Contact Us
Sign In / Sign Up for FREE
Go to advanced search...

Strategies to enchance oral hygiene of the ventilated adult critically ill patient - Research Proposal Example

Comments (0) Cite this document
Strategies to Enhance Oral Hygiene of the Ventilated Adult Critically Ill Patient Name: Institution: STRATEGIES TO ENHANCE ORAL HYGIENE OF THE VENTILATED ADULT CRITICALLY ILL PATIENT Introduction For patients who are critically ill, particularly those requiring endo-tracheal intubation, they carry the greatest risk of all hospitalized patients in the acquisition of nosocomial pneumonia…
Download full paperFile format: .doc, available for editing
GRAB THE BEST PAPER97.5% of users find it useful
Strategies to enchance oral hygiene of the ventilated adult critically ill patient
Read TextPreview

Extract of sample "Strategies to enchance oral hygiene of the ventilated adult critically ill patient"

Strategies to Enhance Oral Hygiene of the Ventilated Adult Critically Ill Patient STRATEGIES TO ENHANCE ORAL HYGIENE OF THE VENTILATED ADULT CRITICALLY ILL PATIENT Introduction For patients who are critically ill, particularly those requiring endo-tracheal intubation, they carry the greatest risk of all hospitalized patients in the acquisition of nosocomial pneumonia. This form of pneumonia for critically ill patients produces an elevation in the rate of morbidity and mortality (Berry et al, 2009: p555). The causative pathway of nosocomial pneumonia oropharyngeal is the pathogen aspiration present in the dental plaque. Dental plaque build up has been increasingly associated with nosocomial respiratory infections. Therefore, the prevention of colonization of pathogens in the oropharyngeal cavity acts as an effective control measure for infection (Pruitt & Jacobs, 2011: p38). Oral care, for critically ill patients, is often an undervalued practice for intensive care health settings. However, a significant collection of evidence that associations the colonization by pathogens of the oropharyngeal cavity and dental plaque with VAP, or ventilator-associated pneumonia exists. In addition, provision of oral care for critically ill patients on a fixed basis is a vital part of giving comfort for patients in critical care (Judith et al, 2012: p125). The optimization of oral health care for patients who are intubated is made difficult because of the presence of orogastric tube and endo-tracheal tubes. Once dental plaque reaches its critical thickness, it serves as a reservoir for anaerobic and aerobic pathogens. If this plaque is not removed, it sets off a complex cascade of biological activity through which pathogens fix them to tooth and mucosal surfaces and what ensues is overgrowth of pathogens (Munro, 2010: p28). In addition, insufficient or neglected oral care acts as the foremost predisposing factor for stomatitis, mucositis, gingivitis, and other oral conditions that supply pathogens with extra entry points. Just a handful of research studies compare the frequency and mode of oral hygiene that is needed to decrease or prevent oropharyngeal colonization (Coyer et al, 2011: p75). Comprehending the relationship that exists between the two will aid in coming up with strategies to prevent the above. This paper will discuss the various strategies, which healthcare professionals could use to ensure the maintenance of oral hygiene for critically ill patients who are prone to oropharyngeal colonization and infections. Background Dental plaque refers to a dynamic bio-film that could be defined in clinical terms as deposits of bacteria that are difficult to rinse off (Hixson et al, 2008: p49). Dental plaque harbors numerous different species of microbes with a one-mm3 plaque volume that contains approximately one hundred million bacteria. In patients who are critically ill and are mechanically ventilated, their mouths are propped open using endo-tracheal tubes that expose the oral cavity, in turn increasing the susceptibility of the oral cavity to desiccation (Cutler & Davis, 2010: p390). Oral intubation, in addition, acts to reduce the role of saliva in cleansing the mouth and impedes nursing staff in the provision of oral hygiene. The patient is also likely to suffer from; impaired cough reflexes, as well as the inability to clear out accumulated secretions. Because of a combination of the problems stated, intensivitis are gaining more awareness on the important role played by dental plaque in the etiology of VAP, or ventilator-associated pneumonia (Grap et al, 2010: p114). Ventilator Associated pneumonia is a hospital acquired pneumonia, which is defined as parenchymal infection of the lungs occurring in people who are intubated and ventilated mechanically for over 48 hours (Davidson & Berry, 2010: p320). This condition is associated with increased mortality, morbidity, increased cost, and long length of stay in the hospital and the ICU. In view of these clinical costs and major adverse effects associated with the management of ventilator-associated pneumonia, coming up with strategies that reduce or prevent its prevalence is appropriate. Documentation of the status of health care has principally focused on the recording of filled, missing, or decayed teeth, as well plaque scoring. The periodontal health, to date, of patients who are intubated has been continuously ignored (Dodek et al, 2012: p440). However, it is essential to study it further because periodontal disease presents as a bacterial disease that is predominantly caused by Gram-negative anaerobic bacteria. Similarly, ventilator associated pneumonia has led to various intensivists to suggest that the process of colonization by periodontal pathogens by endo-tracheal acts as a precursor to ventilator associated pneumonia development. It has also been suggested that the presentation of periodontal disease may lead to systemic endothelial dysfunction, as well as the impairment of glucose control. These two are very important in the management of critical illness. However, the exact link between systemic disease and periodontal disease is still a cause of major debate among clinical practitioners (Dodek et al, 2012: p443). Problem Statement 1. The overarching question for the research study will be: What are the effective clinical practices in the maintenance of oral health for patients who are critically ill? 2. In addition, the specific questions in the study will be: a) What are the consequences of inadequate healthcare in patients who are critically ill? b) What strategies of assessment are effective in the provision of optimal oral care? c) What are the effective solutions in optimal oral care provision? References Berry, Angela. Davidson, Patricia. Masters, Janet. & Rolls, Kaye. (2009). Systematic Literature Review of Oral Hygiene Practices for Intensive Care Patients Receiving Mechanical Ventilation. AmericanJournal of Critical-Care , 552-562. Judith, Jacobi. Fraser, Gills. Coursin, Douglas. & Lumb, Phillip. (2012). Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Critical Care Medicine , 119-141. Coyer, Fiona. Wheeler, M. Wetzig, Susan. & Couchman, Bronwyn. (2011). Nursing care of the mechanically ventilated patient: What does the evidence say? Intensive and Critical Care Nursing , 71-80. Cutler, Constance. & Davis, Nancy. (2010). Improving Oral Care in Patients Receiving Mechanical Ventilation. American Journaln of Critical-Care , 389-394. Davidson, Patricia. & Berry, Angela. (2010). Canadian clinical practiBeyond comfort: Oral hygiene as a critical nursing activity in the intensive care unit. Intensive and Critical Care Nursing , 318-328. Dodek, Peter. Keenan, Sean. Cook, Deborah. Heyland, Daren. & Brun-Buisson, Christian (2012). Evidence-Based Clinical Practice Guideline for the Prevention of Ventilator-Associated Pneumonia. Ann Intern Med , 439-445. Grap, Mary. Munro, Cindy. & Ashtiani, Brooke. (2010). Oral Care Interventions in Critical Care: Frequency and Documentation. American Journaln of Critical-Care , 113-118 . Hixson, Shelby. Lou-Sole, Mary. & King, Tracey. (2008). Nursing Strategies to Prevent Ventilator-Associated Pneumonia. Advanced Practice in Acute & Critical Care , 45-55. Munro, Cindy. (2010). Oral Health and Care in the Intensive Care Unit: State of the Science. American Journaln of Critical-Care , 25-34. Pruitt, Bill. & Jacobs, Michael. (2011). Best-practice interventions: How can you prevent ventilator-associated pneumonia? Nursing , 36-41. Read More
Cite this document
  • APA
  • MLA
(“Strategies to enchance oral hygiene of the ventilated adult critically Research Proposal”, n.d.)
Retrieved de
(Strategies to Enchance Oral Hygiene of the Ventilated Adult Critically Research Proposal)
“Strategies to Enchance Oral Hygiene of the Ventilated Adult Critically Research Proposal”, n.d.
  • Cited: 0 times
Comments (0)
Click to create a comment or rate a document

