An Evidence-Based Oral Care Protocol to Decrease Ventilator-Associated Pneumonia

2012 ◽  
Vol 31 (5) ◽  
pp. 301-308 ◽  
Author(s):  
Lisa Cuccio ◽  
Ellen Cerullo ◽  
Heidi Paradis ◽  
Cynthia Padula ◽  
Cindy Rivet ◽  
...  
Keyword(s):  
Oral Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Protocol

Nurses’ Implementation of Guidelines for Ventilator-Associated Pneumonia From the Centers for Disease Control and Prevention

2007 ◽  
Vol 16 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Carolyn L. Cason ◽  
Tracy Tyner ◽  
Sue Saunders ◽  
Lisa Broome
Keyword(s):  
Intensive Care ◽  
Disease Control ◽  
Intensive Care Units ◽  
Oral Care ◽  
The United States ◽  
Hand Washing ◽  
Ventilator Associated Pneumonia ◽  
Care Protocol ◽  
Control And Prevention ◽  
Centers For Disease Control

• Background Ventilator-associated pneumonia accounts for 47% of infections in patients in intensive care units. Adherence to the best nursing practices recommended in the 2003 guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention should reduce the risk of ventilator-associated pneumonia. • Objective To evaluate the extent to which nurses working in intensive care units implement best practices when managing adult patients receiving mechanical ventilation. • Methods Nurses attending education seminars in the United States completed a 29-item questionnaire about the type and frequency of care provided. • Results Twelve hundred nurses completed the questionnaire. Most (82%) reported compliance with hand-washing guidelines, 75% reported wearing gloves, half reported elevating the head of the bed, a third reported performing subglottic suctioning, and half reported having an oral care protocol in their hospital. Nurses in hospitals with an oral care protocol reported better compliance with hand washing and maintaining head-of-bed elevation, were more likely to regularly provide oral care, and were more familiar with rates of ventilator-associated pneumonia and the organisms involved than were nurses working in hospitals without such protocols. • Conclusions The guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in rates of ventilator-associated pneumonia may be achieved by broader implementation of oral care protocols.

Using Evidence-Based Practice to Prevent Ventilator-Associated Pneumonia

2012 ◽  
Vol 32 (4) ◽  
pp. 41-51 ◽  
Author(s):  
Mary Beth Sedwick ◽  
Mary Lance-Smith ◽  
Sara J. Reeder ◽  
Jessica Nardi
Keyword(s):  
Interdisciplinary Collaboration ◽  
Compliance Rate ◽  
Oral Care ◽  
Feedback System ◽  
Ventilator Associated Pneumonia ◽  
Strict Adherence ◽  
Ulcer Disease ◽  
Vein Thrombosis ◽  
Care Protocol ◽  
Healthcare Improvement

BackgroundStrategies are needed to help prevent ventilator-associated pneumonia.ObjectiveTo develop a ventilator bundle and care practices for nurses in critical care units to reduce the rate of ventilator-associated pneumonia.MethodThe ventilator bundle developed by the Institute for Healthcare Improvement was expanded to include protocols for mouth care and hand washing, head-of-bed alarms, subglottic suctioning, and use of an electronic compliance feedback tool. Compliance audits were used to provide immediate electronic feedback.ResultsAdherence to practices included in the bundle increased. Compliance rates were greater than 98% for prophylaxis for peptic ulcer disease and deep-vein thrombosis, interruption of sedation, and elevation of the head of the bed. The compliance rate for the oral care protocol increased from 76% to 96.8%. Readiness for extubation reached at least 92.4%. Rates of ventilator-associated pneumonia decreased from 9.47 to 1.9 cases per 1000 ventilator days. The decrease in rates produced an estimated savings of approximately $1.5 million.ConclusionStrict adherence to bundled practices for preventing ventilator-associated pneumonia, enhanced accountability for initiating protocols, use of a feedback system, and interdisciplinary collaboration improved patients’ outcomes and produced marked savings in costs.

