A Survey of Oral Care Practice in Intensive Care Units of Grade 3A Hospitals in China_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Qi , XIE Huixu , HE Yao , WANG Ping , HUANG Wei , PENG Shengcheng , TANG Lijie ,  SHI Zongdao

West China College of Stomatology, Sichuan University, Chengdu 610041, China;

Corresponding author：

SHI Zongdao, Email: zhangqi198801@sina.com

Keywords：

Critical illness; Oral care; Intensive care unit; Questionnaire

DOI：

10.7507/1672-2531.20100472

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To explore the type and frequency of oral care practice in intensive care units (ICUs) in Mainland China, and to provide evidence and suggestions for improving oral care practice.
Methods 　Three survey methods, including mailing questionnaires to ICUs of Grade 3A hospitals, consulting experts in this field and visiting accessible ICUs, were used to survey current oral care practice in Mainland China.
Results 　A total of 184 questionnaires were given to the subjects, of which 79 effective ones were collected, and the response rate was 42.93%. All 79 respondents considered oral care very unimportant, and 98.7% of the ICUs performed oral care in different ways. Currently, the cotton ball wipe-off method was the most frequently used for oral care (62.5%), with an average (9.1± 5.1) min per time, twice or three times daily. The mouthwashes often used were saline (76.1%), solutions containing sodium bicarbonate (22.8%), furacilin (13.9%), and hydrogen dioxide (13.9%).
Conclusion 　The oral care practice for the critically-ill patients in ICUs of China is unsatisfactory, although it is perceived as an important item in nursing care. More evidence–based training should be given and it is necessary to establish a national oral care guideline for critically-ill patients.

Citation： ZHANG Qi,XIE Huixu,HE Yao,WANG Ping,HUANG Wei,PENG Shengcheng,TANG Lijie,SHI Zongdao. A Survey of Oral Care Practice in Intensive Care Units of Grade 3A Hospitals in China. Chinese Journal of Evidence-Based Medicine, 2010, 10(6): 665-669. doi: 10.7507/1672-2531.20100472 Copy

