Removal of oral secretion prior to position change can reduce the incidence of ventilator-associated pneumonia for adult ICU patients: A clinical controlled trial study

Yann Fen C Chao, Yin Yin Chen, Kai Wei Katherine Wang, Ru Pin Lee, Hweifar Tsai

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Aim. The purpose of this study was to explore the effect of oral secretion on aspiration and reducing ventilator-associated pneumonia. Background. Ventilator-associated pneumonia is a serious hospital-acquired infection with reported incidence rate of 12·2% and mortality rate of 29·3%. Oral secretion is purported as a media which brings the oropharyngeal pathogens down to the respiratory track. Methods. Two-group comparison study design was adopted. Subjects were recruited from an adult general intensive care unit of a medical centre in Taipei city. Patients in the study group received suction of oral secretion before each positional care, in contrast with patients in the control group who received routine care. Results. Ventilator-associated pneumonia was found in 24 of 159 (15·1%) patients in the control group and in five of 102 (4·9%) patients in the study group with a reduction of risk ratio of 0·32 (95% CI 0·11-0·92). Eight of the 24 ventilator-associated pneumonia patients died in the control group; however, none of those ventilator-associated pneumonia patients died in the study group. The increased chance of survival was 1·50 (95% CI 1·13- 1·99). The length of stay in ICU and duration of mechanical ventilation were reduced in the study group. In consideration of cost, the cost of tubes used to remove oral secretion is much less than the one used to do continuous subglottal suction. Conclusion. Removal of oral secretion is effective in reducing the incidence of ventilator-associated pneumonia with minimum cost intervention. Relevance to Clinical Practice. This study provides evidence that removal of oral secretion prior to position change is cost effective to reduce the incidence of ventilator-associated pneumonia. As such intervention is an easy task, routine removal of oral secretion is recommended as the standard of daily nursing care of patients on ventilator.

Original languageEnglish
Pages (from-to)22-28
Number of pages7
JournalJournal of Clinical Nursing
Volume18
Issue number1
DOIs
Publication statusPublished - Jan 2009
Externally publishedYes

Fingerprint

Ventilator-Associated Pneumonia
Controlled Clinical Trials
Incidence
Costs and Cost Analysis
Suction
Control Groups
Mechanical Ventilators
Cross Infection
Nursing Care
Artificial Respiration
Intensive Care Units
Length of Stay
Odds Ratio
Survival
Mortality

Keywords

  • Aspiration secretion
  • Intensive care unit
  • Nurses
  • Nursing
  • Ventilator-associated pneumonia

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Removal of oral secretion prior to position change can reduce the incidence of ventilator-associated pneumonia for adult ICU patients : A clinical controlled trial study. / Chao, Yann Fen C; Chen, Yin Yin; Wang, Kai Wei Katherine; Lee, Ru Pin; Tsai, Hweifar.

In: Journal of Clinical Nursing, Vol. 18, No. 1, 01.2009, p. 22-28.

Research output: Contribution to journalArticle

Chao, Yann Fen C ; Chen, Yin Yin ; Wang, Kai Wei Katherine ; Lee, Ru Pin ; Tsai, Hweifar. / Removal of oral secretion prior to position change can reduce the incidence of ventilator-associated pneumonia for adult ICU patients : A clinical controlled trial study. In: Journal of Clinical Nursing. 2009 ; Vol. 18, No. 1. pp. 22-28.
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title = "Removal of oral secretion prior to position change can reduce the incidence of ventilator-associated pneumonia for adult ICU patients: A clinical controlled trial study",
abstract = "Aim. The purpose of this study was to explore the effect of oral secretion on aspiration and reducing ventilator-associated pneumonia. Background. Ventilator-associated pneumonia is a serious hospital-acquired infection with reported incidence rate of 12·2{\%} and mortality rate of 29·3{\%}. Oral secretion is purported as a media which brings the oropharyngeal pathogens down to the respiratory track. Methods. Two-group comparison study design was adopted. Subjects were recruited from an adult general intensive care unit of a medical centre in Taipei city. Patients in the study group received suction of oral secretion before each positional care, in contrast with patients in the control group who received routine care. Results. Ventilator-associated pneumonia was found in 24 of 159 (15·1{\%}) patients in the control group and in five of 102 (4·9{\%}) patients in the study group with a reduction of risk ratio of 0·32 (95{\%} CI 0·11-0·92). Eight of the 24 ventilator-associated pneumonia patients died in the control group; however, none of those ventilator-associated pneumonia patients died in the study group. The increased chance of survival was 1·50 (95{\%} CI 1·13- 1·99). The length of stay in ICU and duration of mechanical ventilation were reduced in the study group. In consideration of cost, the cost of tubes used to remove oral secretion is much less than the one used to do continuous subglottal suction. Conclusion. Removal of oral secretion is effective in reducing the incidence of ventilator-associated pneumonia with minimum cost intervention. Relevance to Clinical Practice. This study provides evidence that removal of oral secretion prior to position change is cost effective to reduce the incidence of ventilator-associated pneumonia. As such intervention is an easy task, routine removal of oral secretion is recommended as the standard of daily nursing care of patients on ventilator.",
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T1 - Removal of oral secretion prior to position change can reduce the incidence of ventilator-associated pneumonia for adult ICU patients

