Oral Care Practices for Orally Intubated Critically Ill Adults

2010 ◽  
Vol 19 (2) ◽  
pp. 175-183 ◽  
Author(s):  
Laura L. Feider ◽  
Pamela Mitchell ◽  
Elizabeth Bridges
Keyword(s):  
Critical Care ◽  
Oral Cavity ◽  
Critically Ill ◽  
Oral Care ◽  
Nursing Intervention ◽  
Critical Care Nurses ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Oral Rinse ◽  
Care Practices

Background Ventilator-associated pneumonia is a major threat to patients receiving mechanical ventilation in hospitals. Oral care is a nursing intervention that may help prevent ventilator-associated pneumonia.Objectives To describe oral care practices performed by critical care nurses for orally intubated critically ill patients and compare these practices with recommendations for oral care in the 2005 AACN Procedure Manual for Critical Care and the guidelines from the Centers for Disease Control and Prevention.Methods A descriptive, cross-sectional design with a 31-item Web-based survey was used to describe oral care practices reported by 347 randomly selected members of the American Association of Critical-Care Nurses.Results Oral care was performed every 2 (50%) or 4 (42%) hours, usually with foam swabs (97%). Oral care was reported as a high priority (47%). Nurses with 7 years or more of critical care experience performed oral care more often (P=.008) than did less experienced nurses. Nurses with a bachelor’s degree in nursing used foam swabs (P=.001), suctioned the mouth before the endotracheal tube (P=.02), and suctioned after oral care (P<.001) more often than other nurses. Nurses whose units had an oral care policy (72%) reported that the policy indicated using a toothbrush (63%), using toothpaste (40%), brushing with a foam swab (90%), using chlorhexidine gluconate oral rinse (49%), suctioning the oral cavity (84%), and assessing the oral cavity (73%). Oral care practices and policies differed for all those items.Conclusions Survey results indicate that discrepancies exist between reported practices and policies. Oral care policies appear to be present, but not well used.

Does oral care with chlorhexidine reduce ventilator-associated pneumonia in mechanically ventilated adults?

2019 ◽  
Vol 28 (11) ◽  
pp. 682-689 ◽  
Author(s):  
Laura Jackson ◽  
Melissa Owens
Keyword(s):  
Critical Care ◽  
Oral Cavity ◽  
Critically Ill ◽  
Oral Care ◽  
Ventilator Associated Pneumonia ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Oral colonisation by pathogens contributes to contracting ventilator-associated pneumonia (VAP). The aim of this review was to determine whether the use of the antiseptic chlorhexidine in the intra-oral cavity reduced its incidence in the critically ill, mechanically ventilated adult. The findings from this review led to the conclusion that chlorhexidine reduced the occurrence of VAP. Although a recommendation to implement the use of intra-oral chlorhexidine for mechanically-ventilated patients within critical care can be made, further exploration into required frequency and method of administration would be beneficial to reduce unnecessary exposure and hinder pathogenic resistance.

scholarly journals Awareness and practice of patient’s oral care among critical care nurses in a rural tertiary care hospital

2019 ◽  
Author(s):  
Singla Bhavika ◽  
Akshaya N. N.Shetti ◽  
Rachita Mustilwar ◽  
Singla Anshul
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Oral Care ◽  
Cross Sectional Study ◽  
Critical Care Nurses ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Background and aim: Oral care contributes significantly to the patients’ health outcome in a critical care unit. Nurses play a vital role in maintaining good oral health. However, there remains a dearth of literature regarding oral care practices among nurses workingin an Indian critical care unit. In this descriptive cross sectional study, we assessed the level of awareness and the existing practices of patients’ oral care among our critical care unit (CCU) nurses. Methodology: After obtaining approval from the institutional ethics committee, 64 CCU nurses, having work experience of atleast 6 months in the CCU, were enrolled in this descriptive cross sectional study. A self-structured questionnaire was used to assess the awareness and practice of the nurses. The data collected was analyzed using descriptive statistics and results were expressed as percentages.Result: Of the 64 nurses enrolled in the study, there were no dropouts. It was found that 62 (96.87%) nurses provided oral care to all the CCU patients. 60 (93.7%) nurses claimed that a standard oral care protocol has been provided to them. Documentation of the oral care was carried out by 54 (84.37%) nurses. Although 50% of the nurses had been trained to provide oral care, 54 (84.37%) nurses felt the need of fresh training. 60 (93.7%) nurses preferred using toothbrush in conscious patients. Chlorhexidine was the most commonly used solution. Bleeding, extubation and biting were among the few complications that they faced during routine oral care.Conclusion: Despite working in a rural set up with limited resources available, oral care was provided by most of the nurses. Following a standard protocol and documentation of the same, has helped maintain consistency in oral care of all critical care patients.Citation: Bhavika S, Shetti AN, Mustilwar R, Anshul S. Awareness and practice of patient’s oral care among critical care nurses in a rural tertiary care hospital. Anaesth pain & intensive care 2019;23(3):295-300

scholarly journals Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045550
Author(s):  
Zhigang Zhang ◽  
Guoqiang Wang ◽  
Yuchen Wu ◽  
Jin Guo ◽  
Nannan Ding ◽  
...  
Keyword(s):  
Critical Care ◽  
Observational Study ◽  
Critically Ill ◽  
Content Validity ◽  
Assessment Tool ◽  
Western China ◽  
Validity Index ◽  
Cross Sectional ◽  
Physical Assessment ◽  
Content Validity Index

