The Effects of Oral Care Protocol on the Incidence of Ventilation-Associated Pneumonia in Selected Intensive Care Units in Jordan

Specialized nursing intervention on critically ill patient in the prevention of intubation-associated pneumonia: an integrative literature review

Healthcare-associated infections are adverse events that affect people in critical condition, especially when hospitalized in an intensive care unit. The most prevalent is intubation-associated pneumonia (IAP), a nursing-care-sensitive area. This review aims to identify and analyze nursing interventions for preventing IAP. An integrative literature review was done using the Medline, CINAHL, Scopus and PubMed databases. After checking the eligibility of the studies and using Rayyan software, ten final documents were obtained for extraction and analysis. The results obtained suggest that the nursing interventions identified for the prevention of IAP are elevating the headboard to 30º; washing the teeth, mouth and mucous membranes with a toothbrush and then instilling chlorohexidine 0.12%-0.2% every 8/8 hr; monitoring the cuff pressure of the endotracheal tube (ETT) between 20-30 mm Hg; daily assessment of the need for sedation and ventilatory weaning and the use of ETT with drainage of subglottic secretions. The multimodal nursing interventions identified enable health gains to be made in preventing or reducing IAP. This area is sensitive to nursing care, positively impacting the patient, family, and organizations. Future research is suggested into the effectiveness of chlorohexidine compared to other oral hygiene products, as well as studies into the mortality rate associated with IAP, with and without ETT for subglottic aspiration.

Volume-based subglottic secretion drainage: a randomized controlled trial

Background

This study proposed to explore individual management mode for patients with subglottic secretion drainage.

Methods

Randomly chosen within the hospital ICU 68 patients from 7 April to 15 June 2023, all the patients randomly assigned to the control group or observation group, and control group adopts the model of intermittent drainage management, observation group based on the volume of subglottic secretion in patients with individualized management, and then analysis the two groups of patients clinical trial results.

Results

The clinical trial results showed that there were statistically significant differences (P<0.05) between the control group and the observation group in the incidence of tube blockage events (11 vs. 2), average diurnal pumping frequency (9 vs. 7, 5 vs. 4) between the two groups and the patient satisfaction scores (6 vs. 7), In the partial mucosa injure (22 vs 19) and VAP (5 vs. 1) there were no statistically significant difference (P>0.05). Although there was no statistically significant difference (P>0.05) in the average aspiration volume (12.68±3.41 vs. 12.19±2.68, 8 vs. 8) between the two groups, but the management mode of the observation group indicated that based on patient secretion volume was more consistent with the characteristics of the body's diurnal metabolic differences, because there was a big difference between the average total amount of daytime and nighttime suction between the two groups.

Conclusion

Individualized management based on the volume of subglottic secretions produced by patients can further optimize the airway management of patients and reduce the risk of adverse events of subglottic secretions aspiration.

Clinical application and evaluation of a new type of tracheal catheter fixation belt

AIM

To evaluate a new fixation band for tracheal catheter in intensive care unit.

DESIGN

A cross-sectional study.

METHODS

A total of 90 patients admitted to the ICU between August 2018-February 2019 were enrolled in the study. Patients were randomly divided into experimental group and control group (N = 45/per each group). 3 M strong adhesive tape and a new tracheal catheter fixation band were applied to patients in two groups, respectively. The fixation effect, incidence of mucosal pressure injury and nursing cost were evaluated.

RESULTS

Forty-three patients from the experimental group and 42 patients from the control group participated in this study. Mild, moderate and severe catheter dislocation happened in 2, 0, 0 cases in the experimental group, and 6, 3 and 2 cases in the control group, respectively; the difference was statistically significant. The rates of mucosal pressure injury were 4.7% and 21.4%, which was significantly different, and the experiment group had a lower average daily nursing cost related to tracheal intubation.

CONCLUSIONS

The new tracheal catheter fixation band, which allows for accurate fixation, is simple to operate, may reduce the incidence of mucosal pressure injury, decrease the nursing cost and improve the patients' comfort in clinical practice.