DOI QR코드

DOI QR Code

A Comparison of Different Application Times of Oral Care on Colonies of Microorganisms and Oral Health Status on Intubated Patients

기관 삽관 환자의 구강간호시간에 따른 구강 건강 상태 및 세균집락의 차이

  • 조영미 (강원대학교병원 중환자실) ;
  • 채영란 (강원대학교 의과대학 간호학과) ;
  • 엄재현 (강원관광대학교 간호과)
  • Received : 2015.01.08
  • Accepted : 2015.05.05
  • Published : 2015.05.31

Abstract

Purpose: The aim of the study was to identify effects of oral care protocol on bacterial floras of the oral cavity and oral health status of intubated patients in an intensive care unit. Methods: The participants were 60 intubated patients who were recruited from an intensive care unit of a university hospital from Dec. 28, 2010 to Mar. 25, 2011. The participants were randomly assigned into 3 groups of 20 patients according to the application time of oral care (1-minute oral care, 2-minute oral care, and 3-minute oral care groups). The numbers of bacterial flora colonies in the oral cavity was assessed before and after the oral care. Oral health status was assessed using a Korean version of the Oral Assessment Guide developed by Elier et al. originally. Results: The numbers of bacterial flora colonies were less after oral care than those before the care, but there was no significant differences among the 3 groups after the care. Oral health status was better after the oral care than it was before the care, but there was also no significant differences among the 3 groups. Conclusion: If well-trained nurses perform oral care for 1 minute using a chlorhexidine swab on intubated patients, the numbers of bacterial flora colonies will be reduced and healthy oral status will be maintained.

Keywords

References

  1. Pai H. Nosocomial infections in intensive care unit: Epidemiology and control strategy. Hanyang Medical Reviews. 2011;31(3):153-158. https://doi.org/10.7599/hmr.2011.31.3.153
  2. Cho WH. Comparison of water jet irrigation and gauze cleansing method onoral hygiene for patients in the intensive care unit [master's thesis]. Seoul: Seoul National University; 2004. p.1-59.
  3. Feider BL, Mitchell P, Bridges E. Oral care practices for orally intubated critically ill adults. American Journal of Critical Care. 2010;19(2):175-183. http://dx.doi.org/10.4037/ajcc2010816
  4. Song KJ, Yoo JS, Kyun EO, Jung EJ, Shin HJ, Park OH, et al. The effects of standardized suction and ventilator management protocol on ventilator associated pneumonia in the intensive care unit. Journal of Korean Society of Quality Assurance in Health Care. 2001;8(1):44-55.
  5. Rosenberg SW. Oral care of chemotherapy patients. Dental Clinics of North America. 1990;34(2):239-250.
  6. Binkley C, Furr A, Carrico R, McCurren C. Survey of oral health care practices in US intensive care units. American Journal of Infection Control. 2004;32(3):161-169. https://doi.org/10.1016/j.ajic.2003.05.001
  7. Hanneman SK, Gusick GM. Frequency of oral care and positioning of patients in critical care: A replication study. American Journal of Critical Care. 2005;14(5):378-387.
  8. Miller M, Kearney N. Oral care for patients with cancer: A review of the literature. Cancer Nursing. 2001;24(4):241-254. https://doi.org/10.1097/00002820-200108000-00001
  9. Choi KB, Mo HS, Kim JS. Survey of oral health care practices for intubated patients by intensive care unit nurses. Nursing Science. 2009;21(1):1-12.
  10. Grap MJ, Munro CL, Ashtiani B, Bryant S. Oral care interventions in critical care: Frequency and documentation. American Journal of Critical Care. 2003;12(2):113-119.
  11. Johns Hopkins medicine. Oral care protocol to prevent ventilator-associated pneumonia[Internet]. Maryland: Johns Hopkins University Armstrong Institute; 2013 [cited 2015 April 10]. Available from: http://insidehopkinsmedicine.org/hpo/policies.
  12. An JH, Ju HO, Kang JY. A survey on oral care among ICU nurses. Journal of Korean Critical Care Nursing. 2008;1(1):47-57.
  13. Lee EN, Joo HO, Park HS, Kim SM, Park MJ, Lee YJ, et al. Comparison of oral hygiene effects between 0.1% chlorhexidine and normal saline on the incidence of oral pathogens. The Korean Journal of Fundamentals of Nursing. 2006;13(3):351-358.
  14. Kim YJ. The effect of chlorhexidine gluconate oral care and head of bed $30^{\circ}$ elevation for ventilator-associated pneumonia incidence [master's thesis]. Daegu: Kyungpook National University; 2009. p.1-27.
  15. Park JH, Song KY. Comparison of oral care interventions on the oral status of intubated patients in intensive care units. The Korean Journal of Fundamentals of Nursing. 2010;17(3):324-333.
  16. Kang SK. The effect of oral care protocols on stomatitis in cancer patients receiving chemotherapy [master's thesis]. Jeonju: Chonbuk National University; 2002. p.1-53.
  17. Grap MJ, Munro CL, Elswick RK, Sessier CN, Ward KR. Duration of action of a single, early oral application of chlorhexidine on oral microbial flora in mechanically ventilated patients: A pilot study. Heart and Lung. 2004;33(2):83-91. http://dx.doi.org/10.1016/i.hrting 2003.12.004
  18. Eilers J, Berger AM, Petersen MC. Development, testing and application of the oral assessment guide. Oncology Nursing Forum. 1988;15(3):325-330.
  19. Jung YI. Reliability testing of an oral assessment guide for patients receiving stomatoxic treatment. The Seoul Journal of Nursing. 1996;10(1):45-51.
  20. Noh KP, Kim HK, Kim SG, Moon SY, Kim HJ. Comparative effects of different application time of povidone-iodine solution on salivary bacterial counts. Oral Biology Research. 2008;32(3):29-36.
  21. Kim DJ, Yu KH, Lim HS, Lee SK, Kim SG, Kim HK. Effect of saline irrigation used in combination with antimicrobial agents on salivary bacterial counts. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2010;36(3):202-205. https://doi.org/10.5125/jkaoms.2010.36.3.202
  22. Son WK, Shin SY, Kye SB, Yang SM. The effect of chlorhexidine on reduction of viable organisms in aerosol produced by ultrasonic scaler. Journal of Periodontal and Implant Science. 2009;39(3):303-310.
  23. Kim SY, Noh KP, Kim HK, Kim SG, Kook JK, Park SN, et al. Salivary bacterial counts after application of povidone-iodine and chlorhexidine. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2009;35(5):312-315.
  24. Martin B. Oral care for patients at risk for ventilator-associated pneumonia [Internet]. CA: American Association of Critical Care Nurses; 2010 [cited 2014 December 30]. Available from:http://www.aacn.org/wd/practice/docs/practicealerts/oral-care-patients-at-risk-vap.pdf?menu=aboutus.
  25. Cutler CJ, Davis N. Improving oral care in patients receiving mechanical ventilation. Americal Journal of Critical Care. 2005;14(5):389-394.

Cited by

  1. Effects of a Ventilator-associated Pneumonia Prevention Program on Incidence Rate and Endotracheal Colonization vol.28, pp.6, 2016, https://doi.org/10.7475/kjan.2016.28.6.628
  2. 요양병원환자에게 적용한 김치유산균 함유 동치미즙의 구강간호효과: 클로르헥시딘 용액과의 비교 vol.47, pp.4, 2017, https://doi.org/10.4040/jkan.2017.47.4.540
  3. Oral health care provided by nurses for hospitalized patients in Korea vol.17, pp.4, 2019, https://doi.org/10.1111/idh.12417