The effect of systematic oral care on the preventing ventilator associated pneumonia in critically ill patients

Background and Objective: Ventilator-associated pneumonia is one of the most common nosocomial infections which increase mortality rate and length stay of hospitalization. There are different methods of oral care for critically ill patients. The objective of in this study was to identify the impact of oral care practices on oral health status of patients in intensive care unit and the incidence rate of ventilator-associated pneumonia.Materials and Methods: This study is clinical trial randomize double-blind. 100 patients were enrolled from during 2015-2016 and were randomized into intervention (systematic oral care by researcher) and control (routine oral care by nurses) groups. The inclusion criteria were enrolled samples. Oral health assessment by BOAS and mucus-plaque assessment by MPS. The inclusion criteria were enrolled samples. The oral cavity was examined using BOAS and Mucosal-Plaque Score, and clinical pulmonary infection score was used for detecting pneumonia. Beck oral assessment scale was used to determine the required number of times for receiving oral care with regard to patient s oral health in the intervention group. Each care included adjusting endotracheal tube cuff pressure, brushing with toothpaste, using antiseptics and moistening the lips.Finding: the BOAS scoring showed significant differences between the two groups from the first to fifth day (P< 0.001). The mucosal-plaque index was significantly different between the two groups from the third day to fifth day (P< 0.001). The incidence rate of pneumonia on the third and fifth day was 10% (5) and 14% (7) in the control group, and 4% (2) and 10% (5) in the intervention group, respectively. The incidence rate in the intervention group reduced compared with the control group but the Fisher test did not show significant difference (p = 0.538).Conclusion: although following a systematic oral care program could not significantly decrease the incidence of ventilator-associated pneumonia in critically ill patients compared to the conventional oral care practices, it significantly improved the oral health and mucosal- plaque index.

کلیدواژه ها:

ventilator-associated pneumonia ، oral care ، intensive care unit