Volume 29, Issue 101 (August 2016)                   IJN 2016, 29(101): 12-22 | Back to browse issues page

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Khanjari S, Behzadi F, Haghani H. Nurses' Performance for Oral Care in Children under Mechanical Ventilation: An Observational Study. IJN 2016; 29 (101) :12-22
URL: http://ijn.iums.ac.ir/article-1-2297-en.html
Nurses' Performance for Oral Care in Children under Mechanical Ventilation: An Observational Study
S Khanjari1 , F Behzadi 2, H Haghani3
1- PhD, Nursing Care Research Center, Dept. of Pediatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2- MS. Pediatric Nursing School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. (٭Corresponding author). Tell: 09129379533 Email: fatemebehzadi4@gmail.com
3- Dept. of Biostatistics, School of Management and Information Technology, Iran University of Medical Sciences, Tehran, Iran.
Abstract:   (8214 Views)

Abstract

Background & Aim: Children under mechanical ventilation are at risk of developing pneumonia, due to the lack of cough reflex, swallowing and immobility. Many of the pneumonia preventing strategies related to ventilation are direct responsibilities of clinical nurses. The aim of the study was to evaluate the performance of nurses in the field of oral care in the children under mechanical ventilation.

Method & Materials: The research was a cross-sectional- descriptive study and 100 nurses from pediatric intensive care unit were selected by using convenience sampling, during 2015. The instruments were including the demographic characteristics form and three types of performance checklist related to oral care guideline in the children under mechanical ventilation. The performance of each nurse was observed and examined by one of the three check lists for three times in different shifts. Then the performance of nurses was classified at three levels including less than 50%, between 50% - 74.9% and also 75% and above. Statistical analysis was performed using descriptive statistics.

Results: More than half of nurses (67%) obtained below 50% of the mean performance score, 24% of them received 50% -74.9% of the mean and only 9% of them reached to 75% mean performance score. The most items related to wearing gloves (0.98) and the lowest was brushing (0%).

Conclusion: The nurse’s performance in oral care was poor, hence it is necessary to design education course for nurses, provide proper facilities of evidence-based protocols in improvement of the quality of clinical care and conduct research about the causes of poor performance in nurses.