T2 - A clinical controlled trial study

AU - Chao, Yann Fen C

AU - Chen, Yin Yin

AU - Wang, Kai Wei Katherine

AU - Lee, Ru Pin

AU - Tsai, Hweifar

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N2 - Aim. The purpose of this study was to explore the effect of oral secretion on aspiration and reducing ventilator-associated pneumonia. Background. Ventilator-associated pneumonia is a serious hospital-acquired infection with reported incidence rate of 12·2% and mortality rate of 29·3%. Oral secretion is purported as a media which brings the oropharyngeal pathogens down to the respiratory track. Methods. Two-group comparison study design was adopted. Subjects were recruited from an adult general intensive care unit of a medical centre in Taipei city. Patients in the study group received suction of oral secretion before each positional care, in contrast with patients in the control group who received routine care. Results. Ventilator-associated pneumonia was found in 24 of 159 (15·1%) patients in the control group and in five of 102 (4·9%) patients in the study group with a reduction of risk ratio of 0·32 (95% CI 0·11-0·92). Eight of the 24 ventilator-associated pneumonia patients died in the control group; however, none of those ventilator-associated pneumonia patients died in the study group. The increased chance of survival was 1·50 (95% CI 1·13- 1·99). The length of stay in ICU and duration of mechanical ventilation were reduced in the study group. In consideration of cost, the cost of tubes used to remove oral secretion is much less than the one used to do continuous subglottal suction. Conclusion. Removal of oral secretion is effective in reducing the incidence of ventilator-associated pneumonia with minimum cost intervention. Relevance to Clinical Practice. This study provides evidence that removal of oral secretion prior to position change is cost effective to reduce the incidence of ventilator-associated pneumonia. As such intervention is an easy task, routine removal of oral secretion is recommended as the standard of daily nursing care of patients on ventilator.

AB - Aim. The purpose of this study was to explore the effect of oral secretion on aspiration and reducing ventilator-associated pneumonia. Background. Ventilator-associated pneumonia is a serious hospital-acquired infection with reported incidence rate of 12·2% and mortality rate of 29·3%. Oral secretion is purported as a media which brings the oropharyngeal pathogens down to the respiratory track. Methods. Two-group comparison study design was adopted. Subjects were recruited from an adult general intensive care unit of a medical centre in Taipei city. Patients in the study group received suction of oral secretion before each positional care, in contrast with patients in the control group who received routine care. Results. Ventilator-associated pneumonia was found in 24 of 159 (15·1%) patients in the control group and in five of 102 (4·9%) patients in the study group with a reduction of risk ratio of 0·32 (95% CI 0·11-0·92). Eight of the 24 ventilator-associated pneumonia patients died in the control group; however, none of those ventilator-associated pneumonia patients died in the study group. The increased chance of survival was 1·50 (95% CI 1·13- 1·99). The length of stay in ICU and duration of mechanical ventilation were reduced in the study group. In consideration of cost, the cost of tubes used to remove oral secretion is much less than the one used to do continuous subglottal suction. Conclusion. Removal of oral secretion is effective in reducing the incidence of ventilator-associated pneumonia with minimum cost intervention. Relevance to Clinical Practice. This study provides evidence that removal of oral secretion prior to position change is cost effective to reduce the incidence of ventilator-associated pneumonia. As such intervention is an easy task, routine removal of oral secretion is recommended as the standard of daily nursing care of patients on ventilator.

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KW - Intensive care unit

KW - Nurses

KW - Nursing

KW - Ventilator-associated pneumonia

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