1.	Heo SM, Haase EM, Lesse AJ, et al. Genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation. Clin Infect Dis, 2008, 47(12): 1562-1570.
2.	Nardi G, Di Silvestre AD, De Monte A, et al. Reduction in gram-positive pneumonia and antibiotic consumption following the use of a SDD protocol including nasal and oral mupirocin. Eur J Emerg Med, 2001, 8(3): 203-204.
3.	El-Solh AA, Pietrantoni C, Bhat A, et al. Colonization of dental plaques: a reservoir of respiratory pathogens for hospital-acquired pneumonia in institutionalized elders. Chest, 2004, 126(5): 1575-1582.
4.	Fagon JY, Chastre J, Hance AJ, et al. Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am J Med, 1993, 94(3): 281-288.
5.	Apostolopoulou E, Bakakos P, Katostaras T, et al. Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens. Res Care, 2003, 48(7): 681-688.
6.	Pugin J, Auckenthaler R, Lew DP, et al. Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, double-blind clinical trial. JAMA, 1991, 265(20): 2704-2710.
7.	Loesche WJ. Association of the oral flora with important medical diseases. Curr Opin Periodontol, 1997, 4: 21-28.
8.	Goldie SJ, Kiernan-Tridle L, Torres C, et al. Fungal peritonitis in a large chronic peritoneal dialysis population: a report of 55 episodes. Am J Kidney Dis, 1996, 28(1): 86-91.
9.	Mori H, Hirasawa H, Oda S, et al. Oral Care educes incidence of Ventilator-Associated Pneumonia in ICU Populations. Intensive Care Med, 2006, 32(2): 230-236.
10.	史宗道, 余京儒, 罗勇, 等. 口腔护理作用的系统评价. 中国循证医学杂志, 2004, 4(12): 837-846, 858.
11.	陈玉霞, 李旭茹, 刘素贞, 等. ICU人工气道患者呼吸道致病菌分布的调查及护理. 热带医学杂志, 2004, 4(5): 631-632.
12.	Cook DJ, Walter SD, Cook RJ. Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med, 1998, 129(6): 433-440.
13.	谢蟪旭, 王萍, 张绮, 等. 危重疾病患者口腔护理研究进展. 中华医学杂志, 2010, 90(16): 1148-1150.
14.	de Smet AM, Kluytmans JA, Cooper BS, et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med, 2009, 360(1): 20-31.
15.	Arabi Y, Al-Shirawi N, Memish Z. Ventilator-associated pneumonia in adults in developing countries: a systematic review. Int J Infect Dis, 2008, 12(5): 505-512.
16.	杨琴. 口腔护理. 见: 尚少梅, 主编. 护理学基础. 北京: 北京大学医学出版社, 2008: 240-244.
17.	Jones H, Newton JT, Bower EJ. A survey of the oral care practices of intensive care nurses. Intensive Crit Care Nurs, 2004, 20(2): 69-76.
18.	McNeill H. Biting back at poor oral hygiene. Intensive Crit Care Nurs, 2000, 16(6): 367-372.
19.	Ross A, Crumpler J. The impact of an evidence-based practice education program on the role of oral care in the prevention of ventilator-associated pneumonia. Intensive Cri Care Nurs, 2007, 23(3): 132-136.
20.	Binkley C, Furr LA, Carrico R, et al. Survey of oral care practices in US intensive care units. Am J Infect Control, 2004, 32(3): 161-169.
21.	Pobo A, Lisboa T, Rodriguez A, et al. A Randomized Trial of Dental Brushing for Preventing Ventilator-Associated Pneumonia. Chest, 2009, 136(2): 433-439.
22.	Koeman M, van der Ven A, Hak E, et al. Oral Decontamination with Chlorhexidine Reduces the Incidence of Ventilator-associated Pneumonia. Am J Resp Cri Care Med, 2006, 173(12): 1348-1355.
23.	Tantipong H, Morkchareonpong C, Jaiyindee S, et al. Randomized Controlled Trial and Meta-analysis of Oral Decontamination with 2% Chlorhexidine Solution for the Prevention of Ventilator-Associated Pneumonia. Infect Control Hosp Epidemiol, 2008, 29(2): 131-136.
24.	Seguin P, Tanguy M, Laviolle B, et al. Effect of oropharyngeal decontamination by povidone-iodine on ventilator-associated pneumonia in patients with head trauma. Cri Care Med, 2006, 34(5): 1514-1519.
25.	Sierra R, Macor A, Agbaht K. Oral care practices in intensive care units: a survey of 59 European ICUs. Intensive Care Med, 2007, 33: 1066-1070.
26.	尹培刚, 黄勇, 吴琨, 等. 首次全国ICU现状调查分析. 中国危重病急救医学, 2002, 14(3): 166-168.

