Ventilate Oral Rinse

It has been repeatedly stated that oral care is important in the prevention of ventilator-associated pneumonia (VAP). Endotracheal intubation predisposes patients to developing VAP. The tube acts as a conduit from the mouth to the lungs – a perfect track for bacteria to descend upon. Khezeri, et al. (2014) suggest that “the presence of an endotracheal tube (ETT) inhibits normal coughing, normal swallowing, and the protection of the trachea contact by epiglottis closure.” In addition, an endotracheal tube keeps the patients mouth open – leading to dryness. Bacteria are not washed away by saliva. Also, Landgraf, et al. (2017) mention that the presence of an endotracheal tube in the mouth causes “changes in the oral epithelium” which “might indicate risk for infection in intensive care patients

In clinical experience, it is seen that many patients in the Intensive Care Unit (ICU) are on mechanical ventilation. These patients range from having head trauma, heart surgery and respiratory problems yet there is no clear, concise systematic standard oral care procedures noted on the different floors in the hospital. Oral care is a basic nursing care activity that can provide relief, comfort and prevention of microbial growth yet is given low priority when compared to other critical practices in critically ill patients. The Center for Disease Control reveals that Ventilator-Associated Pneumonia (VAP) is the second most common nosocomial infection that affects approximately 27% of critically ill patients (Koeman, Van der Ven & Hak,

The purpose of this document is a critical study and analysis of the oral care provided by nursing staff as part of the Ventilator Care Bundle (VCB) and to assess whether the frequency of mouth care performed is related to the prevention of Ventilator Associated Pneumonia (VAP) in patients mechanically ventilated (Zilberberg et al. 2009).

To encourage physicians, ICU nurses, and respiratory therapist to use the ventilator associated pneumonia bundle in all ventilated patients in an intensive care unit.

Before bathing/showering with soap and water prior to a procedure/surgery was accepted. It has been proven that antiseptic showering decreases skin microorganism count. Chlorhexidine gluconate products necessitate the need for several applications for the maximum antimicrobial benefit. Thus, each patient receives two preoperative antiseptic showers.

Even though the consequence of saline instillation on a ventilator patient in the acute care setting is pneumonia or the patient may become hemodynamically unstable, this practice remain contentious, the practice of this procedure will also decrease the oxygenation. (Ayhan, et al., 2015),

For instance, there are many different types of infections that occur in the intensive care unit (ICU), as well as various methods of prevention that patients, visitors, providers, and other hospital staff can practice. Of the many different types of infections that occur in these critically ill patients, catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs) are two of the most serious infections, and they also happen to be the most

Among critically-ill patients in acute care facilities, pneumonia is one of the most frequently acquired hospital infections (Curtin, 2011). Ventilator-associated pneumonia (VAP) is the second most common healthcare-associated infection (HAI) in the United States and it is responsible for approximately 25% of infections that occur in intensive care units (Sedwick et al., 2012). VAP is defined as a hospital-acquired lung infection that develops in patients who are intubated and receiving mechanical ventilation at the time of or within 48 hours prior to the onset of infection (Sedwick et al., 2012; Gianakis et al., 2015). The definition of VAP, provided by the Centers for Disease Control and Prevention (CDC), encompasses a combination of radiological,

Another research article about the use of 2% chlorhexidine for daily skin cleansing was established by Munoz-Price and implemented by the task force. Munoz-Price demonstrated that this intervention reduces the rate of CLABSI from 9.5 to 3.8 per 1000 catheter days. The task force also replaced the administration sets and add-on devices no more frequently than every 72 hours unless contamination occurred. Replacing tubing used to administer blood, blood products, or lipids within 24 hours of start of infusion was also monitored, along with changing IV port protectors no more often than 72

Ventilator-associated pneumonia is a bacterial infection that occurs in the lower respiratory system within the first 48 hours of endotrachal intubation (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). Although any hospital patient is susceptible to pneumonia, ventilator dependent patients are at the highest risk of acquiring pneumonia. The purpose of this paper is to identify the risk factors, incidences, and preventions of ventilator-associated pneumonia (VAP) using a quantitative research study performed in Malaysia. “The aim of this

CLABSI prevention is a standard of practice for those who provide care CVCs within an adult ICU and throughout the various units. However, infection rates remain high despite the care that is provided. This provides a clear need for education for those who are in direct care of those with a CVC. Utilizing the ACE Star Model, the discovery of a decrease in CLABSIs due to an education program was observed. In summary, the education program provided proper technique, antisepsis solutions, hand hygiene, and the location of insertion site significantly reduced CLABSI presence within adult ICUs. The creation of an education program as the driving force to change the current practice is to be implemented for those with direct contact of care for

(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

In addition to following policies and procedures, nurses are constantly looking to improve best practices and reduce the amount of people affected by a certain illness or infection. Chlorhexidine bathing can be seen in critical care settings, surgical floors, and other medical floors. However, it’s not a practice that is implemented in all health care settings or hospitals. By studying

Attitudes of Respiratory Therapists and Nurses About Measures to Prevent Ventilator-Associated Pneumonia: A Multicenter, Cross-Sectional Survey Study

Lee E, Kim S and Kim J. Effects of a closed endotracheal suction system on oxygen saturation,ventilator-associated pneumonia, and nursing efficacy. TaehanKanhoHakhoe Chi. 2004 Dec; 34(7):1315-25.