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Improving oral care in patients receiving mechanical ventilation
Constance J Cutler1, Nancy Davis
1Clinical Excellence Department, Advocate Health Care, Oak Brook, IL, USA.
Summary
Implementing standardized oral care protocols significantly improved patient outcomes. Evidence-based practices, including toothbrushing and moisturizing, reduced risks associated with mechanical ventilation.
Area of Science:
- Critical Care Medicine
- Infection Prevention
- Evidence-Based Practice
Background:
- Comprehensive oral care is crucial for preventing ventilator-associated pneumonia (VAP).
- Lack of standardized guidelines previously hindered optimal oral care delivery.
- This study addresses the need for defined protocols in mechanical ventilation settings.
Purpose of the Study:
- To assess current oral care practices in intensive care units.
- To establish and implement a best-practice, standardized oral care protocol.
- To measure compliance and impact of the protocol on patient care.
Main Methods:
- Observational study across 5 acute care hospitals with randomized time blocks.
- Baseline data collection preceded multifaceted education on an oral-cleansing protocol.
- Interventional data collection occurred post-implementation to measure changes.
Main Results:
- Baseline: Oral cleansing primarily via swabs; toothbrushing and moisturizing absent. Only 32% received secretion management.
- Intervention: Toothbrushing increased to 33%, swab cleansing to 65%, and moisturizing to 63%.
- Secretion management improved to 61%, with 38% receiving oropharyngeal suctioning.
Conclusions:
- An evidence-based oral cleansing protocol demonstrably improved patient care for those on mechanical ventilation.
- Multifaceted education and implementation strategies effectively enhanced staff engagement in oral care practices.
- Standardized protocols are vital for optimizing oral hygiene and reducing VAP risk.