Oral care in patients on mechanical ventilation in intensive care unit: literature review

Atay, Selma; Karabacak, Ükke

doi:10.5455/2320-6012.ijrms20140876

Cited by 13 publications

(19 citation statements)

References 52 publications

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“…[34][35] The oral hygiene should not be underestimated, as was evidenced in the present study since it prevents VAP. [17][18][36][37] Oral rinsing performed with potentially contaminated and inadequate fluids such as distilled water already opened and saline droplets the mucosa. It is necessary to use a toothbrush, sterile water for oral rinsing and exclusive materials for this purpose, 38 the products used must be standardized in an institutional protocol, based on evidence.…”

Section: Resultsmentioning

confidence: 99%

“…It is necessary to use a toothbrush, sterile water for oral rinsing and exclusive materials for this purpose, 38 the products used must be standardized in an institutional protocol, based on evidence. 17,39 The use of PPE was low. Non-adherence to the use of standard precautions is directly related to the availability of appropriate materials, professional culture and organizational climate that favor this attitude, as well as its safety.…”

Section: Resultsmentioning

confidence: 99%

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Bed-Bath: The Care-Omitting Behavior of the Nursing Team / Banho no Leito: Cuidados Omitidos pela Equipe de Enfermagem

Ribeiro

Bastos²,

Gonçalves

et al. 2020

R. pesq. cuid. fundam. online

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Objetivo: avaliar o processo de realização do banho no leito e os cuidados realizados pela equipe de enfermagem antes, durante e após o banho no leito. Métodos: estudo transversal e observacional, realizado na Unidade de Terapia Intensiva de um Hospital/Escola, com oito técnicos de enfermagem. Para a coleta de dados foi utilizado instrumento estruturado tipo checklists em 30 momentos de observação de 1080 ações. Resultados: foram observados 10 cuidados antes e 28 durante e após o banho no leito. O banho foi realizado de forma automática sem comunicação prévia, sem considerar a individualidade e privacidade do paciente, principalmente naqueles submetidos a ventilação mecânica. Não houve participação do enfermeiro e a maioria das ações realizadas pela equipe de enfermagem não atendeu às recomendações da literatura. Conclusões: há necessidade de melhoria da qualidade do banho no leito realizado pela enfermagem e adoção de práticas baseadas em evidências no processo de cuidar.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Bed-Bath: The Care-Omitting Behavior of the Nursing Team / Banho no Leito: Cuidados Omitidos pela Equipe de Enfermagem

Ribeiro

Bastos²,

Gonçalves

et al. 2020

R. pesq. cuid. fundam. online

View full text Add to dashboard Cite

show abstract

“…Oral health in patients requiring critical care is vital because it can affect the health and clinical outcomes of these individuals (1,2). Oral epithelium cells, extending from the lips to the oropharynx, are easily damaged in ICU patients due to poor circulation, lack of fluid and food intake, and toxicity of administered drugs (3).…”

Section: Introductionmentioning

confidence: 99%

“…Owing to a variety of reasons such as fear of endotracheal tube displacement, pulmonary aspiration, patients' increased distress and suffering, shortage of time, lack of sufficient knowledge and skills in oral care, unpleasantness of the task, and the perception that oral care is less important than other care procedures, nurses either completely ignore patients' oral health or poorly attend to it (6). As part of nurses' daily tasks, oral care in ICU patients is an effective method for lowering the incidence of VAP (1). Pulmonary infections are the most common nosocomial infections in ICU patients, and they account for 65% of all such infections in these individuals (13).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Oral Care with Miswak Versus Chlorhexidine on the Incidence of Ventilator-Associated Pneumonia: A Clinical Trial Study

