TY - JOUR
T1 - Removal of oral secretion prior to position change can reduce the incidence of ventilator-associated pneumonia for adult ICU patients
T2 - A clinical controlled trial study
AU - Chao, Yann Fen C
AU - Chen, Yin Yin
AU - Wang, Kai Wei Katherine
AU - Lee, Ru Pin
AU - Tsai, Hweifar
PY - 2009/1
Y1 - 2009/1
N2 - Aim. The purpose of this study was to explore the effect of oral secretion on aspiration and reducing ventilator-associated pneumonia. Background. Ventilator-associated pneumonia is a serious hospital-acquired infection with reported incidence rate of 12·2% and mortality rate of 29·3%. Oral secretion is purported as a media which brings the oropharyngeal pathogens down to the respiratory track. Methods. Two-group comparison study design was adopted. Subjects were recruited from an adult general intensive care unit of a medical centre in Taipei city. Patients in the study group received suction of oral secretion before each positional care, in contrast with patients in the control group who received routine care. Results. Ventilator-associated pneumonia was found in 24 of 159 (15·1%) patients in the control group and in five of 102 (4·9%) patients in the study group with a reduction of risk ratio of 0·32 (95% CI 0·11-0·92). Eight of the 24 ventilator-associated pneumonia patients died in the control group; however, none of those ventilator-associated pneumonia patients died in the study group. The increased chance of survival was 1·50 (95% CI 1·13- 1·99). The length of stay in ICU and duration of mechanical ventilation were reduced in the study group. In consideration of cost, the cost of tubes used to remove oral secretion is much less than the one used to do continuous subglottal suction. Conclusion. Removal of oral secretion is effective in reducing the incidence of ventilator-associated pneumonia with minimum cost intervention. Relevance to Clinical Practice. This study provides evidence that removal of oral secretion prior to position change is cost effective to reduce the incidence of ventilator-associated pneumonia. As such intervention is an easy task, routine removal of oral secretion is recommended as the standard of daily nursing care of patients on ventilator.
AB - Aim. The purpose of this study was to explore the effect of oral secretion on aspiration and reducing ventilator-associated pneumonia. Background. Ventilator-associated pneumonia is a serious hospital-acquired infection with reported incidence rate of 12·2% and mortality rate of 29·3%. Oral secretion is purported as a media which brings the oropharyngeal pathogens down to the respiratory track. Methods. Two-group comparison study design was adopted. Subjects were recruited from an adult general intensive care unit of a medical centre in Taipei city. Patients in the study group received suction of oral secretion before each positional care, in contrast with patients in the control group who received routine care. Results. Ventilator-associated pneumonia was found in 24 of 159 (15·1%) patients in the control group and in five of 102 (4·9%) patients in the study group with a reduction of risk ratio of 0·32 (95% CI 0·11-0·92). Eight of the 24 ventilator-associated pneumonia patients died in the control group; however, none of those ventilator-associated pneumonia patients died in the study group. The increased chance of survival was 1·50 (95% CI 1·13- 1·99). The length of stay in ICU and duration of mechanical ventilation were reduced in the study group. In consideration of cost, the cost of tubes used to remove oral secretion is much less than the one used to do continuous subglottal suction. Conclusion. Removal of oral secretion is effective in reducing the incidence of ventilator-associated pneumonia with minimum cost intervention. Relevance to Clinical Practice. This study provides evidence that removal of oral secretion prior to position change is cost effective to reduce the incidence of ventilator-associated pneumonia. As such intervention is an easy task, routine removal of oral secretion is recommended as the standard of daily nursing care of patients on ventilator.
KW - Aspiration secretion
KW - Intensive care unit
KW - Nurses
KW - Nursing
KW - Ventilator-associated pneumonia
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U2 - 10.1111/j.1365-2702.2007.02193.x
DO - 10.1111/j.1365-2702.2007.02193.x
M3 - Article
C2 - 19120729
AN - SCOPUS:57649236211
SN - 0962-1067
VL - 18
SP - 22
EP - 28
JO - Journal of Clinical Nursing
JF - Journal of Clinical Nursing
IS - 1
ER -