Maintaining Oral Hygiene Is A Essential Element Of Preventing Hospital Acquired Pneumonia

The following document is a case study written by an intensive care nurse, who will explore the oral care provided to a patient admitted in an Intensive Care Unit (ICU) and will assess the overall care process. Additionally, the frequency, products used and techniques performed will be evaluated.

Essentials of dental assisting by Debbie S. Robinson - Doni L. Bird Fourth Edition Chapter 8 page 122

Keeping our hands clean is one of the most effcient and important steps we can do as humans to avoid getting sick or spreading germs to other people. Unwashed hands spread many diseases such as the flue, E. coli, and salmonella. Unfortunately, hand hygiene is still one of today’s most leading causes of infection in health care facilities. The risk of clinicians, patients, and visitors not complying with hand hygiene protocols creates a practice problem for nurses and their patient care. The cause of health care infections, also known as, health care-associated infections (HAIs) are increasing along with the rise of the inability to control or treat infections that are multi-drug resistant. Lack of proper hand hygiene is a major problem in clinical settings sourcing from critical care divisions where the most contaminations are prevalent. This paper will discuss how hand hygiene affects the nursing process and solutions of how to better prevent HAIs within the nursing scope of practice.

The patient was keen to get her oral hygiene up to a good standard and prevent any

The main priority for all the pediatric patient was to make sure they are getting enough air. They needed an open airway. Without an open airway nothing else matters. To help with the patients airways we monitored their O2 sats and if they were low we made sure to apply oxygen, and continue to monitor their sats. Once oxygen was applied we worked on

(2012) evaluated whether oral care by swabbing with 0.2% CHX decreases the risk of ventilator-associated pneumonia (VAP) in hospitalized patients. Patients 18 years and older were included in the study if they had no episode of chemical pneumonitis and have never been diagnosed with thrombocytopenia. Eligible patients were randomly assigned to one of two groups as follows: a CHX group (n=29) and a control group (n=32). Oral care was performed by swabbing oral mucosa with either CHX or saline on sponge pellets, four times daily (at 6 AM, 12 AM, 6 PM and 12 PM). Approximately 30 mL of 0.2% CHX or saline was applied and this lasted for about 1 minute. The control group received the standard oral care (saline applications). All patients were followed for at least 14 days or until discharge from the hospital, extubation or death. The main outcome in this study was the incidence of VAP and was assessed using a mouth mirror together with a headlight. VAP was observed in 34/61 patients (55.7%) within 6.8 days. The rate of the development of VAP was significantly higher in the control group (68.8%) compared to the CHX group (41.4%) [p = 0.03] with a significant odds ratio of 3.12 (95% CI = 1.09-8.91). This study identified acinetobacter baumannii (64.7%) as the most frequent pathogen of all study

Clinical Practice guidline AANC (2010). Proposes expected practice that include brushing teeth, and gum at least twice a day with the use of a soft adult toothbrush, providing oral moisturizing to the mucosa and lips every 2-4 hours, using an oral chlorhexidine (0.12%) rinse twice a day during the perioperative period for adult patients who undergo cardiac surgery (based on CDC guidelines). However, routine use of oral chlorhexidine gluconate (0.12%) is not recommended at this

VAP continues to be a major clinical challenge and contributes to increased healthcare costs, duration of mechanical ventilation, length of stay, and patient mortality (Grap et al., 2011). These statistics are astounding as VAP is a preventable condition. A current clinical care effort utilized to reduce the incidence of VAP in mechanically ventilated (MV) patients is to include chlorhexidine in oral care protocols. Chlorhexidine is an oral antiseptic rinse with broad-spectrum activity used “to decrease oral bacteria and potential oropharynx colonization” (Zuckerman, 2016). This is an easy and low cost intervention and is currently exercised in the clinical care environment by nurses when performing oral care for MV patients.

