Implementation Of Oral Care Guidelines To Reduce Incidences Of Ventilator-Associated Pneumonia: A Systematic Review Of The Literature

Abstract

Background/Purpose: Ventilator-Associated Pneumonia (VAP) is a disease process that can arise during the use of mechanical ventilation in the critical care setting. VAP can be prevented if adequate oral care practices are followed. The purpose of this study was to investigate how the implementation of oral care guidelines impact incidence rates of VAP in the Intensive Care Unit (ICU) and to determine specific oral care practices that are useful in the prevention of this disease process. Method: A systematic review of English-language literature was conducted of articles that were published after 2009. The CINAHL Plus Full Text database was used to determine suitable articles based on specific inclusion criteria. Results: Six articles were found to be relevant and were included in this systematic literature review. This systematic review of the literature investigated specific oral care practices that are recommended to prevent VAP. The American Association of Critical-Care Nurses (AACN) has oral care recommendations in place for nurses to follow however there have yet to be recommendations in place specific to patients undergoing mechanical ventilation. Additionally, this review concluded that facility implementation of oral care guidelines is found to increase nursing adherence to these recommendations. Conclusion: Implementation of oral care guidelines is encouraged to decrease incidences of VAP in the ICU. Interventions included in these protocols provide education and direction to guide nursing care and increase nursing compliance, resulting in decreased VAP incidences in the ICU. Further research is suggested to enhance evidence based nursing practices to determine oral care guidelines that are specific to the prevention of VAP in critical care settings.