Impact of an Educational Intervention Aimed at Nursing Staff on Oral Hygiene Care on the Incidence of Ventilator-Associated Pneumonia in Adults Ventilated in Intensive Care Unit
DOI:
https://doi.org/10.17533/udea.iee.v39n3e06Keywords:
pneumonia, ventilator-associated, health education, dental, oral hygiene, intensive care units, nursing staffAbstract
Objective. This work sought to evaluate the impact of an educational intervention on oral hygiene care aimed at nursing care staff, on the incidence of Ventilator-Associated Pneumonia (VAP) in adults from an ICU in Colombia.
Methods. Quasi-experimental study pre- and post-educational intervention aimed at nursing staff in which theoretical-practical sessions were conducted during 12 weeks to explain different oral hygiene techniques according to the oral conditions of patients. The study gathered sociodemographic, clinical, and characteristic variables of the oral and dental care received. The VAP was diagnosed according with international criteria.
Results. The educational intervention received participation from 60 individuals (40 nurses and 20 nursing aides), 80% were women. The work collected data from 171 patients, 70 (40.9%) cared for after the educational intervention. Daily oral and dental care by the staff increased from 29.6% to 92.8% after the intervention. Although the accumulated incidence of VAP diminished from 8.9% to 2.8% and the rate of incidence dropped from 9 to 3.5 cases per 1000 days of intubation, these changes were not statistically significant.
Conclusion. The educational intervention aimed at the nursing staff in oral care reduced the incidence of VAP in adults connected to ventilator in ICU; although this decrease was not statistically significant, it was a clinically relevant result for the institution, which is why it is necessary to continue the educational strategies on oral health studied in this staff.
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1. Rosenthal VD, Maki DG, Mehta Y, Leblebicioglu H, Memish ZA, Al-Mousa HH, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module. Am. J. Infect. Control. 2014; 42(9):942–56.
2. Maldonado E, Fuentes I, Riquelme M, Sáez M, Villarroel E. Documento de Consenso: Prevención de Neumonía Asociada a Ventilación Mecánica del Adulto. Rev. Chil. Med. Intensiva. 2018 ;33(1):15–28.
3. Instituto Nacional de Salud. Protocolos de vigilancia y control [Internet]. 2018 [cited 8 Aug. 2021]. Available from: http://www.ins.gov.co/buscador-eventos/Paginas/Fichas-y-Protocolos.aspx
4. Varón-Vega FA, Hernández-Parra Á, Molina F, Poveda CM, Mezad RA, Castro H, et al. Traqueobronquitis y neumonía asociadas a ventilación mecánica en unidades de cuidado intensivo de Latinoamérica: epidemiología, curso clínico y desenlaces (estudio LATINAVE). Infectio. 2016 ;21(2):74–80. Available from: http://www.revistainfectio.org/index.php/infectio/article/view/650
5. Sierra RE, Bordelois Abdo MS, Díaz Trujillo E, Estevan Soto JA, González Hechavarria JA. Characterization of maternal morbidity and mortality in the intensive care unit. Rev. Inf. Científica. 2018; 97(4):722–31.
6. Rodríguez-Álvarez L, Lamos-Duarte A. Prevalencia y factores de riesgo de neumonía asociada a la ventilación mecánica en una unidad de cuidados intensivos adultos, Cúcuta, Colombia. Rev. Investig. Salud Univ. Boyacá. 2017; 4(2):248–66.
7. Organización Mundial de la Salud. Carga mundial de infecciones asociadas a la atención sanitaria [Internet]. 2013 [cited 2021 May 5]. Available from: https://www.who.int/gpsc/country_work/burden_hcai/es/
8. Hua F, Xie H, Hv W, Furness S, Zhang Q, Li C. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia (Review). Cochrane Libr. 2016; 10(10):CD008367.
9. Jansson MM, Syrjälä HP, Talman K, Meriläinen MH, Ala-Kokko TI. Critical care nurses’ knowledge of, adherence to, and barriers toward institution-specific ventilator bundle. Am. J. Infect. Control. 2018;46(9):1051–6.