PurposeTo translate and adapt the Chelsea Critical Care Physical Assessment Tool (CPAx) into Chinese version (‘CPAx-Chi’), test the reliability and validity of CPAx-Chi, and verify the cut-off point for the diagnosis of intensive care unit-acquired weakness (ICU-AW).Study designCross-sectional observational study.MethodsForward and back translation, cross-cultural adaptation and pretesting of CPAx into CPAx-Chi were based on the Brislin model. Participants were recruited from the general ICU of five third-grade class-A hospitals in western China. Two hundred critically ill adult patients (median age: 53 years; 64% men) with duration of ICU stay ≥48 hours and Glasgow Coma Scale ≥11 were included in this study. Two researchers simultaneously and independently assessed eligible patients using the Medical Research Council Muscle Score (MRC-Score) and CPAx-Chi.ResultsThe content validity index of items was 0.889. The content validity index of scale was 0.955. Taking the MRC-Score scale as standard, the criterion validity of CPAx-Chi was r=0.758 (p<0.001) for researcher A, and r=0.65 (p<0.001) for researcher B. Cronbach’s α was 0.939. The inter-rater reliability was 0.902 (p<0.001). The area under the receiver operating characteristic curves of CPAx-Chi for diagnosing ICU-AW based on MRC-Score ≤48 were 0.899 (95% CI 0.862 to 1.025) and 0.874 (95% CI 0.824 to 0.925) for researcher B. The best cut-off point for CPAx-Chi for the diagnosis of ICU-AW was 31.5. The sensitivity was 87% and specificity was 77% for researcher A, whereas it was 0.621, 31.5, 75% and 87% for researcher B, respectively. The consistency was high when taking CPAx-Chi ≤31 and MRC-Score ≤48 as the cut-off points for the diagnosis of ICU-AW. Cohen’s kappa=0.845 (p=0.02) in researcher A and 0.839 (p=0.04) for researcher B.ConclusionsCPAx-Chi demonstrated content validity, criterion-related validity and reliability. CPAx-Chi showed the best accuracy in assessment of patients at risk of ICU-AW with good sensitivity and specificity at a recommended cut-off of 31.

scholarly journals The risk factors and outcome of early identified acute kidney injury among critically ill obstetric patients

2017 ◽  
Vol 6 (1) ◽  
pp. 11
Author(s):  
Amal Abd El-Hafez1 ◽  
Asmaa Mahjoub ◽  
Eman Ahmad
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Critical Care ◽  
Sofa Score ◽  
Postpartum Hemorrhage ◽  
Kidney Injury ◽  
Total Sample ◽  
Critical Care Nurses ◽  
Cross Sectional ◽  
Pregnancy And Postpartum

Background: Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy and postpartum period that facing critical care nurses in Intensive Care Unit (ICU). Having a uniform standard for identifying and classifying AKI would enhance critical care nurses’ ability to recognize these patients and leading to better outcomes.Objective: This work aimed to explore the risk factors and outcome of early identified acute kidney injury of critically obstetric patients in Obstetric ICU. Design. A descriptive cross sectional research design was used in this study. Participants: A total sample of 338 women admitted to Obstetric ICU at Woman Health Hospital, Assiut City, Egypt. Method: Three tools were used.Tool I was developed by the researcher and included demographic and obstetric history, lab parameters, complications and outcomes arising from AKI. The Sequential Organ Failure Assessment (SOFA) score as tool II to determine the extent of a patient's organ function or rate of failure. Measurement of serum creatinine and urine output were used to early identify AKI stages according to Acute Kidney Injury Network (AKIN) Criteria (tool III). Results: The prevalence of AKI among obstetric patients admitted to obstetric ICU was 10.1%; of them 52.9% needed renal replacement therapy and the mortality rate was 29.4%. Postpartum hemorrhage was the most common cause of AKI and its prevalence was 41.2%. It was also found that 74.5% of AKI patients developed complications. Conclusion: AKI complicated 10.1% of total admitted women to the OICU in the studied period. Postpartum hemorrhage represents the most prevalent risk factors with a highly significant SOFA score compared to other risk factors as sever preeclampsia, eclampsia, HEELP & APH with acute fatty liver.

Sign in / Sign up

Export Citation Format

Share Document