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Outcomes of an Oral Care Protocol in Postmechanically Ventilated Patients
Author(s) -
Chipps Esther M.,
Carr Michele,
Kearney Rachel,
MacDermott Jennifer,
Visger Tania,
Calvitti Kristin,
Vermillion Brenda,
Weber Michele L.,
Newton Cheryl,
Clair Jamie,
Harper Dorina,
Yamokoski Todd,
Belcher Marcia,
Ali Naeem,
Hoet Armando E.,
Balen Joany,
Holloman Christopher,
Landers Timothy
Publication year - 2016
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/wvn.12124
Subject(s) - medicine , throat , randomized controlled trial , tongue , intensive care unit , protocol (science) , emergency medicine , intensive care medicine , surgery , alternative medicine , pathology
Background Oral care is standard practice to prevent hospital‐associated infections while patients are intubated and in the intensive care unit. Following extubation and transfer, infections remain an important risk for patients, but less attention is paid to oral care. Few studies have assessed the impact of oral care in recently extubated acutely ill patients. Aims To develop an evidence‐based oral care protocol for hospitalized patients and determine the impact of this protocol on health outcomes in recently extubated patients. Methods In this randomized controlled trial, subjects were randomized to usual care or an intervention protocol that included tooth brushing, tongue scraping, flossing, mouth rinsing, and lip care. Major outcome measures were the revised THROAT (R‐THROAT; oral cavity assessment) and overall prevalence of methicillin‐sensitive Staphylococcus aureus and methicillin‐resistant S. aureus on oral cultures. Results Seventy‐four subjects were randomized. As measured by the R‐THROAT, oral cavity health improved over time in both groups, but the intervention group demonstrated significantly more improvement than the control group (R‐THROAT score improved by 1.97 intervention vs. 0.87 control; p = .04). Two categories, tongue and mouth comfort, demonstrated the most significant improvement. There was no difference in MSSA/MRSA colonization between the groups at the conclusion of the study. Overall, subjects in the intervention group were more satisfied with their protocol than subjects in the usual care group. Linking Evidence to Action This study offers an important evaluation of an oral care protocol after extubation. Results demonstrated improvement in the oral cavity assessment with the designed oral care protocol. Patients expressed a preference for the intervention protocol, which included a battery‐operated toothbrush, higher‐quality toothpaste and mouth rinse, tongue scraper, floss, and lip balm. The implementation of an oral care protocol specifically addressing patients in the immediate postintubation is essential.