while that of those in the control group was elevated to 25 degrees (Keeley, 2007). The results of the study relied upon the diagnosis of ventilator acquired pneumonia either clinically or confirmed through microbiological tests. The results of the study demonstrated that about five patients in the treatment group (25% of patients) and seven of those in the control group (54% of patients) developed ventilator acquired pneumonia. The study indicated that there is a decreased incidence of VAP in patients nursed at a head elevation of 45 degrees. Unfortunately, the sample size was not adequate to reach statistical significance and thus, the study is not reliable (Keeley, 2007). Lacherade et al. carried out a research in various centres to demonstrate the relationship between intermittent sub-glottis secretion drainage in the reduction of VAP (Lacherade, 2010).

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