How does an evidence-based oral hygiene protocol, when compared to standard of care, affect oropharyngeal colonization and rate of iatrogenic infection in patients with chronic respiratory compromise?

2.50
Hdl Handle:
http://hdl.handle.net/10755/307982
Category:
Abstract
Type:
Presentation
Title:
How does an evidence-based oral hygiene protocol, when compared to standard of care, affect oropharyngeal colonization and rate of iatrogenic infection in patients with chronic respiratory compromise?
Author(s):
Heuschneider, Stacy L.
Lead Author STTI Affiliation:
kappa gamma
Author Details:
Stacy L. Heuschneider, RN, BSN, MS, ANP-C, CCRN, ACNS-BC, stacy.heuschneider@stonybrookmedicine.edu
Abstract:

Poster presented on: Tuesday, November 19, 2013, Monday, November 18, 2013

Background:  Oral pathogens pose significant risk to patients with chronic conditions and are associated with hospital-acquired pneumonias (HAP). HAP is the second most common iatrogenic infection in hospital settings, accounting for 300,000 cases yearly. Mortality rates range from 24% to 50%. Invasive airway devices provide an established conduit for transmission of bacteria to the pulmonary system.  Although chronic respiratory compromise carries a two-fold risk for pneumonia and tracheobronchitis, there has been little advancement in the standardization of oral hygiene protocols that are evidence-based for patients with self-care deficits, or those with alternative oxygen delivery methods. 

Purpose:  The purpose of this study is to examine the relationships among oropharyngeal colonization, xerostomia, gingival and plaque index, rate of iatrogenic infection and type of oral care protocol in patients with chronic respiratory compromise.  Introduction of an evidence-based oral care protocol and assessments of compliance will also be implemented.

Methods: This study will utilize a pretest-posttest, one-group design to compare outcomes associated with standard oral care and an evidence-based protocol. Eligible subjects will have tracheostomy, tracheostomy on mechanical ventilation or non-invasive ventilation.  Plaque, gingival indexes and xerostomia will be measured on subjects within 48 hours of admission, then bi-weekly. Saliva specimens will be cultured for pathogenic organisms. Sputum specimens will be sent for comparison and diagnostic correlation weekly and upon discharge. The pre-intervention data collection will last 6 months with subjects studied until downgrade or discharge. The interventions will be introduced among the study patients following the six-month pre-intervention period.  The evidence-based oral protocol will consist of mechanical toothbrushing, oral moisturizer, oral chlorhexidine, toothbrush storage protocol, subglottic suctioning prior to cuff deflation and a comprehensive oral-systemic nursing educational program emphasizing impact of care provided. Compliance with oral care protocols will also be measured.

Results: Study in progress.

Conclusion/Convergence: Study in progress.

Keywords:
chlorhexidine; toothbrush; toothpaste
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott
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.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleHow does an evidence-based oral hygiene protocol, when compared to standard of care, affect oropharyngeal colonization and rate of iatrogenic infection in patients with chronic respiratory compromise?en_GB
dc.contributor.authorHeuschneider, Stacy L.en_GB
dc.contributor.departmentkappa gammaen_GB
dc.author.detailsStacy L. Heuschneider, RN, BSN, MS, ANP-C, CCRN, ACNS-BC, stacy.heuschneider@stonybrookmedicine.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/307982-
dc.description.abstract<p>Poster presented on: Tuesday, November 19, 2013, Monday, November 18, 2013</p><b>Background:</b>  Oral pathogens pose significant risk to patients with chronic conditions and are associated with hospital-acquired pneumonias (HAP). HAP is the second most common iatrogenic infection in hospital settings, accounting for 300,000 cases yearly. Mortality rates range from 24% to 50%. Invasive airway devices provide an established conduit for transmission of bacteria to the pulmonary system.  Although chronic respiratory compromise carries a two-fold risk for pneumonia and tracheobronchitis, there has been little advancement in the standardization of oral hygiene protocols that are evidence-based for patients with self-care deficits, or those with alternative oxygen delivery methods.  <p><b>Purpose:</b>  The purpose of this study is to examine the relationships among oropharyngeal colonization, xerostomia, gingival and plaque index, rate of iatrogenic infection and type of oral care protocol in patients with chronic respiratory compromise.  Introduction of an evidence-based oral care protocol and assessments of compliance will also be implemented. <p><b>Methods:</b> This study will utilize a pretest-posttest, one-group design to compare outcomes associated with standard oral care and an evidence-based protocol. Eligible subjects will have tracheostomy, tracheostomy on mechanical ventilation or non-invasive ventilation.  Plaque, gingival indexes and xerostomia will be measured on subjects within 48 hours of admission, then bi-weekly. Saliva specimens will be cultured for pathogenic organisms. Sputum specimens will be sent for comparison and diagnostic correlation weekly and upon discharge. The pre-intervention data collection will last 6 months with subjects studied until downgrade or discharge. The interventions will be introduced among the study patients following the six-month pre-intervention period.  The evidence-based oral protocol will consist of mechanical toothbrushing, oral moisturizer, oral chlorhexidine, toothbrush storage protocol, subglottic suctioning prior to cuff deflation and a comprehensive oral-systemic nursing educational program emphasizing impact of care provided. Compliance with oral care protocols will also be measured. <p><b>Results:</b> Study in progress. <p><b>Conclusion/Convergence:</b> Study in progress.en_GB
dc.subjectchlorhexidineen_GB
dc.subjecttoothbrushen_GB
dc.subjecttoothpasteen_GB
dc.date.available2013-12-19T17:24:59Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:24:59Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_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.en_GB
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