Keywords: Performance, Nurses, Oral, Care, Children, Mechanical Ventilation
Full-Text [PDF 815 kb]   (2493 Downloads)    
Type of Study: Research | Subject: Midwifery
Received: 2016/04/27 | Accepted: 2016/08/9 | Published: 2016/08/9
References
1. Wunsch H, Linde-Zwirble WT, Angus DC, Hartman ME, Milbrandt EB, Kahn JM. The epidemiology of mechanical ventilation use in the United States. Crit Care Med. 2010;38(10):1947-53. [DOI:10.1097/CCM.0b013e3181ef4460] [PMID]
2. Seyedalshohadaee M, Rafii F, Faridian Arani F. [Evaluating the effect of mouth washing with chlorhexidine on the ventilator Associated pneumonia]. I J N. 2012;25(79):34-44.
3. Nassaji M, Mosavi S, Ghorbani R. [Incidences of nosocomial pneumonia in patients above 15 years in intensive care units of university hospital in Semnan]. Koomesh. 2004;5(1):89-94.
4. Talaie H, Sabeti S, Mahdavinejad A. [A survey on microorganisms and their sensitivity by E-Test inventilator-associated pneumonia at Toxicological-IntensiveCare Unit of Loghman-Hakim Hospital]. Acta Bio Medica Atenei Parmensis. 2011;81(3):210-6.
5. Dean JA, Avery DR, McDonald RE. Dentistry for the Child and Adolescent. Boston: Mosby. 2011.
6. Longo D, Fauci A, Kasper D, Hauser S. Harrison's Principles of Internal Medicine 18th ed: McGraw-Hill Professional; 2011.
7. A Alhazzani W, Smith O, Muscedere J, Medd J, Cook D. Toothbrushing for critically ill mechanically ventilated patients: a systematic review and meta-analysis of randomized trials evaluating ventilator-associated pneumonia. Crit Care Med. 2013;41(2):646-55. [DOI:10.1097/CCM.0b013e3182742d45] [PMID]
8. Johnstone L, Spence D, Koziol-McClain J. Oral hygiene care in the pediatric intensive care unit: practice recommendations. Pediatr Nurs. 2010;36(2):85-96. [PMID]
9. Munro CL, Grap MJ, Jones DJ, McClish DK, Sessler CN. Chlorhexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults. Am J Crit Care. 2009;18(5):428-37. [DOI:10.4037/ajcc2009792] [PMID] [PMCID]
10. Morris AC, Hay AW, Swann DG, Everingham K, McCulloch C, McNulty J, et al. Reducing ventilator-associated pneumonia in intensive care: impact of implementing a care bundle. Crit Care Med. 2011;39(10):2218-24. [DOI:10.1097/CCM.0b013e3182227d52] [PMID]
11. Grap MJ, Munro CL, Elswick R, Sessler 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 Lung: The Journal of Acute and Critical Care. 2004;33(2):83-91. [DOI:10.1016/j.hrtlng.2003.12.004] [PMID]
12. Mori H, Hirasawa H, Oda S, Shiga H, Matsuda K, Nakamura M. Oral care reduces incidence of ventilator-associated pneumonia in ICU populations. Intensive Care Med. 2006;32(2):230-6. [DOI:10.1007/s00134-005-0014-4] [PMID]
13. Ullman AJ, Letton G. Survey of Australian paediatric critical care nurses' attitudes, practice, knowledge and education surrounding oral care. Neonatal, Paediatric & Child Health Nursing. 2014;17(1):11.
14. Aeen FB, Zolfaghari M, Noghabi AAA, Mehran A. [Nurses' Performance in Prevention of Ventilator associated Pneumonia]. HAYAT. 2013;19(3):17-27.
15. Adib Hajbagari M, Ansari A. [Nurses Opinions and Practice in Mouth Care for ICU Patients Under Mechanical Ventilation].Journal Urmia Nursing And Midwifery Faculty.2012;10(4):485-93.
16. Society AT, America IDSo. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171:388-416. [DOI:10.1164/rccm.200405-644ST] [PMID]
17. Cason CL, Tyner T, Saunders S, Broome L. Nurses' implementation of guidelines for ventilator-associated pneumonia from the Centers for Disease Control and Prevention. Am J Crit Care. 2007;16(1):28-37. [PMID]
18. Jeanette Grady PCNE. Nursing Procedure: Oral Hygiene for the Highly Dependent or Critically Ill Infant or Child 2015.
19. Pedreira ML, Kusahara DM, de Carvalho WB, Nú-ez SC, Peterlini MAS. Oral care interventions and oropharyngeal colonization in children receiving mechanical ventilation. Am J Crit Care. 2009;18(4):319-28. [DOI:10.4037/ajcc2009121] [PMID]
20. Berry AM, Davidson PM. Beyond comfort: oral hygiene as a critical nursing activity in the intensive care unit. Intensive Crit Care Nurs. 2006;22(6):318-28. [DOI:10.1016/j.iccn.2006.04.003] [PMID]
21. Soh KL, Ghazali SS, Soh KG, Raman RA, Abdullah SSS, Ong SL. Oral care practice for the ventilated patients in intensive care units: a pilot survey. The Journal of Infection in Developing Countries. 2011;6(04):333-9.
22. Abidia RF. Oral care in the intensive care unit: a review. J Contemp Dent Pract. 2007;8(1):76-82. [PMID]
23. Ganz FD, Fink NF, Raanan O, Asher M, Bruttin M, Nun MB, et al. ICU Nurses' Oral‐Care Practices and the Current Best Evidence. J Nurs Scholarsh. 2009;41(2):132-8. [DOI:10.1111/j.1547-5069.2009.01264.x] [PMID]
24. Lin YS, Chang JC, Chang TH, Lou MF. Critical care nurses' knowledge, attitudes and practices of oral care for patients with oral endotracheal intubation: a questionnaire survey. J Clin Nurs. 2011;20(21‐22):3204-14. [DOI:10.1111/j.1365-2702.2011.03819.x] [PMID]
25. S Shi Z, Xie H, Wang P, Zhang Q, Wu Y, Chen E, et al. Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia. The Cochrane Library. 2013.
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