Theoretical Frameworks in - Research Paper Example

Use of Theoretical Frameworks in Research

According to Connelly (2014), a specific theory is utilized to define a problem, create an intervention, and direct a research study. The author describes a theory as a set of interconnected ideas and meanings that are developed into hypotheses or propositions to identify the association of constructs (Connelly, 2014). In this research, the theory that directs the investigation states that ‘implementation of oral care protocols prevents and reduces the prevalence of ventilaventilator-associatedtor associated pneumonia.' This theory is grounded on the proposition that enhanced oral care hygiene contributes significantly to the reduction of ventilator-associated pneumonia in adults in the ICU. The literature on oral care hygiene protocols encompasses techniques such as aventilator-associated tooth brushing and use of chlorhexidine rinse (Ignatavicius & Workman, 2015).

Use of theoretical and conceptual framework in qualitative research

As argued by Green (2014), a methodology that involves two case studies is used in qualitative research to determine the research questions that guide discussions and interviews concentrating on the research. The aim of this proposed research is to find out the most effective intervention to reduce ventilator associated pneumonia in adult ICU patients applying the oral care hygiene protocols. The theoretical framework is utilized in this research to come up with the following questions that are used to direct the deliberations and interviews that are centered on the study. The questions state 'What is the most effective intervention to reduce ventilator-associated pneumonia in adult ICU patients? Performing oral care (use of toothbrush)? Or the use of an antiseptic agent (chlorhexidine)?'

Question two

Other theories cited

In the prevention of ventilator-associated pneumonia, other theories that exist include the application of ventilator bundle care. Ventilator bundle care stops bacterial translocation and aspiration to the lower respiratory tract in ICU adults undergoing mechanical ventilation (Broaddus et al., 2015). The common theme between applthe ication of oral care hygiene protocols and ventilator bundle care is that they both prevent or reduce the incidence of ventilator assoventilator-associatedciated pneumonia in patients receiving mechanical ventilation in the ICU.

Question three

Conceptual map

TooThe tootThe toothhth brushing technique used in a patient undergoing mechanical ventilation three times a day has been shown to be operative in the prevention of ventilator asventilator-associatedsociated pneumonia. In a adadditiondiion, the use of 0.12% solution chlorhexidine oral swab twice daily is assumed to have a significant change on the reduction of ventilator-associated pneumOralonia. The oral care hygiene is critical because the risk of devventilator-associatedelode ventilator-associated elopingping ventilator assoc iated pneumonia is increasedthe  by colonization of the oropharnyoropharynxx by possible microorganisms such as gram-negative rods, Staphylococcus aureus, and Streptococcus pneumonia. Upon admission of critically ill patients in the ICU, the oral flora transforms to predominantly gram-negative florafloral that consists of virulent pathogens within 48 hours. The dental plaque creates an environment that isto conducive for pathogens rventilator-associated ventilatoresponsible for vventilator-associatedentilator associated pneumonia (Parrillo & Dellinger, 2014).

Therefore, the contamination of the oral cavity by microorganisms connected with ventilator associated pneumonia creates a need for oral care hygiene interventions to minimize the colonization of these pathogens. The tooth brushing protocol involves dividing the patient’s mouth into four sections (left lower, left upper, right upper and right lower). Each section is brushed in a distinct pattern for five strokes using a soft pediatric tooth brush and tooth paste. The tongue and the palate are also brushed. Each section is rinsed using 2.5 ml by a transfer pipette, and Yaunker suction is employed to remove excess water and saliva from the mouth during the process. The last step involves applying a moisturizing gel to all soft exteriors of the lips and oral cavity using a toothpaste swab. Likewise, chlorhexidine solution is applied in a specified pattern using an oral swab to coat evenly each palate, tooth and tongue (Perry, Potter, & Ostendorf, 2015).

Concept map for tooth brushing and application of chlorhexidine to prevent VAP

ICU adult with mechanical ventilation at risk of VAP

Colonization of the oropharnyx within 48 hrs

Gram negative rods                    Staphylococcus aureus        Streptococcus pneumonia    

Oral care hygiene protocols

Use of tooth brushing thrice a day                 Use of antiseptic agent (chlorhexidine) twice daily

Soft tooth brush             toothpaste                            0.12% chlorhexidine solution        oral swabs

Performed on four sections of the mouth,

Tongue & palate  Applied on each tooth, palate,& tongue

Rinse with 2.5ml water using a transfer pipette

Use Yaunker suction to remove excess water and saliva from the mouth

Apply a moisturizing gel to the lips and oral cavity using a toothpaste swab

Reduces and prevents the prevalence of ventilator-associated pneumonia