2.50
Hdl Handle:
http://hdl.handle.net/10755/157163
Category:
Abstract
Type:
Presentation
Title:
Standardizing Oral Care Practice within Intensive Care Units in Academic Teaching Center
Author(s):
Reed, Charles; Pao, Wen; Cochetti, Josephina; Harper, Christie; Beadle, Randy
Author Details:
Charles Reed, University Hospital, San Antonio, Texas, USA, email: charles.reed@uhs-sa.com; Wen Pao; Josephina Cochetti; Christie Harper; Randy Beadle
Abstract:
PURPOSE: To determine current baseline oral care practices on mechanically ventilated ICU patients at a level one trauma center. Secondly, to understand the nurses' definition and perceptions of performing oral care. Lastly to ascertain how nurses learned to perform oral care, the frequency oral care is provided and barriers to oral care. BACKGROUND: Ventilator Associated Pneumonia (VAP) is the leading cause of morbidity and mortality in the ICU, according to the US agency for Health Research and Quality (AHRQ). Recent research has shown the oral cavity is the primary source of respiratory-related infection and proper oral care contributes to the reduction in VAP. In our organization no oral care protocol or education activity exists, and interviews with nurses revealed a lack of consensus regarding proper oral assessment and care. METHODS: IRB approval was obtained. Approximately 200 ICU nurses at University Hospital were invited to participate in the study. A paper/pencil survey tool was distributed to all participants. The Oral Care in Ventilated Population Questionnaire (OCVPQ) developed a team of ICU nurses after an extensive literature review. It included 4 areas of focus: attitude, assessment, practice, and barriers/tools. The questions included open ended, yes/no, multiple choice and scaled responses. The survey tool was anonymous and confidential. Completed surveys were deposited into a sealed box in each nurse's lounge. Boxes were collected by the research team two weeks after distribution of the survey tool. RESULTS: 97% of respondents indicated oral care was part of their routine practice and cited prevention of VAP as the foremost reason to perform oral care. 76% rated it as "very important" to patient outcomes. Nurses reported learning oral care primarily by experience, with some crediting nursing schools. Frequency of oral care varied from every 2 to 12 hours, with the average being every 4 hours. 50% indicated that they assessed the patient's mouth every hour. Oral care tools ranged from a washcloth, toothbrush and tooth paste to pre-packaged kits. Barriers identified to performing oral care included patient's agitation, lack of cooperation, acuity, physical limitation and nursing time constraints. CONCLUSIONS: Our survey revealed inconsistencies in oral care practices that could lead to higher incidences of VAP. Essential elements to consider in improving effective practice are education and development of an evidenced based guideline (EBG) and standardized assessment tool. Further research on patient outcomes related to implementation of an EBG and assessment tool needs to be studied.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleStandardizing Oral Care Practice within Intensive Care Units in Academic Teaching Centeren_GB
dc.contributor.authorReed, Charlesen_GB
dc.contributor.authorPao, Wenen_GB
dc.contributor.authorCochetti, Josephinaen_GB
dc.contributor.authorHarper, Christieen_GB
dc.contributor.authorBeadle, Randyen_GB
dc.author.detailsCharles Reed, University Hospital, San Antonio, Texas, USA, email: charles.reed@uhs-sa.com; Wen Pao; Josephina Cochetti; Christie Harper; Randy Beadleen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157163-
dc.description.abstractPURPOSE: To determine current baseline oral care practices on mechanically ventilated ICU patients at a level one trauma center. Secondly, to understand the nurses' definition and perceptions of performing oral care. Lastly to ascertain how nurses learned to perform oral care, the frequency oral care is provided and barriers to oral care. BACKGROUND: Ventilator Associated Pneumonia (VAP) is the leading cause of morbidity and mortality in the ICU, according to the US agency for Health Research and Quality (AHRQ). Recent research has shown the oral cavity is the primary source of respiratory-related infection and proper oral care contributes to the reduction in VAP. In our organization no oral care protocol or education activity exists, and interviews with nurses revealed a lack of consensus regarding proper oral assessment and care. METHODS: IRB approval was obtained. Approximately 200 ICU nurses at University Hospital were invited to participate in the study. A paper/pencil survey tool was distributed to all participants. The Oral Care in Ventilated Population Questionnaire (OCVPQ) developed a team of ICU nurses after an extensive literature review. It included 4 areas of focus: attitude, assessment, practice, and barriers/tools. The questions included open ended, yes/no, multiple choice and scaled responses. The survey tool was anonymous and confidential. Completed surveys were deposited into a sealed box in each nurse's lounge. Boxes were collected by the research team two weeks after distribution of the survey tool. RESULTS: 97% of respondents indicated oral care was part of their routine practice and cited prevention of VAP as the foremost reason to perform oral care. 76% rated it as "very important" to patient outcomes. Nurses reported learning oral care primarily by experience, with some crediting nursing schools. Frequency of oral care varied from every 2 to 12 hours, with the average being every 4 hours. 50% indicated that they assessed the patient's mouth every hour. Oral care tools ranged from a washcloth, toothbrush and tooth paste to pre-packaged kits. Barriers identified to performing oral care included patient's agitation, lack of cooperation, acuity, physical limitation and nursing time constraints. CONCLUSIONS: Our survey revealed inconsistencies in oral care practices that could lead to higher incidences of VAP. Essential elements to consider in improving effective practice are education and development of an evidenced based guideline (EBG) and standardized assessment tool. Further research on patient outcomes related to implementation of an EBG and assessment tool needs to be studied.en_GB
dc.date.available2011-10-26T19:28:40Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:28:40Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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