SVN frequency of change

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Permalink Reply by Michael on February 10, 2009 at 9:26am

Hi Donna. It really depends on hospital protocols and the Repiratory team. Changing of SVN every treatment or every 3 days will most likely decrease the incidence of VAP, however there are ways to modify the practice. Like there are some who either washes or disinfects SVN so that it can be used again safely without compromising the patient. While some do change it every 3-5 days. Although changing and/or cleaning of SVN were practiced, there are still other ways for VAP to occur. As we all know, once the patient is intubated, there's a high probability for the infection to occur, it may start from secretions, NG tubes, fresh oral wounds, or even from the ourselves. Sterile techniques and/or standard (universal) precautions such as proper hand washing and gloving, and maintenance of the patient's ventilator will really make a difference in the prevention of VAP.

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Permalink Reply by ric mandanas on February 10, 2009 at 11:34am

This might sound a bit odd but after carefully realizing what the rationale of the protocol means it makes sense thou it could create arguments on both sides.
Moisture and water droplets caused by humidity left after each treatment (specially we're using nss.) is a perfect medium for any organism. Recently as per instruction by infection control department, we are to wash the neb kit with sterile water and wipe dry the medication cup and air dry it to complete dryness every after treatment to reduce VAP.
Now imagine this with our concurrent therapy presently prevailing and following this instruction. but since your question is the best practice to reduce VAP, to me this is next to using new sterilized neb kit each and every treatment if you believe in the concept above.
Now we normally change neb kit everyday as per our department protocol and nurses changes it every other day. Remember your question here is to reduce VAP.

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Permalink Reply by Lisa Martinez on February 10, 2009 at 5:43pm

We try to limit the use of SVN. We mainly use MDI's to cut down on VAP. CDC has guidelines on equipment change outs. Also AARC website has information.

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Permalink Reply by Prem on February 11, 2009 at 12:16pm

Greetings!

Well its Good Questions.Do not change SVN Routinely for Infection Control Purpose.SVN change is only based on Technolgy and the Type of Nebulizer. Aerosol is Science.Therefore pls specify type ,make ,design and manufacture.

Regarding MDI Compared with SVN .The Drug deposition is greater than SVN ,But this depends upon a lot of factor.Pls check the AARC .Again MDI depends upon the design and Accessories and ofcourse the Patient.

Pls mail me premthangam@rediffmail.com will send you the some information

Regards.

Prem.

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Permalink Reply by Dona on February 14, 2009 at 2:28am

I was looking for best practice in regarding to changing out nebs, realizing that there are many contributing factors to VAP. We do protocol to MDIs and we do not routinely break the circuit. We normally do not use nebs on ventilated patients, however some of the new drugs used for PHTN, can only be aerolized. I was just wondering if nebs were reused or replaced with each treatment. We are now using once and then throwing away. Thanks for all responses.
Regards

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Permalink Reply by matthew lipsey on April 9, 2009 at 8:28am

VAP is a very serious problem. To combat this problem to make sure it is true VAP and not a problem before they came in is we swab all CCU patients the first day they are admitted and we were able to rule out several vap patients to patients with pre existing infections prior to intubation or admission

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Permalink Reply by Dona on April 9, 2009 at 5:41pm

Great info, thanks for the responce, I will present to my director!

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