et al. 2020

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Background: Inadequate oral care in ICU patients can lead to lethal complications such as ventilator-associated pneumonia (VAP). Objectives: The purpose of this study was to compare the effect of oral care using miswak and chlorhexidine mouthwash on the incidence of VAP in ICU patients. Methods: This single-blind randomized clinical trial was carried out in 2018 on 70 patients undergoing mechanical ventilation in the intensive care units of Khatam-al-Anbia Hospital in Zahedan, Iran. The inclusion criteria were the insertion of endotracheal tube, scoring 10 or below based on Beck oral assessment scale (BOAS), scoring below 5 based on the modified clinical pulmonary infection score (MCPIS) at the beginning of the study, absence of chronic pulmonary disease, and no history of pulmonary aspiration. The subjects were selected through convenience sampling and randomly divided into the intervention (n: 35) and control (n: 35) groups. For five days, oral care was administered using miswak in the intervention group and chlorhexidine mouthwash in the control group. Data were collected through a demographic and clinical information questionnaire, MCPIS, and BOAS. After normality tests, the obtained data were analyzed in SPSS 22 using independent t-test, chi-square test, and Fisher's exact test at the significance level of P < 0.05. Results: The two groups were similar in terms of age, gender, cause of hospitalization, level of consciousness, administered antibiotics, history of ICU admission, and smoking. After oral care with miswak, none of the patients in the intervention group developed VAP, but 6 patients in the control group (17.1%) were diagnosed with this condition. The results of Fisher's exact test showed a significant difference between the two groups in terms of VAP incidence (P = 0.01). Conclusions: In addition to promoting the oral health of ICU patients, miswak can mitigate the incidence of ventilator-associated pneumonia. Therefore, because of its availability, cost-effectiveness, and fewer side effects compared to chlorhexidine mouthwash, it is strongly recommended to be administered to ICU patients.

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“…The use of antiseptic chlorhexidine gluconate 0.2% is recommended in the oral hygiene of patients with mechanical ventilators. 7,10,11 In the XXX: Dr. Saiful Anwar General Hospital intensive care unit, the use of 0.2% chlorhexidine gluconate as an antiseptic agent for oral hygiene is used by applying sterile gauze to the entire surface of the teeth, tongue, and mouth (conventional technique). Recent studies have shown that using 0.2% chlorhexidine gluconate can be more effective using comprehensive techniques (using a soft toothbrush).…”

mentioning

confidence: 99%

Conventional and comprehensive oral hygiene procedures using Chlorhexidine 0.2% in patients with mechanical ventilator

2019

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Background: Ventilator-Associated Pneumonia (VAP) in the intensive care unit patients is related to the oropharyngeal bacteria colonization. The purpose of this study was to compare the number of oropharyngeal bacterial colonies after conventional and comprehensive oral hygiene procedures in patients with mechanical ventilators.Methods: This study uses an experimental design on 32 subjects with mechanical ventilators. Conventional group/K group (n=16) used 0.2% chlorhexidine gluconate antiseptic conventionally using a sterile gauze while the comprehensive group/L group (n=16) used 0.2% chlorhexidine gluconate antiseptic comprehensively using a toothbrush every 12 hours. Bacterial Isolation is done using swab technique. The number of bacterial colonies and bacterial identification before and after oral hygiene procedure was examined. The data were statistically analyzed using the Wilcoxon test and the Mann Whitney test using SPSS 19.0 software.Results: There was a significant decrease in the number of oropharyngeal bacterial colonies before and after oral hygiene both in the conventional group (p=0.002) and comprehensive group (p=0.002). However, there was no significant difference between the number of bacterial colonies in the two groups before (p=0.269) and after the oral hygiene procedure (p=0.295). The most common bacterium in the conventional and comprehensive group are Enterobacter gergoviae and Escherichia coli, respectively. Klebsiella pneumonia have decreased the most after conventional oral hygiene while Pseudomonas aeruginosa has decreased the most after comprehensive oral hygiene.Conclusions: Conventional and comprehensive oral hygiene significantly reduces the number of oropharyngeal bacterial colonies. Both techniques can be used as oral hygiene techniques with relatively similar results.

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Oral care in patients on mechanical ventilation in intensive care unit: literature review

Cited by 13 publications

References 52 publications

Bed-Bath: The Care-Omitting Behavior of the Nursing Team / Banho no Leito: Cuidados Omitidos pela Equipe de Enfermagem

Bed-Bath: The Care-Omitting Behavior of the Nursing Team / Banho no Leito: Cuidados Omitidos pela Equipe de Enfermagem

The Effect of Oral Care with Miswak Versus Chlorhexidine on the Incidence of Ventilator-Associated Pneumonia: A Clinical Trial Study

Conventional and comprehensive oral hygiene procedures using Chlorhexidine 0.2% in patients with mechanical ventilator

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