Purpose of Oral Hygiene in Conjunction with Chlorhexidine

Purpose of Oral Hygiene in Conjunction with Chlorhexidine

Evidence- Based Practice Proposal

The basis for the proposal is ventilator-associated pneumonia’s (VAP) occurrence can potentially be controlled by cautious consideration to the process of oral hygiene, where routine oral hygiene versus oral hygiene in conjunction with chlorhexidine (CHX) are examined to make sure the ideal outcomes for these patients occur.

Background

A ventilator- associated pneumonia (VAP) is a critical contamination preventable by a multitude of prevention strategies aimed at the care process. Pneumonia is an infectious disease of the organs of the lungs, with the ventilator as a device that facilitates patient respirations by providing oxygen through a tube. The tube can be located in a patient’s mouth, nose, or through a hole in the front of the neck, with the tube attached to the ventilator. Therefore, a VAP is pulmonary pathogenic infectivity that cultivates in a ventilator patient (CDC, 2010).

Problem Statement

A multitude of risk factors for VAP have been recognized with one of the risk factors as the colonization of the oral cavity by probable pathogens. After 2 days of entering the intensive care unit (ICU), seriously ill patient’s oral flora changes to mainly gram-negative inhabitants including more powerful organisms. Dental plaque offers an environment for microbes at fault for VAP, and probable pulmonary pathogens can colonize this plaque specifically of patients in the ICU (Munro et al., 2009). For the most part, there exist 2 approaches of intervention to eradicate the microbes on the dental plaque in critically ill patients: mechanical intervention and direct pharmacological. Even though mechanical elimination may be a successful approach for removal of oral pathogens, oral hygiene is deemed standard nursing care, often uncared for in critically ill patients or is performed by rapidly swabbing the patient’s oral cavity (Pedreira et al., 2009).

Significance of Problem

VAP is preventable with oral hygiene as one of the multitude of vital prevention strategies for VAP. VAP is significant because 15 % of all infectivity borne at the hospital and nearly 1/3 of all infectivity obtained in the ICU is VAP. Institutional fatality of VAP in ventilated patients is 46% measured up to 32% for ventilated patients who do not contract VAP. VAP extends ICU and hospital stay, totaling an extra $40,000 to the admission. VAP is the principal source of mortality of hospital associated infections (Pyrek, 2010).

Target Population, Target Setting, Clinical Question, Objective

The target population is the dependent adult oral care ventilator population susceptible to VAP.