Antiseptic Chlorhexidine Oral Care and Standard Toothbrush Oral Care in Ventilator-Associated Pneumonia - Research Paper Example

Prevention of Ventilator Associated Pneumonia in Adult Intensive Care Unit Julie Joe Texas NURS 6052N, Section 18, Essentials of Evidence-Based Practice March 14, 2015 Discussion of the Literature The analysis of the most effective intervention to decrease VAP in adult ICU is conducted through the PICOT form. The significance of the intervention measures in the nursing profession is critical and worth discussion. In the modern society, it is important to identify the growing body of research in the nursing profession and medical care unit. In addition, evaluating the most effective practice in the healthcare sector will reduce the cost of hospitalization and mortality rate for the patients. This indicates that there is need to understand the critical paths in the realization of the right procedures to utilize in healthcare in order to achieve the best results. Nursing is a critical area in the healthcare sector, hence the need to embrace its significance in the treatment process. This research will analyze the most effective intervention to decrease VAP in adult ICU. To achieve the best results, it will utilize the PICOT analysis is the attainment of the research objective. The first article to examine is by GU, Gong, Pan, Ni, & Liu (2012) that carried out a meta-analysis of the impacts of oral hygiene on the VAP for critically ill patients. In their study, GU, Gong, Pan, Ni, & Liu (2012) noted that oral hygiene did not show significant variation in VAP condition for ill patients who had mechanical ventilation who used toothbrush and those who did not. In addition, the study revealed that the toothbrushing did not have significant results in reducing the mortality rate, the hospital length of stay during both the antibiotics free day and also the mechanical ventilation free day of the study. There is a contradiction with the findings of this study with those of the previous studies. In the 828 patients used in this study show that there was no significant variation in changes when oral hygiene was practiced and when it was not in the control of VAP. However, then it is viewed, discussed that the use of oral hygiene with purified water was effective in controlling the chances for the occurrence of VAP in critically ill patients. This research contradicted the previous research where oral hygiene for patients in the ICUs would significantly reduce the chances of VAP infection for the patients who are under mechanical ventilation. On the other hand, the study conducted by Cindy, et al (2009) found out that VAP increases the cost of health care, morbidity, and mortality of the patients in the intensive care units. In addition, the study found that there is a significant reduction in VAP infection through observation of oral hygiene. However, this was especially to those who had no pneumonia infection at the baseline. In addition, the study narrated that combining tooth brushing and chlorhexidine did not have much difference with the case where chlorhexidine was used alone. The study was randomized and controlled clinical trial on whether the two oral interventions for hlorhexidine and tooth brushing could significantly reduce the infection by the VAP for the patients who were receiving mechanical ventilation in the intensive care units (Cindy, Mary, Deborah, Donna, & Curtis, 2009). In addition, it was revealed that the study had both men and women in the clinical trial study. Accumulation of dental plaque was considered to the main cause of predictive of pneumonia in the patients. Dental plaque was considered to encourage growth of the pathogens that causes VAP in the ICU patients under mechanical ventilation. It is also noted that the tooth brushing protocol did not cause significant influence on the VAP infections in these patients. Even if both chlorhexidine and tooth brushing reduces the cases for accumulation of dental plaque, where the chlorhexidine has bactericidal activity that kills the micro-organisms while toothbrushing only reduces the number of bacteria present in the dental plaque. The mere reduction in the number of bacteria causing VAP was not enough to reduce instances of acquiring the VAP infection (Cindy, Mary, Deborah, Donna, & Curtis, 2009). Significance to Nursing The evidence presented in this research is crucial for caregivers on their activities in the healthcare sector. This knowledge that is gained from this analysis is critical for caregivers and ensures that they are able to provide services to the patients in the ICUs effectively enhancing the healing process. The utilization of the information on the role chlorhexidine as an oral care protocol for the j patients who are intubated will enhance their chances of not acquiring VAP infection. When the patients catch the VAP infection, their survival in affected and possibly their lives in danger. The PICOT research question is critical in the integration of effective care provision to the patients to fasten the healing process in the ICUs (Cindy, Mary, Deborah, Donna, & Curtis, 2009). In the nursing profession, the Quality & Safety Education for Nurses (QSEN) is a model that gives them guidance that is competency based resource important in areas such as ensuring nurses acquire knowledge, skills, and attitudes that are crucial in improving the quality and safety of the patients in the healthcare system (Sage Products, 2013). The implementation of the chlorhexidine oral care, concern for the patients under mechanical ventilation in the ICU is believed to decrease the mortality rate of the patients. In the modern society, most hospitals are being equipped with oral care for the Adult Ventilated Patients. The discovery that oral hygiene measures for the patients would reduce their mortality rate by reducing their chances of acquiring a VAP infection is critical for the caregivers (Nieswiadomy, 2012). The provision of evidence that oral hygiene care is a remedy for reduced cases of VAP infection is a step forward in ensuring that the health concerns of patients in the ICUs are taken care. The application of meticulous oral care to the patients through the use of antiseptics will enhance the survival rate for the patients undergoing intensive care and treatment (Nieswiadomy, 2012). According to the American Nurses Association (ANA), there is great concern for the nurses to gain competencies essential in ensuring quality health care concern for the patients that is crucial in reducing the mortality rate and hospitalization expenses (Melnyk & Fineout-Overholt, 2011). This new development in oral hygiene will expand the scope for fighting secondary infections in the patients that arise as a result of poor hygiene concern. In addition, enriching the nursing profession with evidence based models facilitate the process of comprehensive care to patients fastening the healing process and reducing the hospitalization fee on patients in the treatment of secondary infections such as VAP (Sage Products, 2013). References Cindy, L. M., Mary, J. G., Deborah, J. J., Donna, K. M., & Curtis, N. S. (2009). Chlorhexidine, Toothbrushing, And Preventing Ventilator-Associated Pneumonia In Critically Ill Adults. Am J Crit Care, 428–438. Gu, W. J., Gong, Y. Z., Pan, L., Ni, Y. X., & Liu, J. C. (2012 ). Impact of oral care with versus without toothbrushing on the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled trials. Crit Care, 1-9. Melnyk, B., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia: Williams & Wilkins. Nieswiadomy, R. M. (2012). Foundations of nursing research. Upper Sadle River: Pearson. Sage Products. (2013 ). ORAL HYGIENE. Sage Production , 1-20. Read More