Changing for Better Outcome

As application of CASS procedure would significantly reduce VAP cases, and any nurse working in units with vent-dependent clients should support the application of this procedure. Nursing accountability to clients would mean that they are accountable for implementing this practice safely. The application of the CASS procedure requires proper staff training, and nurses who care for vent-dependent clients should attend these training courses and in-services. Moreover, when nurses are competent to perform this procedure, they should strictly follow its guidelines. The additional mechanical suctioning apparatus only takes effect when monitored on hourly basis by nurses. The tubes may be disconnected due to built up pressure or by being accidentally hit by other staff members, thus frequent monitoring is a must. The aspiration function also stops automatically when the collection bottle for secretions is full. The negative pressure of the suctioning apparatus is set at proper level according to secretion status of a particular client. Following evidence-based practice would guarantee for uninterrupted application of CASS procedure. To exemplify, the following sections present a potential client for such practice, as well as an understanding of my accountability as his nurse.
VAP was not new to a vent-dependent client in my unit because this 59 year old male client had VAP almost monthly, if not biweekly. This client was in a comatose state. He had a diagnosis of chronic obstructive pulmonary disease (COPD).