All patients were followed with pulmonary artery catheters and invasive blood pressure. After orotracheal intubation, patients were ventilated with intermittent positive pressure with a tidal volume of 8 mL / kg, final expiratory positive pressure of 5 to 8 cmH2O and FiO2 of 60 to 100% to maintain arterial oxygen saturation above 95%.

This includes elevating the head of the bed at least 30 degrees, preventing aspiration, turning and positioning, and most importantly, performing oral care. A major source of VAP is the aspiration of microorganisms from the mouth, proving oral hygiene for mechanically ventilated patients is of top priority. Although, methods and timing of oral care varies widely between facilities, for instance, some hospitals may brush teeth with a tooth brush while others may use a sponge swab. A common oral care protocol is usually brushing teeth every 8 hours and using an antimicrobial rinse (chlorhexidine) every 2 hours (Ignatavicius & Workman, 2013). It should be noted that quality education on the link between poor oral hygiene and ventilator-associated pneumonia should be provided to licensed nurses as well as nurses’ aides that would be responsible for providing oral care. Understanding the importance of being vigilant at providing oral care may further reduce VAP occurrences due to increased compliance and efficiency of oral care

Which may further lead to prioritising oral care as a less priority for nurses than other aspects of care (H. Jones et al., 2004). In turn, even the tapes that are used in the fixation of the tube quickly become heavily contaminated with the bacterium in the existence of salivary secretions and the hitches associated with cleaning the mouth (Abidia, 2007). So, they have greater susceptibility to nosocomial-acquired infections such as ventilator-Associated Pneumonia (VAP) (Zurmehly, 2013). Patients who are intubated are also forced to keep their mouths open which leads to xerostomia, caused due to dryness of oral mucosa (Miranda, de Paula, de Castro Piau, Costa, & Bezerra, 2016). Furthermore, patients who may have some medical conditions have oral manifestations such as diabetes, Crohn’s disease, Leukaemia (H. Jones et al., 2004). In order to prevent these life-threatening complications, it is important to prioritise oral care as an essential nursing priority in high acuity settings by doing appropriate and more frequent oral assessments followed by mouth care with an evidence-based approach.

An examination file and a treatment file were created for each patient after inclusion. The examination file, which contained information about the clinical measurements, was accessible only to the examiner. The treatment file, which provided data about the randomization modalities was filled before each treatment. Patients were instructed in oral hygiene, and supragingival cleaning of the teeth was performed using hand instruments and a sonic device with tip no. 5/6/ with increasing amplitudes of 120 mm. The sonic device was used with a frequency of 6,000 Hz and constant water irrigation according to the instructions of the manufacturer Oral hygiene instructions were repeated at every appointment. Subsequently, two quadrants Group I were

The results showed patients treated with Peridex and tooth-brushing had shorter ICU stays, less time on the mechanical ventilator, and a decrease in mortality rates compared to those only receiving the Peridex. The study showed tooth brushing not only removed microorganisms but also increased the effectiveness of the Peridex. Although the results indicated tooth-brushing with the aid of Peridex was superior, there was not a significant difference between the control and intervention groups and also the sample size was relatively small to demonstrate a strong argument towards the use of tooth-brushing.

Infection control is very important in the health care profession. It’s very important that we as a dental assistant make sure we follow the guidelines to protect the patient, the community and ourselves. Health care professionals, who do not practice proper infection control, can expose multiple bacteria and diseases to others. The main objective is to prevent the transmission of infectious diseases from both patients and health personnel. Today, infection control is a continuous concern for its professionals. We have to contact patients routinely and be exposed to their blood, saliva, dental plaque and pus that may contain infectious pathogens. It is important for the dental professionals to treat these fluids as if they are infectious and take special precautions when handling them. In this essay, I will go in detail of infection control practices in dental clinics and how infectious microorganisms are transmitted in the dental clinic. Also, I will talk about some infection control guidelines that are important in dental clinics and how to protect the dental professional environment and dental professions.

3) How does the dental care team carry out infection control in the dental clinic?