Identifying the effect of an oral care protocol using different solutions on the oral health status of mechanically ventilated patients

الملخص EN

Oral health has a profound effect on general health.

Oropharyngeal colonization is associated with several systemic diseases.

Dental plaque and xerostomia are two main factors that affect oral health especially among mechanically ventilated patients.

Oral care in intensive care units is the responsibility of nurses.

There is a strong need for evidence-based oral health care programs.

Objectives : The current study was conducted to explore the effect of oral care protocol, using different solutions, on the oral health status of mechanically ventilated patients.

Design : A quasi-experimental research design was applied.

Setting: This study was conducted in the surgical intensive care unit, Emergency Hospital, Mansoura University.

Sample : Fourty mechanically ventilated patients of both sexes were included in the study.

They were randomly assigned into four equal groups, 10 patients in each, among which a different solution was used for oral care (water, normal saline, hydrogen peroxide H2O2, and sodium bicarbonate NaHCO3).

Method: A numeric gauge of patient oral health was adopted and used for each patient on admission and for seven days to assess the oral dysfunction.

Oral care protocol was developed by the researchers after reviewing the related literature, and implemented by the critical care nurses using a different solution to each group.

After that, comparison between the first and the seventh day oral health assessment was done to determine the effect of the protocol on the oral health status.

Oral mucosa cultures were carried out for gram positive and gram negative bacteria.

Results : The median oral dysfunction score (ODS) was found to lie in the area of mild to moderate oral dysfunction.

Hydrogen peroxide solution improved all items of oral health, while sodium bicarbonate improved teeth and saliva conditions only.

Age, sex, diagnosis, medical history, baseline culture of oral mucosa and drugs had a significant influence on the progress of oral health status using the four solutions.

Application of the oral care protocol did not affect significantly the results of the oral mucosa culture.

Conclusion and Recommendations: Critical care nurse should be trained in basic oral assessment.

An oral care plan appropriate to individual needs should be developed for each patient.

Factors such as age, general health, medical condition and medications, as well as, level of consciousness should be taken into account to provide oral care.

Dilute hydrogen peroxide solution can be used because it can bubble out anaerobic organisms from inaccessible areas, and remove debris and dissolve tenacious mucus.