Oral Care of Intubated Intensive Care Patient
Condition: Pneumonia; Mechanical Ventilation Complication; Salivation; Dry Mouth
MeSH terms: Pneumonia; Xerostomia
Study type: Interventional

Summary: 
      The aim of the research was to examine the effect of oral care bundle application on oral
      health, salivary pH (power of hydrogen), dry mouth and ventilator associated pneumonia in
      intubated patients compared to standard oral care.
    

Detailed description: 
      Maintaining the integrity of the oral mucosa in intensive care unit patients is very
      important due to its close relationship with systemic health, disease risk and self-image, as
      well as comfort and nutrition. Serious problems develop in patients who have no or
      insufficient saliva movement or production, are unconscious, or have an artificial airway.
      Oral health problems, which begin with the deterioration of the saliva flow and content of
      intubated patients, lead to much more risky and costly situations that end in ventilator
      associated pneumonia. In the literature, it is seen that oral care practices performed in
      accordance with protocols increase the risk of complications and that bundle care practices
      used in different care areas increase the performance of care.In this randomized controlled
      study, people who were aged between 18 and 70, had received mechanical ventilation support,
      were intubated orally and in the first 24 hours of intubation, and had a stable hemodynamic
      status were included in the study.
    

Intervention name(s): oral care bundle; clinical oral care
Intervention type(s): Other; Other
Intervention description(s): In the first stage, oral health was evaluated and data about the patient was collected.
In the second stage, an oral care bundle containing an oral care combination was applied to the experimental group. According to this bundle application, patients were received tooth brushing (with chlorhexidine solution) and ice water application twice a day and moisturizing attempts 4 times a day.
In the 3rd stage, saliva pH, dry mouth (amount of salivation) and ventilator associated pneumonia development status of the experimental group patients were evaluated.
Measurements were made by the researcher using the Bedside Oral Exam scale, pH (power of hydrogen) strip and Schirmer Tear Test Strip.
Data regarding whether patients were diagnosed with ventilator associated pneumonia were obtained from the Infection Control Committee.; In the first stage, oral health was evaluated and data about the patient was collected.
In the second stage, routine oral care protocol used in intensive care unit was applied to patients by the patients' primary nurse. According to this application, patients were received oral care using tongue depressor with wrapped in gauze and chlorhexidine solution 4 times a day.
In the 3rd stage, saliva pH (power of hydrogen), dry mouth (amount of salivation) and ventilator associated pneumonia development status of the experimental group patients were evaluated.
Measurements were made by the researcher using the Bedside Oral Exam scale, pH (power of hydrogen) strip and Schirmer Tear Test Strip.
Data regarding whether patients were diagnosed with ventilator associated pneumonia were obtained from the Infection Control Committee.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The randomization of the study was achieved by the faculty member of the University's Faculty of Medicine, Department of Biostatistics and Medical Informatics, with the R version 3.1.3 program. First of all, the individuals included in the study were stratified according to two age groups (19-44 years and 45-70 years) in the computer environment. Then, individuals in each age group were included in the experimental and control groups in a balanced manner using the block randomization method. The randomization list was hidden from the researcher and the patient and was given to the researcher by a third party during the application. Eligibility and randomization assessment was performed by a critical care nurse independent of the study.
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: oral health; oral care; intensive care; nursing; intubation; dry mouth