The Impact of a Comprehensive Oral Hygiene Program (COHP) on the Development of Ventilator Associated Pneumonia

2.50
Hdl Handle:
http://hdl.handle.net/10755/157174
Category:
Abstract
Type:
Presentation
Title:
The Impact of a Comprehensive Oral Hygiene Program (COHP) on the Development of Ventilator Associated Pneumonia
Author(s):
Sarsfield, Erin; Villanueva, Nancy
Author Details:
Erin Sarsfield, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA, email: esarsfield@hmc.psu.edu; Nancy Villanueva
Abstract:
PURPOSE: To determine what effect the initiation of a COHP, composed of brushing the teeth every 12 hours, cleaning the teeth and gums every 4 hours, and applying mouth moisturizing gel every 6 hours had on the ventilator-associated pneumonia (VAP) rate for mechanically ventilated critically ill patients in the neuroscience (NSICU) and medical (MICU) intensive care units. BACKGROUND: Mechanically ventilated patients are at increased risk of developing VAP. VAP increases morbidity, mortality, length of stay and cost. Interventions making a positive impact on VAP have been identified. One nursing intervention is the quality and consistency of oral care. The oral care policy for critically ill patients at our institution was revised to include standardized mouth care procedures and supplies. The impact this change had on nursing practice and the incidence of VAP was evaluated. METHODS: A quantitative study design measuring VAP rates pre and post-test intervention was used. Chart reviews were conducted on patients having positive respiratory nosocomial infection markers in the 6 months prior to and after implementation of the COHP. The oral care policy was revised and in-service education was conducted. Chart reviews determined if the patient met inclusion criteria. Those meeting criteria the determination of VAP was made using the CDC/NNIS flow diagram. The VAP rate was calculated for the 6 months before and after initiation of the COHP. A 2-tailed t-test was performed using SPSS Version 15. Data from the NSICU and MICU were analyzed separately as well as in combination. RESULTS: The pre-intervention VAP rate for the NSICU was 20.07 and 7.17 post-intervention. A 2-tailed t-test showed statistical significance at p = 0.014. For the MICU the pre-intervention rate was 11.15, and post-intervention 5.32. Analysis revealed no statistically significant difference between these rates (p = 0.079). Combining the units revealed a statistically significant difference between the pre and post intervention rates (p = 0.004). CONCLUSIONS: The COHP intervention made a significant difference in improving VAP rates in NSICU and in the combined units. Although positive trends were produced in the MICU VAP rate, it was not statistically significant. This finding may be attributed in part to the fact that differences between pre and post rates in the MICU were not as great as in the NSICU. These results provide strong evidence to support the COHP intervention; and also suggest that more work is required to further reduce VAP rates.
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.titleThe Impact of a Comprehensive Oral Hygiene Program (COHP) on the Development of Ventilator Associated Pneumoniaen_GB
dc.contributor.authorSarsfield, Erinen_GB
dc.contributor.authorVillanueva, Nancyen_GB
dc.author.detailsErin Sarsfield, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA, email: esarsfield@hmc.psu.edu; Nancy Villanuevaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157174-
dc.description.abstractPURPOSE: To determine what effect the initiation of a COHP, composed of brushing the teeth every 12 hours, cleaning the teeth and gums every 4 hours, and applying mouth moisturizing gel every 6 hours had on the ventilator-associated pneumonia (VAP) rate for mechanically ventilated critically ill patients in the neuroscience (NSICU) and medical (MICU) intensive care units. BACKGROUND: Mechanically ventilated patients are at increased risk of developing VAP. VAP increases morbidity, mortality, length of stay and cost. Interventions making a positive impact on VAP have been identified. One nursing intervention is the quality and consistency of oral care. The oral care policy for critically ill patients at our institution was revised to include standardized mouth care procedures and supplies. The impact this change had on nursing practice and the incidence of VAP was evaluated. METHODS: A quantitative study design measuring VAP rates pre and post-test intervention was used. Chart reviews were conducted on patients having positive respiratory nosocomial infection markers in the 6 months prior to and after implementation of the COHP. The oral care policy was revised and in-service education was conducted. Chart reviews determined if the patient met inclusion criteria. Those meeting criteria the determination of VAP was made using the CDC/NNIS flow diagram. The VAP rate was calculated for the 6 months before and after initiation of the COHP. A 2-tailed t-test was performed using SPSS Version 15. Data from the NSICU and MICU were analyzed separately as well as in combination. RESULTS: The pre-intervention VAP rate for the NSICU was 20.07 and 7.17 post-intervention. A 2-tailed t-test showed statistical significance at p = 0.014. For the MICU the pre-intervention rate was 11.15, and post-intervention 5.32. Analysis revealed no statistically significant difference between these rates (p = 0.079). Combining the units revealed a statistically significant difference between the pre and post intervention rates (p = 0.004). CONCLUSIONS: The COHP intervention made a significant difference in improving VAP rates in NSICU and in the combined units. Although positive trends were produced in the MICU VAP rate, it was not statistically significant. This finding may be attributed in part to the fact that differences between pre and post rates in the MICU were not as great as in the NSICU. These results provide strong evidence to support the COHP intervention; and also suggest that more work is required to further reduce VAP rates.en_GB
dc.date.available2011-10-26T19:29:15Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:29:15Z-
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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