The Impact of a Simple, Low-cost Oral Care Protocol on Ventilator-associated Pneumonia Rates in a Surgical Intensive Care Unit

2008 ◽  
Vol 24 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Carrie S. Sona ◽  
Jeanne E. Zack ◽  
Marilyn E. Schallom ◽  
Maryellen McSweeney ◽  
Kathleen McMullen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Low Cost ◽  
Oral Care ◽  
Surgical Intensive Care Unit ◽  
Ventilator Associated Pneumonia ◽  
Surgical Intensive Care ◽  
Care Protocol ◽  
The Impact

scholarly journals Effect of an oral care protocol in preventing ventilator-associated pneumonia in ICU patients

Critical Care ◽  
2008 ◽  
Vol 12 (Suppl 2) ◽  
pp. P48 ◽  
Author(s):  
L Yao ◽  
C Chang ◽  
C Wang ◽  
C Chen
Keyword(s):  
Oral Care ◽  
Ventilator Associated Pneumonia ◽  
Icu Patients ◽  
Care Protocol

A SIMPLE, LOW-COST ORAL CARE PROTOCOL REDUCES VENTILATOR-ASSOCIATED PNEUMONIA RATES.

2005 ◽  
Vol 33 ◽  
pp. A13 ◽  
Author(s):  
Carrie Sona ◽  
Jeanne Zack ◽  
Lynn Schallom ◽  
Linda Schwartkopf ◽  
Way Huey ◽  
...  
Keyword(s):  
Low Cost ◽  
Oral Care ◽  
Ventilator Associated Pneumonia ◽  
Care Protocol

scholarly journals Chlorhexidine Oral Care in Critically Ill Adults

2021 ◽  
Vol 1 (10) ◽  
Author(s):  
Anusree Subramonian ◽  
Jennifer Horton
Keyword(s):  
Critical Care ◽  
Randomized Clinical Trials ◽  
Oral Care ◽  
Clinical Effectiveness ◽  
Ventilator Associated Pneumonia ◽  
Specific Recommendation ◽  
Mechanically Ventilated ◽  
Care Protocol ◽  
Significant Difference ◽  
Critically Ill Adults

Three systematic reviews and 2 randomized clinical trials were identified regarding the clinical effectiveness of chlorhexidine oral care in adult patients who were in critical care and being mechanically ventilated. The evidence was of limited quality, with methodological limitations. Compared to ozonated water and to Nanosil, chlorhexidine oral care was associated with a significantly higher risk of ventilator-associated pneumonia. Compared to bicarbonate, chlorhexidine oral care was associated with a significantly lower risk of ventilator-associated pneumonia. There was no significant difference in the risk of ventilator-associated pneumonia between chlorhexidine and other agents, such as potassium permanganate, hydrogen peroxide, or miswak. There was no significant difference in the risk of mortality between oral care with chlorhexidine and that with other oral care drugs. An evidence-based guideline targeting individuals who require assistance on oral care recommended a multi-component oral care protocol. No specific recommendation regarding the use of oral care agents for the prevention of ventilator-associated pneumonia was made because of lack of evidence. There is a lack of evidence on the safety or cost-effectiveness of chlorhexidine oral care in adults who are in critical care and being mechanically ventilated.

scholarly journals Preventing Ventilator-Associated Pneumonia: Educating Emergency Room Nurses

2014 ◽  
Author(s):  
Dana Ferrazzano
Keyword(s):  
Intensive Care ◽  
Emergency Room ◽  
Oral Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Preventative Measures ◽  
Emergency Room Nurses ◽  
Evidence Based Guidelines ◽  
The Impact ◽  
Nurses Knowledge

<p>Ventilator-associated pneumonia (VAP) is the second most common hospital acquired infection and is primarily found in the intensive care units. The presence of an endotracheal tube is the primary risk factor for developing VAP. Many times the process of intubation occurs pre-hospital, in the emergency room (ER) or in the operating room. Ventilator associated pneumonia is associated with increased hospital stay and costs. Evidence-based guidelines have been developed to decrease the occurrence of VAP and decrease patient mortality. Preventative measures are initiated on the intensive care unit once the patient is transferred. The purpose of this study was to evaluate the impact of an educational program on ER nurses knowledge of VAP and preventative measures to decrease VAP.</p> <p>The study took place at Rhode Island Hospital, a level 1 trauma center located in Providence, RI. Participants were ER nurses who worked in the critical care area of the ER. A pre-intervention-posttest design was used to evaluate emergency room nurses knowledge regarding VAP. The intervention consisted of a posterboard and study guide that provided information regarding evidence-based guidelines that could be implemented in the ER such as oral care, and head of bed elevation. The overall results on the pre and posttest demonstrated that ER nurses were unaware that oral care and the use of chlorhexidine were important interventions to reduce the incidence of developing VAP. Recommendations and implications for advanced practice nursing and the need for future research are discussed.</p>

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