降低呼吸器相關肺炎與口腔護理執行工序－利口多潔牙霸牙刷之創新設計

Reducing Ventilator-Associated Pneumonia and Improving Oral Care-the Innovative Design of the Jie Chi-Ba Toothbrush

劉岳幗(Liou, Y.-G.) ； 劉影梅(Liou, Y.-M.) ； 周承珍(Chou, C.-C.)

《福祉科技與服務管理學刊》 9卷1期 (2021/03) Pp. 90-100

https://doi.org/10.6283/JOCSG.202103_9(1).90

摘要

牙菌斑是由口中唾液、食物和液體結合的白色黏稠物，其中包含著許多口腔微生物菌落，可能會在氣管內管及呼吸器轉移到下呼吸道，導致呼吸器相關性肺炎發生，是重症加護病房最常見的院內感染。呼吸器相關肺炎的產生會增加加護病房住院天數、死亡率及醫療成本。因此，口腔衛生會影響到氣管內管微生物，良好的口腔照護可促進病人舒適及減少口腔、氣管內管、呼吸道細菌滋生，有效降低感染的發生。由於臨床護理人員在執行口腔護理時，口腔內視野不良且程序繁瑣及耗時，耗費過多護理時數，可能縮短口腔清潔時間，導致口腔護理執行不夠嚴謹。為因應臨床照護之嚴峻需求，利口多潔牙霸牙刷設計改變了牙刷本體基本結構，刷頭處可更換刷毛及海綿，牙刷本體側邊開孔以利置入抽吸管，可進行噴灑含0.2% chlorhexidine漱口水及抽吸動作。牙刷本體後方有一套環，插入可補充漱口水之瓶罐。牙刷本體內建設有LED-405nm藍光探照燈，在清潔牙齒時，可增加照明以輔助牙菌斑檢測，大幅提升護理人員口腔清潔之成效。若能通過臨床人體試驗及衛生福利部食品藥物管理署醫療器材許可，可望證實利口多潔牙霸降低呼吸器相關性肺炎發生率的成效，提升臨床照護的品質。

關鍵字

呼吸器相關性肺炎 ； 牙刷 ； 口腔護理 ； 漱口水

並列摘要

Dental plaque is a biofilm of microorganisms that exist in the mouth. Such microorganisms may transfer from an endotracheal tube or ventilator to the lower respiratory tract, causing ventilator-associated pneumonia, the most common nosocomial infection seen in an intensive care unit. Oral mucosal health is therefore related to microorganisms found on endotracheal tubes or ventilators. Good oral care can promote a patient's comfort and reduce the growth of bacteria in the oral cavity, on endotracheal tubes, and in the respiratory tract, effectively reducing the possibility of infection. Due to the poor visual field in the oral cavity, complicated and time-consuming procedures, and excessive nursing hours, the clinical nursing staff may reduce the time and thoroughness needed to conduct good oral cleansing. To meet the critical needs of clinical care, the toothbrush design of Jie Chi-Ba changes the basic structure of the common toothbrush body. The traditional toothbrush head can be replaced with those made of bristles and sponges. A hole is opened at the side of the toothbrush body to insert a suction tube, which can spray and suck mouthwash consisting of 0.2% chlorhexidine. There is a ring at the bottom of the toothbrush shaft, where a bottle of supplement mouthwash can be inserted. An LED-405 nm blue light is also built into the toothbrush body, which can increase illumination and detect dental plaque when cleaning teeth. All of the features above can greatly improve the effectiveness of oral cleansing. If the Jie Chi-Ba toothbrush passes clinical human trials and receives approval from the Food and Drug Administration of the Ministry of Health and Welfare, it can prove its effectiveness in reducing any incidences of ventilator-associated pneumonia and improve the quality of clinical care.

並列關鍵字

ventilator-associated pneumonia ； toothbrush ； oral care ； chlorhexidine