CHECK THESE SAMPLES OF Strategies to enchance oral hygiene of the ventilated adult critically ill patient

A reflection on the care of a critically ill patient of surgery and the attainment of a desired body balance. Sedation Although still used, sedation was seen to be well controlled and administered in minimum quantities due to concerns of side effects that might result. Sedation is done under sophisticated mechanical ventilators to permit the comfort of the patient as well as increase their awareness, and also enhance coughing. Sedation drugs that were administered to the patient include midazolam and Fentanyl. The dosage was constantly reduced over time to minimize side effects from affecting the patient further (Rello 2012). Conclusion It is recognized world over that the mortality rate of...
16 Pages(4000 words)Essay

Nursing acutely ill patient

...? Nursing Acutely ill patient Health s and health providers should always ensure that strategies are in the right place in order to manage the patients who are in bad shape or those who are recovering from a critical illness. The best strategy to employ is to empower the practitioners caring for the patients with the recommended knowledge, competence, and skills in order to recognize and effectively manage them. Acute illness courses offer most healthcare practitioners with various experiences that assist in promoting opportunities for the learning students to improve their skills and knowledge in caring for the vulnerable patients. This work is mainly going to discuss the management of patients admitted in Accident and Emergency... . 6The...
14 Pages(3500 words)Essay