10. Gatti-Petito J, Lakatos BE, Bradley HB, Cook L, Haight IE, Karl CA. Clinical scholarship and adult learning theory: A role for the DNP in nursing education. Nurs Educ Perspect. 2013;34(4):273–6.
11. American Thoracic Society. Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia. Am. J. Respir. Crit. Care Med. 2005; 171:388–416.
12. Alí-Munive A, Ortiz-Ruíz G, Dueñas-Castell C. Consenso colombiano de neumonia nosocomial 2013. Infectio. 2013; 17(1):6–18.
13. Barahona N, Rodríguez M, De Moya Y. Importancia de la vigilancia epidemiológica en el control de las infecciones asociadas a la atención en salud. Biociencias. 2019; 14(1):79–96.
14. Richardson DB, Kinlaw AC, MacLehose RF, Cole SR. Standardized binomial models for risk or prevalence ratios and differences. Int. J. Epidemiol. 2015 ;44(5):1660–72.
15. Jaimes F, De La Rosa G, Gómez E, Múnera P, Ramírez J, Castrillón S. Incidence and risk factors for ventilator-associated pneumonia in a developing country: Where is the difference? Respir. Med. 2007; 101(4):762–7.
16. Fang WF, Fang YT, Huang CH, Chen YM, Chang YC, Lin CY, et al. Risk factors and associated outcomes of ventilator-associated events developed in 28 days among sepsis patients admitted to intensive care unit. Sci. Rep. 2020; 10(1):1–10.
17. Jarvis WR, Edwards JR, Culver DH, Hughes JM, Horan T, Emori TG, et al. Nosocomial infection rates in adult and pediatric intensive care units in the United States. Am. J. Med. 1991; 91(3B):185S-191S.
18. Álvarez-Lerma F, Palomar M, Olaechea P, Otal J, Insausti J, Cerdá E. Estudio Nacional de Vigilancia de Infección Nosocomial en Unidades de Cuidados Intensivos: Informe evolutivo de los años 2003-2005. Med. Intensiva. 2007; 31(1):6–17.
19. Elias-Sierra R, Elias-Armas KS, Pérez-Capdevila J, Vargas-Alonso R. Factores relacionados con la mortalidad por neumonía asociada a la ventilación mecánica en adultos mayores. Rev. Electrónica Dr. Zoilo E Mar Vidaurreta. 2018; 43(5). Available from: http://revzoilomarinello.sld.cu/index.php/zmv/article/view/1492/pdf_518
20. Ortiz G, Fonseca N, Molina F, Garay M, Lara A, Dueñas C, et al. Epidemiología de la neumonía asociada a ventilador en 39 unidades de cuidados intensivos de Colombia (2007-2009). Informe año 2010. Acta Colomb. Cuid. Intens. 2011; 11(1):12–9.
21. Shieh G. Sample size calculations for logistic and Poisson regression models. Biometrika. 2001; 88(4):1193–9.
22. Hairani Damanik SR, Utami GT, Nurcahyati S. Organ failure of patients using ventilator based on the sequence organ failure assessment score (SOFA) admitted in Intensive Care Unit. Enferm. Clin. 2019; 29:5–8.
23. Younan D, Delozier SJ, Adamski J, Loudon A, Violette A, Ustin J, et al. Factors Predictive of Ventilator-associated Pneumonia in Critically Ill Trauma Patients. World J. Surg. 2020; 44(4):1121–5.
24. Subramanian P, Choy KL, Gobal SV, Mansor M, Ng KH. Impact of education on ventilator-associated pneumonia in the intensive care unit. Singapore Med. J. 2013; 54(5):281–4.
25. Booker S, Murff S, Kitko L, Jablonski R. Mouth Care to Reduce Ventilator-Associated Pneumonia. Am. J. Nurs. 2013; 113(10):24–30.
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