Oral Care Practices for the Deployed Critical Care Nurse in Orally Intubated Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/157726
Type:
Presentation
Title:
Oral Care Practices for the Deployed Critical Care Nurse in Orally Intubated Patients
Abstract:
Oral Care Practices for the Deployed Critical Care Nurse in Orally Intubated Patients
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Feider, Laura, PhD
P.I. Institution Name:U.S. Army, Nursing Research Service, Madigan Army Medical Center
Title:Nurse Researcher
Contact Address:9040A Reid Street, Tacoma, WA, 98431-1100, USA
Contact Telephone:253-968-1494
Co-Authors:Katherine Chiapulis, MA, MS, RN-BC, Ltc; Nancy Steele, PhD, RNC, NP, Chief, Nursing Research Service
Background: Ventilator-associated pneumonia (VAP) represents a major threat to all mechanically ventilated patients. Oral care is one nursing intervention that targets VAP prevention. Oral care policies and practices vary from state to state, hospital to hospital, and even within intensive care units. In addition, oral care practices can be inconsistent or lacking altogether. Although essential in the care of mechanically ventilated patients, preventive oral care procedures are based on tradition and anecdotal evidence rather than scientific research. It is currently unknown what the oral health status is of orally intubated patients in theater and what oral care practices are performed by military critical care nurses in combat support hospitals. Purpose/Aims:  The purpose of this study is to describe oral care practices by military critical care nurses for orally intubated critically ill patients. The specific components of oral care to be described included teeth brushing, swabbing, chlorhexidine gluconate (CHX) oral rinsing, and oral secretion management. Methods:  The study is a descriptive, cross-sectional, self-administered web-based survey to examine oral care practices reported by military critical care nurses working in the deployed critical care settings of two selected Combat Support Hospitals (CSH) in Iraq. Results:  Preliminary descriptive analysis has been conducted. Fifty participants are expected to enroll in the study. To date, 33 participants have completed the on-line survey. Preliminary data show that: 63% perform oral care every 4 hours; 8% brush with a toothbrush twice a day; 60% use chlorhexidine gluconate rinse (CHG); 40% do not combine teeth brushing with CHG therapies; 84% suction the oropharynx at all the correct intervals; 90% do not assess the oral cavity with a standard oral assessment tool; 53% report moderate priority of care 50% report having adequate time to perform oral care every 4 hours; 70% are not aware of the AACN Oral Care Practice Alert (2006); 53% are not aware of the AACN Procedure Manual (2005); 63% are not aware of the IHI VAP Bundle; 60% have an ICU oral care policy; 38% report the main barrier to oral care is the bite block providing limited access, while 30% report they have no resources or supplies to provide oral care; and 83% report having adequate education and knowledge to provide oral care.  In February 2009, the descriptive and comparative data analysis will be completed. Implications:  By recruiting a military nurse sample, this study will provide the data needed to describe current oral care practices in theater and lead to interventions to prevent VAP in intubated patients in the ICU. This is the first study to describe oral care practices performed by critical care nurses in a deployed combat hospital setting. Similar to findings in civilian nurses, this military nurse study reports:  the majority of every 4 hour oral care is being completed as well being a moderate priority of care; oral care policies appear to be present, but not well utilized; the majority are using CHG oral rinse; and the majority of nurses are not aware of the published evidence-based guidelines for oral care. Results of this military survey indicate that discrepancies exist between reported practices and policies. A gap exists between national oral care standards, reported oral care practices, and unit level oral care policies. The results of this study may lead to implementation of evidence-based practices and policies in the austere deployed hospital as well as improve wounded warrior care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleOral Care Practices for the Deployed Critical Care Nurse in Orally Intubated Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157726-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Oral Care Practices for the Deployed Critical Care Nurse in Orally Intubated Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Feider, Laura, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">U.S. Army, Nursing Research Service, Madigan Army Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Researcher</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">9040A Reid Street, Tacoma, WA, 98431-1100, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">253-968-1494</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">laura.feider@us.army.mil</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Katherine Chiapulis, MA, MS, RN-BC, Ltc; Nancy Steele, PhD, RNC, NP, Chief, Nursing Research Service</td></tr><tr><td colspan="2" class="item-abstract">Background: Ventilator-associated pneumonia (VAP) represents a major threat to all mechanically ventilated patients. Oral care is one nursing intervention that targets VAP prevention. Oral care policies and practices vary from state to state, hospital to hospital, and even within intensive care units. In addition, oral care practices can be inconsistent or lacking altogether. Although essential in the care of mechanically ventilated patients, preventive oral care procedures are based on tradition and anecdotal evidence rather than scientific research. It is currently unknown what the oral health status is of orally intubated patients in theater and what oral care practices are performed by military critical care nurses in combat support hospitals. Purpose/Aims:&nbsp; The purpose of this study is to describe oral care practices by military critical care nurses for orally intubated critically ill patients. The specific components of oral care to be described included teeth brushing, swabbing, chlorhexidine gluconate (CHX) oral rinsing, and oral secretion management. Methods:&nbsp; The study is a descriptive, cross-sectional, self-administered web-based survey to examine oral care practices reported by military critical care nurses working in the deployed critical care settings of two selected Combat Support Hospitals (CSH) in Iraq. Results:&nbsp; Preliminary descriptive analysis has been conducted. Fifty participants are expected to enroll in the study. To date, 33 participants have completed the on-line survey. Preliminary data show that: 63% perform oral care every 4 hours; 8% brush with a toothbrush twice a day; 60% use chlorhexidine gluconate rinse (CHG); 40% do not combine teeth brushing with CHG therapies; 84% suction the oropharynx at all the correct intervals; 90% do not assess the oral cavity with a standard oral assessment tool; 53% report moderate priority of care 50% report having adequate time to perform oral care every 4 hours; 70% are not aware of the AACN Oral Care Practice Alert (2006); 53% are not aware of the AACN Procedure Manual (2005); 63% are not aware of the IHI VAP Bundle; 60% have an ICU oral care policy; 38% report the main barrier to oral care is the bite block providing limited access, while 30% report they have no resources or supplies to provide oral care; and 83% report having adequate education and knowledge to provide oral care. &nbsp;In February 2009, the descriptive and comparative data analysis will be completed. Implications:&nbsp; By recruiting a military nurse sample, this study will provide the data needed to describe current oral care practices in theater and lead to interventions to prevent VAP in intubated patients in the ICU. This is the first study to describe oral care practices performed by critical care nurses in a deployed combat hospital setting. Similar to findings in civilian nurses, this military nurse study reports:&nbsp; the majority of every 4 hour oral care is being completed as well being a moderate priority of care; oral care policies appear to be present, but not well utilized; the majority are using CHG oral rinse; and the majority of nurses are not aware of the published evidence-based guidelines for oral care. Results of this military survey indicate that discrepancies exist between reported practices and policies. A gap exists between national oral care standards, reported oral care practices, and unit level oral care policies. The results of this study may lead to implementation of evidence-based practices and policies in the austere deployed hospital as well as improve wounded warrior care.</td></tr></table>en_GB
dc.date.available2011-10-26T20:08:45Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:08:45Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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