Care of the Ill Adult

...Care for the ill Adult Introduction. Holistic nursing involves the health care practise that focuses on healing the body. It entails the identification of a patient’s health care needs, which can be either actual or potential (Amato, 2006). It is worth noting that providing a holistic assessment to the patient during admission to the ward is one of the fundamental requirements of nursing. This is because, through holistic nursing, it becomes possible to ensure that unity of the body, mind, spirit, emotion, and the environment becomes guaranteed. This implies that nurses, who strive to offer holistic assessment, need to consider all the needs of every...
14 Pages(3500 words)Essay


.... Final searches tools were investigated by selecting keywords and MESH terminology, adult ventilated patients, oral care, and oral hygiene, orally intubated, nasally intubated, tracheal tube, critically ill patients, and ventilator bundles. The last keywords were eliminated due to additional care instructions that were not part of the initial PICO question and addressed additional plans of care for a patient intubated. Additional journals searched were investigated by adjusting the keywords: Chlorhexidine, tooth brush, and...
23 Pages(5750 words)Essay

Treatment of Adult Mentally Ill Offenders

...Treatment of Adult Mentally Ill Offenders Abstract This paper critically analyzes the treatment of adult mentally ill offenders in the U.S. “The New Asylums”, is a movie that shows the lives of inmates who are mentally ill in the prisons, and have been locked up for one reason or another. It further assesses the pain and trauma that these inmates go through everyday in their prison life. Introduction The United States is considered to be one of the countries in the world that has been rated with the highest number of prisoners suffering from mental illnesses such as depression and bipolar disorders,...
7 Pages(1750 words)Research Paper

EvaluatIon/critique a piece of research in relation to caring for an acutely ill adult patient

...on research quality and appropriateness. It is within this context that this paper will endeavor to critique, critically, the article by Siobhan Warne et al.:Non-therapeutic omission of medications in acutely ill patients. Critique The article adheres to the conventional structure of a research article. According to Beauchamp, specification in research is unavoidable (BEAUCHAMP & CHILDRESS 2001). This might be hinged on the effectiveness of the research. This article is in line with this assertion as it has incorporated research specification in the article. As such, the critique will analyze the complete structure of this article coupled with its content. This entails a...
8 Pages(2000 words)Essay

Dental Hygiene - Oral Health on Special Needs Patients

...defects, gum disease, less teeth, tooth decay, and oral sores (World Health Organization, 2013). This study particularly focuses on special needs patients and how their conditions affect their day-to-day routines, and how he people taking care of them ensure they have all their necessities. It will also go into depth of how difficult it is for them to obtain and maintain good oral health, and suggest the potential strategies that can apply in enhancing and maintaining their good oral health. According to Gluck & Morganstein (2003), the United States has an estimated 53 million physically or mentally impaired people. One of the major problems that special...
8 Pages(2000 words)Research Paper

The decision to terminally wean a critically ill patient

...Nursing Running head: THE DECISION TO TERMINALLY WEAN A CRITICALLY ILL PATIENT The decision to terminally wean a critically ill patient Please write your name here Write the place of employment or academic institution here Abstract The involvement of the medical staff in the decision to wean a terminally ill patient, as well as assisting the family of the deceased with the emotional burden is evident. We view the involvement of the nurse, as a part of the medical personnel, in the decision to terminate the patient, as well as the emotional assistance provided to the family...
5 Pages(1250 words)Article

Oral hygiene

...information on oral care for the intensive care unit and seriously ill patient other than in the geriatric, cancer and diabetic related studies. Currently, the National Institutes of Health Clinical Center is sponsoring a study on Oral Care to Reduce Mouth and Throat Infections in Critically Ill Patients (ClinicalTrials 2005). Their research uses phase three longitudinal studies of one-thousand to three-thousand patients in intensive care units to evaluate a program of oral hygiene that may prevent respiratory infections in patients, which "occur five...
20 Pages(5000 words)Essay

Care of the Adult Patient

...Tindall Elsevier. p. 74. Jevon, P. and Ewens, B. (2012). Monitoring the Critically Ill Patient. WEst Sussex: Blackwell Publishing Ltd. Kralik, R., Trnovsky, P. and Kopacova, M. (2013). Transabdominal Ultrasonography of the Small Bowel. Gastroenterology Research and Practice, Mason, R. (2001). Anaesthesia Databook: A Perioperative and Peripartum Manual. 3rd Edition. London: Greenwich Medical Media Ltd. p. 130. Misra, R. (2007). Ian Donalds Practical Obstetric Problem. 6th Edition. New Delhi: B.I. Publications Pvt. Ltd. p. 581. NHS. (2014). Discharge Planning. [Online] Available...
12 Pages(3000 words)Assignment
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.

Let us find you another Research Proposal on topic Strategies to enchance oral hygiene of the ventilated adult critically ill patient for FREE!

Contact Us