Literature DB >> 17384927

Oral care practices in intensive care units: a survey of 59 European ICUs.

Jordi Rello1, Despoina Koulenti, Stijn Blot, Rafael Sierra, Emili Diaz, Jan J De Waele, Antonio Macor, Kemal Agbaht, Alejandro Rodriguez.   

Abstract

OBJECTIVE: To explore the type and frequency of oral care practices in European ICUs and the attitudes, beliefs, and knowledge of health care workers.
DESIGN: An anonymous questionnaire was distributed to representatives of European ICUs. Results were obtained from 59 ICUs (one questionnaire per ICU) in seven countries 91% of respondents were registered nurses. MEASUREMENTS AND
RESULTS: Of the respondents 77% reported that they had received adequate training on providing oral care; most (93%) also expressed the desire to learn more about oral care. Oral care was perceived to be high priority in mechanically ventilated patients (88%). Cleaning the oral cavity was considered difficult by 68%, and unpleasant as well as difficult by 32%. In 37% of cases respondents felt that despite their efforts oral health worsens over time in intubated patients. Oral care practices are carried out once daily (20%), twice (31%) or three times (37%). Oral care consists principally of mouth washes (88%), mostly performed with chlorhexidine (61%). Foam swabs (22%) and moisture agents (42%) are used less frequently as well as manual toothbrushes (41%) although the literature indicates that these are more effective for thorough cleaning of the oral cavity. Electric toothbrushes were never used.
CONCLUSIONS: In European ICUs oral care is considered very important. It is experienced as a task that is difficult to perform, and that does not necessarily succeed in ensuring oral health in patients with prolonged intubation. Oral care consists primarily of mouth washes. The use of toothbrushes should be given more attention.

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Year:  2007        PMID: 17384927     DOI: 10.1007/s00134-007-0605-3

Source DB:  PubMed          Journal:  Intensive Care Med        ISSN: 0342-4642            Impact factor:   17.440


  25 in total

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3.  Enterococcal intravascular catheter-related bloodstream infection: management and outcome of 61 consecutive cases.

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4.  Factors affecting quality of oral care in intensive care units.

Authors:  L Allen Furr; Catherine J Binkley; Cynthia McCurren; Ruth Carrico
Journal:  J Adv Nurs       Date:  2004-12       Impact factor: 3.187

5.  Oral care reduces incidence of ventilator-associated pneumonia in ICU populations.

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Review 6.  Preventing ventilator-associated pneumonia: an evidence-based approach of modifiable risk factors.

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7.  Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonprophylactic systemic antibiotic use in patients undergoing heart surgery.

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Review 8.  The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention.

Authors:  Nasia Safdar; Christopher J Crnich; Dennis G Maki
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9.  Prophylactic chlorhexidine oral rinse decreases ventilator-associated pneumonia in surgical ICU patients.

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  30 in total

Review 1.  Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis.

Authors:  Ee Yuee Chan; Annie Ruest; Maureen O Meade; Deborah J Cook
Journal:  BMJ       Date:  2007-03-26

2.  Improving standards of oral hygiene in intensive care.

Authors:  Matt P Wise; Jade M Cole
Journal:  Intensive Care Med       Date:  2007-10-05       Impact factor: 17.440

Review 3.  Year in review in Intensive Care Medicine, 2007. II. Haemodynamics, pneumonia, infections and sepsis, invasive and non-invasive mechanical ventilation, acute respiratory distress syndrome.

Authors:  Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Johan Groeneveld; Goran Hedenstierna; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Philipp Metnitz; Jerme Pugin; Jan Wernerman; Haibo Zhang
Journal:  Intensive Care Med       Date:  2008-01-31       Impact factor: 17.440

4.  Toothbrushing does not need to reduce the risk of VAP to be indispensable.

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5.  Effects of systematic oral care in critically ill patients: a multicenter study.

Authors:  Nancy J Ames; Pawel Sulima; Jan M Yates; Linda McCullagh; Sherri L Gollins; Karen Soeken; Gwenyth R Wallen
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6.  Understanding chlorhexidine decolonization strategies.

Authors:  Michael J Noto; Arthur P Wheeler
Journal:  Intensive Care Med       Date:  2015-06-19       Impact factor: 17.440

7.  Ventilator-associated pneumonia with or without toothbrushing: a randomized controlled trial.

Authors:  L Lorente; M Lecuona; A Jiménez; S Palmero; E Pastor; N Lafuente; M J Ramos; M L Mora; A Sierra
Journal:  Eur J Clin Microbiol Infect Dis       Date:  2012-03-16       Impact factor: 3.267

8.  Oral care and bacteremia risk in mechanically ventilated adults.

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9.  Physicians' and nurses' opinions on selective decontamination of the digestive tract and selective oropharyngeal decontamination: a survey.

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Journal:  Crit Care       Date:  2010-07-13       Impact factor: 9.097

10.  Evaluation of different methods for removing oral biofilm in patients admitted to the intensive care unit.

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Journal:  J Int Oral Health       Date:  2014-06-26
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