Effectiveness Of Oral Care Protocol On Oral Health Status Of Hospitalized Children Admitted In Intensive Care Units Of Selected Hospitals Of Haryana.

Background: Ventilated patients with chronic liver diseases are at more risk of developing gingival bleeding and oral mucosal lesion. Purposes: The objective of the present study is to evaluate the Effectiveness of a Need Based Oral Care Protocol on Oral Health Status, Occurrence and Progression of Pneumonia among ventilated patients. Methods: Quasi experimental time series design was used. Fifty ventilated patients were randomly allocated to study (n=27) and comparison (n=23) groups. Severity of illness was assessed by APACHE II score. Occurrence of Pneumonia was assessed using Microbiological profile. The CPIS score was assessed for assessing Progression of Pneumonia and to rule out HAP. Need for oral care and Oral Health Status was assessed daily in terms of frequency of oral care as assessed by MBOAS score. Need based Oral care as per American Association of Critical Care Nurse was provided by the researcher to the patients in the study group. Comparison group received routine oral care as per the existing guidelines by the staff on duty. Assessment of the oral health status was done using MBOAS. Results: The findings related to Oral Health Status showed that the mean MBOAS scores differed significantly (F=5.82, P =0.001), across the time; and across the groups over time (F=19.16, p=0.001). The results of Microbiological Profile revealed that the most common causative organism for VAP in both the Study and Comparison group on day three as well as on day six were Klebsiella Pneumonia, Staphylococcus, Acinetobacter Baumanni, Pseudomonas and gram-negative bacteria. In terms of occurrence of Pneumonia there was statistically significant difference found between the groups on day three (?2= 5.83, p=0.05) and on day six (?2= 7.40, p=0.02). There was significant difference seen between the groups in the Progression of Pneumonia with time from day 1 to 6 (F=39.90; p=0.001), and also across the groups over time (F=5.14, p=0.03). A significant relationship (r=0.66, p=

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THE EFFECT OF ORAL CARE INTERVENTION ON ORAL HEALTH STATUS OF INTUBATED PATIENTS IN THE INTENSIVE CARE UNIT

Belitung Nursing Journal ◽

10.33546/bnj.971 ◽

2020 ◽

Vol 6 (1) ◽

pp. 21-26

Author(s):

Diah Tika Anggraeni ◽

Ayu Trisna Hayati ◽

Aan Nur'aeni

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Health Status ◽

Oral Health ◽

Univariate Analysis ◽

Oral Care ◽

Oral Health Status ◽

Bivariate Analysis ◽

Oral Infections ◽

Care Intervention

Background: Oral infections can be a potential source of infection resulting in a variety of systemic diseases, especially in intubated patients in an Intensive Care Unit (ICU). Endotracheal tube (ETT) of the intubated patient’s mouth can be an entry point and place of bacteria colonization that causes ventilator-associated pneumonia which is one of the causes of the patient’s death in ICU. Nurses as caregivers have an important role in providing oral care intervention to maintain oral health and prevent the infection.Objective: This study aimed to analyze the effect of oral care intervention on oral health status of intubated patients in the ICU. Methods: This was a pre-experimental study with one group pre-test post-test design. A consecutive sampling was used to select 18 intubated patients in the ICU of Al Islam hospital in Bandung. Oral health status was evaluated by Beck Oral Assessment Scale (BOAS). Descriptive analysis was used for the univariate analysis and t-test was used for bivariate analysis. Results: The results showed that oral health scores before and after intervention were 11.94 and 13.28 (p=.004). The BOAS subscales had a significant worsening of the lips, gingiva, oral mucosa and saliva (p<.05), while there was an improvement in teeth subscale after oral care intervention (p<.001).Conclusion: The results suggested that the oral health status of intubated patients had worsened, despite routinely oral care intervention using chlorhexidine gluconate. Mucosa care may become an essential part of the oral care intervention for intubated patients. Therefore, additional topical agent is needed to maintain the moisture of the mucosal membrane, so that the oral health status of intubated patients will be better.

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Assessment of the oral health status of visually impaired students after oral care instructions given to them.

