Critical Study And Analysis Of Oral Care

Nardi (2012) has found the following: Ventilator-Associated Pneumonia (VAP) is the second most common Healthcare-Associated Infection (HAI) in the United States and is responsible for 25% of the infections that occur in intensive care units (ICUs). VAP is associated with increases in death rates, lengths of stay, and healthcare costs. (p. 41) As frontline caregivers and advocates for their patients, nurses need to understand the basics of VAP, risk factors for this type of pneumonia, and strategies that may avoid the

Clinical problem: Oral care and ventilator-associated pneumonia (VAP) is extremely important in all healthcare organizations and has gained increased attention. For this reason, oral care has been introduced in many hospital settings. However, there is not enough evidence on critically ill patients concerning the effect of oral care interventions on the development of VAP. In order to evaluate the effect of oral care on VAP for hospitalized patients, additional studies are required.

Cost-effective oral hygiene may result in improved oral health and comfort in the critically ill. To date, there are few literature reviews by Dental Healthcare Professionals combining the different methods and strategies for adequate oral hygiene measures and protocol of care to be routinely followed for

Nurses are often in charge of caring for individuals that are critically ill. In order to care for these patients, it takes knowledge of patient issues as well as the ability to collaborate with the interdisciplinary team to find the best plan of care. In order to develop this plan of care it takes knowledge of evidence based research which is ever changing. In this case study patient ML will be discussed. This case study will involve the patient’s problem as well as research which supports the care given as well as new alternative that could have been beneficial to the patient’s care. Patient ML suffered from a septic infection which was likely the result of multiple infected pressure ulcers. The article discussed will detail the use of a

In Egypt the incidence rate of VAP was 15.3% that increased the risk of mortality rate by 33% in contrast to the patient without VAP which was just 24.3% (Timsit, Zahar and Chevret, 2011, p.469). However, VAP independently cannot predict the death of the patient, there are other reasons associated with the VAP such as severity of disease, and duration of ICU stay (Myny et al., 2014, p.120). A study of Faisy et al.,(2011, p.1257) reveals that the risk factor associated with the VAP are: history of lungs diseases, immune compromised state, nutritional deficiency. In order to reduce the incidence rate of VAP in ICU settings, it is very necessary to follow the evidence based process indicator as a quality indicator because it tries to find out the obstacle that had been faced in the past and provides a proper guideline and feedback to improve the quality of service, in addition close surveillance, monitoring the previous outbreak and feedback from results could help to reduce the incidence rate (Wong, Mathieu and Williams, 2012, p.80). While working in ICU, the most patient experiences the problem of weaning. A study of Prasad, Chaudhry and Khanna,(2009, p. 221) reveals that patient experience the weaning failure at the time of extubate because of prolonged and dependency on mechanical ventilation. Other reason behind the weaning failure are: old age, increased minute ventilation, severe

Mechanically ventilated patients are increasingly at the risk of acquiring Ventilator-associated pneumonia (VAP) which is the leading infectious complication, affecting from 8% to 28% of patients admitted in the intensive care units. Morbidity and mortality associated with the development of VAP is high, with mortality rates ranging from 20 to 41%.Development of VAP increases ventilator days, critical care and hospital lengths of stay. Essential airway management is one of the important interventions to prevent ventilator associated pneumonia. Manual Hyperinflation (MH) enhances clearance of airway secretions and thereby improved lung compliance, reduced inspiratory resistance, improved V/Q matching, cleared airway and re-expanding the collapsed alveoli. MH could resemble a forceful cough, with which, sputum could propagate from distal to more proximal areas that is, from the smaller airways toward the larger airways, where it can be easily removed through endotracheal suctioning. Hence MH followed by suctioning is considered to be a suitable intervention to prevent VAP among intubated and mechanically ventilated patients.

critically ill intubated patients and is an important cause of mortality and morbidity in ICU

Similar to attitude domain, nurses from age group of more than 30 years old had good practices towards the oral care to the patient before undergo any oral surgery. The finding from this study also revealed the significant association between their practices. This was similar to Hsin et al., (2014), where the study was conducted among ICU nurses found that nurses will be complied with clinical care guidelines for performing the oral care if they were older. Senior nurses were strict in practices of what they had already learned besides their ability to influenced uncooperative patient in performing the oral care (Soh et al., 2011).

VAP is defined as pneumonia that develops in an intubated patient after 48 hours or more of mechanical ventilation (Fields, 2008). It is the most common nosocomial infection in mechanically ventilated patients and is a preventable secondary consequence of intubation and mechanical ventilation (Barclay & Vega, 2005), so its development and prevention is a concern.

Ventilator Associated Pneumonia (VAP) is a hospital acquired infection which happens to patients who are intubated. It costs the hospital and the patient money. It is a deadly disease that can be prevented through the right type of interventions. Current practice generally depends on the hospital; most hospitals use a VAP bundle. According to the Institute for Healthcare Improvement (2012) the VAP bundle consists of; head of the bed elevation of at least 30 degrees, daily sedation from weaning, readiness to extubate, Deep Vein Thrombosis (DVT) prophylaxis, stress ulcer prophylaxis, oral care with chlorohexidine (How to Guide, 2012). This currently is the protocol at Gerald Champion Regional Medical Center. However, adding subglottic secretion suctioning to this bundle has the ability to improve patient outcomes

Nurses and carers have a key role in promoting good oral health, as they are aware that bad

• Conclusions The guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in

There are generally three different groups of patients who are candidates for weaning (Crit Care Med 2009). The first group is candidates for easy weaning and make up roughly 70% of patients on MV. They fall into this category because their first attempt at spontaneous breathing is a success. The second group makes up about 25% of MV patients. They are so categorized because their first attempt at spontaneous breathing failed, often due to weakened muscles, and they have to spend about seven more days on MV before another attempt at weaning can be made. The last group makes up about 5% of patients who are extremely hard to wean. Muscle weakness is once again a factor for these patients. Their most critical stage of weaning is the post-extubation period. Muscle weakness can often be minimized through early mobilization of the patient, well-controlled use of sedation and early use of sedation, often called a “sedation vacation” (Nursing 2006).

Intubated patients need to be assessed to determine the need for suction, deflation of the endotracheal cuff and repositioning of endotracheal tube.

This section will discuss the background of the issue in question. The section will also provide a rationale for the selection of this topic for study. Oral health problems are common in most countries with some countries like the United States of America recording over 500 million patients each year (Larsen, 2009). Despite the fact that most problems related to oral health are preventable using simple measures, many people incur huge costs treating these problems when they occur. Problems related to oral health range from dental caries to oral cancer. Dentists have identified more than 120 health conditions that are directly related to oral health. Some of these conditions are health threatening, although they are