1. Heo SM, Haase EM, Lesse AJ, et al. Genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation. Clin Infect Dis, 2008, 47(12): 1562-1570.
2. Nardi G, Di Silvestre AD, De Monte A, et al. Reduction in gram-positive pneumonia and antibiotic consumption following the use of a SDD protocol including nasal and oral mupirocin. Eur J Emerg Med, 2001, 8(3): 203-204.
3. El-Solh AA, Pietrantoni C, Bhat A, et al. Colonization of dental plaques: a reservoir of respiratory pathogens for hospital-acquired pneumonia in institutionalized elders. Chest, 2004, 126(5): 1575-1582.
4. Fagon JY, Chastre J, Hance AJ, et al. Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am J Med, 1993, 94(3): 281-288.
5. Apostolopoulou E, Bakakos P, Katostaras T, et al. Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens. Res Care, 2003, 48(7): 681-688.
6. Pugin J, Auckenthaler R, Lew DP, et al. Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, double-blind clinical trial. JAMA, 1991, 265(20): 2704-2710.
7. Loesche WJ. Association of the oral flora with important medical diseases. Curr Opin Periodontol, 1997, 4: 21-28.
8. Goldie SJ, Kiernan-Tridle L, Torres C, et al. Fungal peritonitis in a large chronic peritoneal dialysis population: a report of 55 episodes. Am J Kidney Dis, 1996, 28(1): 86-91.
9. Mori H, Hirasawa H, Oda S, et al. Oral Care educes incidence of Ventilator-Associated Pneumonia in ICU Populations. Intensive Care Med, 2006, 32(2): 230-236.
10. 史宗道, 余京儒, 罗勇, 等. 口腔护理作用的系统评价. 中国循证医学杂志, 2004, 4(12): 837-846, 858.
11. 陈玉霞, 李旭茹, 刘素贞, 等. ICU人工气道患者呼吸道致病菌分布的调查及护理. 热带医学杂志, 2004, 4(5): 631-632.
12. Cook DJ, Walter SD, Cook RJ. Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med, 1998, 129(6): 433-440.
13. 谢蟪旭, 王萍, 张绮, 等. 危重疾病患者口腔护理研究进展. 中华医学杂志, 2010, 90(16): 1148-1150.
14. de Smet AM, Kluytmans JA, Cooper BS, et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med, 2009, 360(1): 20-31.
15. Arabi Y, Al-Shirawi N, Memish Z. Ventilator-associated pneumonia in adults in developing countries: a systematic review. Int J Infect Dis, 2008, 12(5): 505-512.
16. 杨琴. 口腔护理. 见: 尚少梅, 主编. 护理学基础. 北京: 北京大学医学出版社, 2008: 240-244.
17. Jones H, Newton JT, Bower EJ. A survey of the oral care practices of intensive care nurses. Intensive Crit Care Nurs, 2004, 20(2): 69-76.
18. McNeill H. Biting back at poor oral hygiene. Intensive Crit Care Nurs, 2000, 16(6): 367-372.
19. Ross A, Crumpler J. The impact of an evidence-based practice education program on the role of oral care in the prevention of ventilator-associated pneumonia. Intensive Cri Care Nurs, 2007, 23(3): 132-136.
20. Binkley C, Furr LA, Carrico R, et al. Survey of oral care practices in US intensive care units. Am J Infect Control, 2004, 32(3): 161-169.
21. Pobo A, Lisboa T, Rodriguez A, et al. A Randomized Trial of Dental Brushing for Preventing Ventilator-Associated Pneumonia. Chest, 2009, 136(2): 433-439.
22. Koeman M, van der Ven A, Hak E, et al. Oral Decontamination with Chlorhexidine Reduces the Incidence of Ventilator-associated Pneumonia. Am J Resp Cri Care Med, 2006, 173(12): 1348-1355.
23. Tantipong H, Morkchareonpong C, Jaiyindee S, et al. Randomized Controlled Trial and Meta-analysis of Oral Decontamination with 2% Chlorhexidine Solution for the Prevention of Ventilator-Associated Pneumonia. Infect Control Hosp Epidemiol, 2008, 29(2): 131-136.
24. Seguin P, Tanguy M, Laviolle B, et al. Effect of oropharyngeal decontamination by povidone-iodine on ventilator-associated pneumonia in patients with head trauma. Cri Care Med, 2006, 34(5): 1514-1519.
25. Sierra R, Macor A, Agbaht K. Oral care practices in intensive care units: a survey of 59 European ICUs. Intensive Care Med, 2007, 33: 1066-1070.
26. 尹培刚, 黄勇, 吴琨, 等. 首次全国ICU现状调查分析. 中国危重病急救医学, 2002, 14(3): 166-168.

Chinese Journal of Evidence-Based Medicine

A Survey of Oral Care Practice in Intensive Care Units of Grade 3A Hospitals in China

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content