Journal of Indian Dental Association ◽

10.33882/jida.13.24915 ◽

2019 ◽

Author(s):

Bhakti Datar ◽

Amit Kumar ◽

Bhumika Badiyani

Keyword(s):

Health Status ◽

Oral Health ◽

Visually Impaired ◽

Dental Treatment ◽

Statistical Significance ◽

Oral Care ◽

Oral Health Status ◽

Tooth Brushing ◽

Dental Examination ◽

Visually Impaired Students

Good oral care and adapting to proper tooth brushing technique can be a difficult task for the visually impaired individuals. Unlike the normal individuals, visually impaired ones cannot suspect the early dental problem in their oral cavity till it is symptomatic simply because they cannot visualize the intricacies of it. Hence, assessment of the oral health status in the visually impaired individuals and teaching them preventive oral care are extremely important for them. Objective: The study was undertaken to compare and assess the oral health status of the visually impaired students before and after giving them oral care instructions. Materials and Methods: A group of 120 visually impaired students was selected. They were subjected to simple dental examination and were given oral care instructions verbally. Proper tooth-brushing technique was taught to them individually. The subjects were evaluated as per the need of dental restorations, extractions, orthodontic treatment, oral prophylaxis and good dentition subjects needing no dental treatment. The same subjects were re-evaluated after four months under similar guidelines. The data collected from both the phases of dental examination was compared and subjected to analysis. Results: The present study did not show much of improvement of statistical significance though it did not show much of worsening in the oral health status of the visually impaired subjects as well. Summary and conclusion: The study emphasizes the serious need for repetitive and collective efforts with multi-dimensional cross-involvement for the better oral health status of the visually impaired individuals in the society. Key Words: Visually impaired, oral health, instructions, tooth-brushing technique.

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

American Journal of Critical Care ◽

10.4037/ajcc2007.16.1.28 ◽

2007 ◽

Vol 16 (1) ◽

pp. 28-37 ◽

Cited By ~ 88

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.

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The impact of oral care on oral health status and prevention of ventilator-associated pneumonia in critically ill patients

Australian Critical Care ◽

10.1016/j.aucc.2016.07.002 ◽

2017 ◽

Vol 30 (2) ◽

pp. 69-73 ◽

Cited By ~ 7

Author(s):

Abdullah Haghighi ◽

Vida Shafipour ◽

Masoumeh Bagheri-Nesami ◽

Afshin Gholipour Baradari ◽

Jamshid Yazdani Charati

Keyword(s):

Health Status ◽

Oral Health ◽

Critically Ill ◽

Critically Ill Patients ◽

Oral Care ◽

Oral Health Status ◽

Ventilator Associated Pneumonia ◽

The Impact

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Oral evaluation of children and adolescents in intensive care unit

RSBO ◽

10.21726/rsbo.v14i3.656 ◽

2017 ◽

Vol 14 (3) ◽

pp. 135-41

Author(s):

Fernanda Haverroth Schunemann ◽

Soraia Hopfner Canani ◽

Constanza Marín

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Oral Health ◽

Children And Adolescents ◽

Oral Care ◽

Hospitalized Children ◽

Older Children ◽

Oral Biofilm ◽

Numeric Scale ◽

Oral Condition

Hospitalized children can present some complications if they do not present a correct oral care during hospitalization. Objective: This study aimed to perform an oral evaluation of children and adolescents hospitalized in an intensive care unit of a children’s hospital at southern Brazil. Material and methods: 49 subjects were examined, aged from 0 to 17 years old, using the modified Oral Assessment Guide (OAGm). The lips, corner of the mouth, gums, oral mucosa, saliva, tongue, and teeth were examined. Each category was classified in a numeric scale from 1 to 3, where 1 means the better condition and 3 the worse. Results: The results showed alterations in the lips, tongue, oral biofilm, and saliva in most of the subjects. The OAGm value indicated a worse oral condition in older children. The OAGm values for children with teeth were higher than that for edentulous children, this difference was statistically significant (p<0.05). Conclusion: It could be concluded that children hospitalized in an intensive care unit show deficiency in oral health when assessed through OAGm.> p<0.05). Conclusion: It could be concluded that children hospitalized in an intensive care unit show deficiency in oral health when assessed through OAGm.

