- 會議論文
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- Ahead-of-Print
Oral hygiene care using chlorhexidine gel for neurosurgery intensive care unit patients to prevent ventilator-associated pneumonia
摘要
Title: Oral hygiene care using chlorhexidine gel for neurosurgery intensive care unit patients to prevent ventilator-associated pneumonia Background: Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in persons who have received mechanical ventilation. Oral hygiene care using chlorhexidine gel may reduce the risk of VAP in these patients. Purpose: To assess the effects of oral hygiene care using chlorhexidine gel and VAP bundle care on incidence of VAP in critically ill patients receiving mechanical ventilation in neurosurgery intensive care units. Method: Retrospective with cross-sectional design was used in this study. This study was conducted in neurosurgery intensive care unit of a medical center in Tainan, Taiwan, from January 2016 to December 2017. The VAP bundle care used for our hospital includes the following measures (1) maintaining head of bed at 30-45 degrees, (2) oral care using chlorhexidine gel twice a day, (3) daily interruption of sedatives, (4) draining of ventilator circuit, and (5) daily assessment for extubation. Result The historical average rate of VAP in 2016 was 2.2 cases/1000 ventilator-days. After the inception of the quality improvement project, VAP rates decreased to 1.3 cases/1000 ventilator-days for 2017. The use of an oral care protocol intervention and ventilator bundle (1) maintaining head of bed at 30-45 degrees implementation rate increase from 99.62% to 99.49%,(2) oral hygiene care using chlorhexidine gel twice a day implementation rate increase from 93.69% to 97.07%,(3) daily interruption of sedatives implementation rate increase from 94.09% to 96.91%,(4) draining of ventilator circuit implementation rate increase from 99.62% to 100%,(5) daily assessment for extubation implementation rate increase from 94.61% to 96.8%. VAP is a main cause of death due to nosocomial infections in the intensive care unit. Oral hygiene care, using chlorhexidine gel may reduce the risk of VAP in these patients. The effective oral hygiene care for ventilator patient not only nosocomial infection risks can be lowered but also days of hospitalization reduced, protecting patients from disease and ensuring patient safety. Our results show that implementation of ventilator bundles can reduce VAP incidence.
延伸閱讀
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