Effects of Oral Health Care Nursing Practice Guidelines on the Prevention of Ventilator Associated Pneumonia

Abstract

Purposes : To assess the practice of nurses, compare the oral health scores, compare the incidence of ventilator-associated pneumonia (VAP)

Study design : Quasi-experimental study

Materials and Methods : 25 of consisted nurses working in the female medical ward2 Roi Et hospital conducted between September - December 2023, 76 ventilated patients were purposive sampling. They were simple random sampling was divided into 38 control groups and 38 experimental groups. The research instruments were a general record form of nurses and patients, an oral health care nursing practice assessment form, a questionnaire on nurse satisfaction with clinical practice guidelines, an oral assessment guide, a ventilator-associated pneumonia infection report form, oral care nursing practice guideline. This study was divided into assessing the practice of nurses before and after implementing the guideline, the control group received standard oral health nursing care, the experimental group of patients provided nursing care according to the oral health care nursing practice guidelines on the prevention of pneumonia infection in ventilator patients. Data were analyzed using descriptive statistics and Independent t-test.

Main findings : The results yielded that there were: 1) Nurse (n=25), average age 29.76 years, bachelor's degree 100 percent, average work experience 6.6 years, never received knowledge about oral health nursing 100 percent. After applying the guidelines, nurses were able to assess their oral health correctly by 86 percent, an increase from the previous ones that had not been practiced. Nurses choose to use toothbrushes, toothpaste, and mouthwash that are suitable for the patient's condition, 96 percent, an increase from the original preparation of only cotton swabs and mouthwash. 2) Patients (n=78), divided into 2.1 the control group consisted of 38 patients, mean age 71.5 years, average bedtime 16.21 years, number of intubation days 8.34 days, diagnosis pneumonia 84.21 percent, platelet count greater than 140,000 cells/mm³ 100 percent. 2.2 The experimental group consisted of 38 patients, the mean age was 68.39 years, the average bedtime was 13.68 years, the number of intubation days was 6.31 days, pneumonia 86.84 percent, platelet count greater than 140,000 cells/mm³. The oral status of patients between control and experimental groups was found on 1^st day (Mean diff.= 0.44; 95%CI: 0.32-1.22, p=.251) and 3^rd day (Mean diff.= 0.71; 95%CI: 0.09-1.32, p=.224) was not different. While on 5^th day, the experimental group had a cleaner oral condition than the control group and was significantly and statistically (Mean diff.= 0.86; 95%CI: 0.29-1.43, p=.003). As a result, the experimental group did not find while in the control group, VAP was 7.89 percent.

Conclusion and recommendations  : The oral health care nursing practice guideline can prevent VAP.