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Evaluation of Oral Health Status and Oral Care of Patients with Rheumatoid Arthritis

International Journal of Dentistry ◽

10.1155/2020/8896766 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Małgorzata Radwan-Oczko ◽

Irena Duś-Ilnicka ◽

Pamela Richards ◽

Anna Marie Thomsen ◽

Claus Rasmussen

Keyword(s):

Rheumatoid Arthritis ◽

Health Status ◽

Oral Health ◽

Oral Cavity ◽

Mutual Influence ◽

Oral Care ◽

Oral Health Status ◽

Gingival Bleeding ◽

Periodontal Infection ◽

Two Factors

Objective. Rheumatoid arthritis (RA) and periodontal disease (PD) are common chronic, immunoinflammatory, destructive, and progressive diseases; however, the correlations between those two are not yet widely discussed. The purpose of this study was to evaluate the relationship between the selected demographic and clinical parameters of RA patients and oral health status parameters, on the basis of self-assessment. Materials and Methods. Three hundred patients under treatment were included in the study. Questionnaires were completed by 164 out of 300 patients. Results. A total of 100 females and 64 males took part in the study, with a mean age of 65 ± 11.1 years. In younger patients, the disease activity score (DAS28) was higher, and it was associated with pain or discomfort in the oral cavity and with difficulties in toothbrushing. Discomfort or pain in the oral cavity was to a significant extent associated with the poor gingival state, gingival bleeding, and difficulties in biting or chewing. Conclusions. In RA patients, difficulties in biting or chewing, discomfort or pain in oral cavity, feeling of the presence of movable teeth, and gingival bleeding are indications of periodontal infection. Maintaining awareness of oral health and RA is a key issue in the simultaneous management of proper oral care and RA due to the mutual influence of those two factors.

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The Effect of Professional Oral Care by Time Point on Oral Health Status of Inpatients in A Nursing Hospital

The Korean Society of Oral Health Science ◽

10.33615/jkohs.2019.7.3.92 ◽

2019 ◽

Vol 7 (3) ◽

pp. 92-97

Author(s):

Kyeung-Ae Jang ◽

Go Eun Kim ◽

Seong-Eun Heo

Keyword(s):

Health Status ◽

Oral Health ◽

Oral Care ◽

Oral Health Status ◽

Time Point

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Protocol for a multi-centered, stepped wedge, cluster randomized controlled trial of the de-adoption of oral chlorhexidine prophylaxis and implementation of an oral care bundle for mechanically ventilated critically ill patients: the CHORAL study

Trials ◽

10.1186/s13063-019-3673-0 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 6

Author(s):

Craig M. Dale ◽

Louise Rose ◽

Sarah Carbone ◽

Orla M. Smith ◽

Lisa Burry ◽

...

Keyword(s):

Health Status ◽

Oral Health ◽

Excess Mortality ◽

Primary Outcome ◽

Controlled Trial ◽

Oral Care ◽

Oral Health Status ◽

Care Bundle ◽

Mechanically Ventilated ◽

Cluster Randomized

Abstract Background Routine application of chlorhexidine oral rinse is recommended to reduce risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. Recent reappraisal of the evidence from two meta-analyses suggests chlorhexidine may cause excess mortality in non-cardiac surgery patients and does not reduce VAP. Mechanisms for possible excess mortality are unclear. The CHORAL study will evaluate the impact of de-adopting chlorhexidine and implementing an oral care bundle (excluding chlorhexidine) on mortality, infection-related ventilator-associated complications (IVACs), and oral health status. Methods The CHORAL study is a stepped wedge, cluster randomized controlled trial in six academic intensive care units (ICUs) in Toronto, Canada. Clusters (ICU) will be randomly allocated to six sequential steps over a 14-month period to de-adopt oral chlorhexidine and implement a standardized oral care bundle (oral assessment, tooth brushing, moisturization, and secretion removal). On study commencement, all clusters begin with a control period in which the standard of care is oral chlorhexidine. Clusters then begin crossover from control to intervention every 2 months according to the randomization schedule. Participants include all mechanically ventilated adults eligible to receive the standardized oral care bundle. The primary outcome is ICU mortality; secondary outcomes are IVACs and oral health status. We will determine demographics, antibiotic usage, mortality, and IVAC rates from a validated local ICU clinical registry. With six clusters and 50 ventilated patients on average each month per cluster, we estimate that 4200 patients provide 80% power after accounting for intracluster correlation to detect an absolute reduction in mortality of 5.5%. We will analyze our primary outcome of mortality using a generalized linear mixed model adjusting for time to account for secular trends. We will conduct a process evaluation to determine intervention fidelity and to inform interpretation of the trial results. Discussion The CHORAL study will inform understanding of the effectiveness of de-adoption of oral chlorhexidine and implementation of a standardized oral care bundle for decreasing ICU mortality and IVAC rates while improving oral health status. Our process evaluation will inform clinicians and decision makers about intervention delivery to support future de-adoption if justified by trial results. Trial registration ClinicalTrials.gov, NCT03382730. Registered on December 26, 2017.

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