Brushing teeth with purified water to reduce ventilator-associated pneumonia

Li Yin Yao, Cheng Kuei Chang, Suh Hwa Maa, Charlotte Wang, Cheryl Chia Hui Chen

研究成果: 雜誌貢獻文章

25 引文 (Scopus)

摘要

Background: Oral care may decrease the development of ventilator-associated pneumonia (VAP) and improve oral hygiene. However, little evidence is available to guide the development of oral care protocols. The practical effect of toothbrushing on VAP development and oral health and hygiene improvement is inconclusive. Purpose: This study evaluated the effects in postneurosurgical, intensive care unit patients of brushing teeth twice daily with purified water on VAP rates and oral health or hygiene. Methods: This study conducted a randomized controlled pilot trial. Patients consecutively admitted to the surgical intensive care unit at a suburban hospital in 2007 were invited to participate if they met two inclusion criteria: (a) under ventilator support for at least 48 to 72 hours and (b) no current pneumonia. Upon obtaining informed consent, subjects were randomized into experimental and control groups. Both groups received usual hospital care, that is, daily oral care using cotton swabs. The experimental group additionally received a twicedaily oral care protocol of toothbrushing with purified water, elevating the head of the bed, and before-and-after hypopharyngeal suctioning. The control group also received twice-daily mock oral care (elevating the head of the bed, moisturizing the lips, and before-and-after hypopharyngeal suctioning). VAP was defined by a clinical pulmonary infection score of 9 6. Oral hygiene and health was assessed after conclusion of the intervention. Results: Patients (N = 53) were predominantly male (64.2%), mean age was 60.6 years old, and most had received emergency surgery (75.5%). After 7 days of toothbrushing with purified water, cumulative VAP rates were significantly lower in the experimental (17%) than in the control (71%; p G.05) group. The experimental group also had significantly better scores for oral health (p G.05) and plaque index (p G.01). Conclusion/Implication for Practice: Findings suggest that, as an inexpensive alternative to existing protocols, toothbrushing twice daily with purified water reduces VAP and improves oral health and hygiene.
原文英語
頁(從 - 到)289-297
頁數9
期刊The journal of nursing research : JNR
19
發行號4
DOIs
出版狀態已發佈 - 2011

指紋

Ventilator-Associated Pneumonia
Oral Hygiene
Oral Health
Toothbrushing
Tooth
Water
Intensive Care Units
Control Groups
Mechanical Ventilators
Critical Care
Lip
Informed Consent
Pneumonia
Emergencies
Randomized Controlled Trials
Lung
Infection

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)

引用此文

Brushing teeth with purified water to reduce ventilator-associated pneumonia. / Yao, Li Yin; Chang, Cheng Kuei; Maa, Suh Hwa; Wang, Charlotte; Chen, Cheryl Chia Hui.

於: The journal of nursing research : JNR, 卷 19, 編號 4, 2011, p. 289-297.

研究成果: 雜誌貢獻文章

Yao, Li Yin ; Chang, Cheng Kuei ; Maa, Suh Hwa ; Wang, Charlotte ; Chen, Cheryl Chia Hui. / Brushing teeth with purified water to reduce ventilator-associated pneumonia. 於: The journal of nursing research : JNR. 2011 ; 卷 19, 編號 4. 頁 289-297.
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abstract = "Background: Oral care may decrease the development of ventilator-associated pneumonia (VAP) and improve oral hygiene. However, little evidence is available to guide the development of oral care protocols. The practical effect of toothbrushing on VAP development and oral health and hygiene improvement is inconclusive. Purpose: This study evaluated the effects in postneurosurgical, intensive care unit patients of brushing teeth twice daily with purified water on VAP rates and oral health or hygiene. Methods: This study conducted a randomized controlled pilot trial. Patients consecutively admitted to the surgical intensive care unit at a suburban hospital in 2007 were invited to participate if they met two inclusion criteria: (a) under ventilator support for at least 48 to 72 hours and (b) no current pneumonia. Upon obtaining informed consent, subjects were randomized into experimental and control groups. Both groups received usual hospital care, that is, daily oral care using cotton swabs. The experimental group additionally received a twicedaily oral care protocol of toothbrushing with purified water, elevating the head of the bed, and before-and-after hypopharyngeal suctioning. The control group also received twice-daily mock oral care (elevating the head of the bed, moisturizing the lips, and before-and-after hypopharyngeal suctioning). VAP was defined by a clinical pulmonary infection score of 9 6. Oral hygiene and health was assessed after conclusion of the intervention. Results: Patients (N = 53) were predominantly male (64.2{\%}), mean age was 60.6 years old, and most had received emergency surgery (75.5{\%}). After 7 days of toothbrushing with purified water, cumulative VAP rates were significantly lower in the experimental (17{\%}) than in the control (71{\%}; p G.05) group. The experimental group also had significantly better scores for oral health (p G.05) and plaque index (p G.01). Conclusion/Implication for Practice: Findings suggest that, as an inexpensive alternative to existing protocols, toothbrushing twice daily with purified water reduces VAP and improves oral health and hygiene.",
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AB - Background: Oral care may decrease the development of ventilator-associated pneumonia (VAP) and improve oral hygiene. However, little evidence is available to guide the development of oral care protocols. The practical effect of toothbrushing on VAP development and oral health and hygiene improvement is inconclusive. Purpose: This study evaluated the effects in postneurosurgical, intensive care unit patients of brushing teeth twice daily with purified water on VAP rates and oral health or hygiene. Methods: This study conducted a randomized controlled pilot trial. Patients consecutively admitted to the surgical intensive care unit at a suburban hospital in 2007 were invited to participate if they met two inclusion criteria: (a) under ventilator support for at least 48 to 72 hours and (b) no current pneumonia. Upon obtaining informed consent, subjects were randomized into experimental and control groups. Both groups received usual hospital care, that is, daily oral care using cotton swabs. The experimental group additionally received a twicedaily oral care protocol of toothbrushing with purified water, elevating the head of the bed, and before-and-after hypopharyngeal suctioning. The control group also received twice-daily mock oral care (elevating the head of the bed, moisturizing the lips, and before-and-after hypopharyngeal suctioning). VAP was defined by a clinical pulmonary infection score of 9 6. Oral hygiene and health was assessed after conclusion of the intervention. Results: Patients (N = 53) were predominantly male (64.2%), mean age was 60.6 years old, and most had received emergency surgery (75.5%). After 7 days of toothbrushing with purified water, cumulative VAP rates were significantly lower in the experimental (17%) than in the control (71%; p G.05) group. The experimental group also had significantly better scores for oral health (p G.05) and plaque index (p G.01). Conclusion/Implication for Practice: Findings suggest that, as an inexpensive alternative to existing protocols, toothbrushing twice daily with purified water reduces VAP and improves oral health and hygiene.

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