CI: Monitoring Criteria: Patient Positioning (2006)

Citation:
Bowton D. Nosocomial pneumonia in the ICU-year 2000 and beyond. Chest 1999; 115(3): 28S-33S. PubMed ID: 10084457
 
Study Design:
Narrative Review
Class:
R - Click here for explanation of classification scheme.
Quality Rating:
Negative NEGATIVE: See Quality Criteria Checklist below.
Research Purpose:

To describe for clinicians promising strategies to employ against ventilator-associated pneumonia.

Inclusion Criteria:
  • Strategies to optimize enteral delivery and minimize risks
  • Antibiotic use
  • Potential preventive modalities
  • Semi-recumbent positioning
  • Change ventilator circuits to decrease bacterial counts
Exclusion Criteria:
Description of Study Protocol:

Review of literature

Data Collection Summary:
Ventilator-associated pneumonia
Description of Actual Data Sample:
Summary of Results:

Data favor semi-recumbent positioning to ¯ volume of aspirated secretions compared to prone positioning.

Author Conclusion:

Promising treatment modalities for nosocomial ventipator-associated pneumonia include use of a semi-recumbent position, continuous aspiration of secretions and heat and moisture exchangers.

Funding Source:
University/Hospital: Wake Forest School of Medicine
Reviewer Comments:

Only 26 references to this review.

Narrative, not discerning.

Quality Criteria Checklist: Review Articles
Relevance Questions
  1. Will the answer if true, have a direct bearing on the health of patients? Yes
  2. Is the outcome or topic something that patients/clients/population groups would care about? Yes
  3. Is the problem addressed in the review one that is relevant to dietetics practice? Yes
  4. Will the information, if true, require a change in practice? Yes
 
Validity Questions
  1. Was the question for the review clearly focused and appropriate? Yes
  2. Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? No
  3. Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? No
  4. Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? No
  5. Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? Yes
  6. Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? Yes
  7. Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? No
  8. Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? Yes
  9. Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? Yes
  10. Was bias due to the review's funding or sponsorship unlikely? Yes