WGU EBT Task 1  - Highly Rated Work

 

A.1. Topic of interest is the effects of oral care on patients with ventilator associated pneumonia.

 

A.2.

Article

Garcia, R., Jendresky, L., Colbert, L., Bailey, A., Zaman, M., & Majumber, M.  (2009). Reducing ventilator-associated pneumonia through advanced oral-dental care: A 48- month study. American journal of critical care, 18(6), 523-534.

Background Information

The purpose statement of this study was to establish the effect of implementing an inclusive oral and dental care system and protocol on the rate of ventilator associated pneumonia.

The problem with ventilator associated pneumonia not only at a 20% rate, but can cause mortality and monetary impact on this issue can range up to $150,000 per case.

The issue that is described in this study makes perfect sense to me as I used to be an ICU nurse and knows how detrimental ventilator associated pneumonia can be on a patient. The study did have an abstract and was structured.  

Review of Literature

The authors were very up to date on their information. They were thorough and explained not only the problem, but the task at hand and the results in plain language.

Methodology

The methodology was quantitative in nature. The study clearly described the effect of oral and dental care on patients receiving mechanical ventilation. A group of 779 patients were studied before interventions were given. This particular group received no oral care which included suctioning, tooth brushing and removal of secretions from the oral cavity. A group of 759 patients were studied during the intervention as they were given a strict protocol of oral cleansing, tooth brushing and suctioning every 4-6 hours.

Data Analysis

There were 4 distinct characteristics of both test groups that were involved in this study. These characteristics were: age, sex of patients, APACHE scores and reason for ICU admissions. Since the focus was on measuring the effectiveness or oral-dental protocol over a constant period, the length of study was utilized in this particular study design. This design was utilized instead of using the target number of patients because the goal was to detect a 15% difference in the occurrence rate of ventilator associated pneumonia between the two groups.

Conclusion

The conclusion of this particular study was that patients experienced shorter length of stays in the ICU and the mortality rate decreased.

 

A.3.

The research obtained in this particular study does support the conclusion. When all five area’s were studied, it verified that the incidence of ventilated associated pneumonia was decreased when oral care and dental care was performed onto these mechanically ventilated patients. The background information that was provided was direct, to the point and relevant to the impact of today’s heath care. Millions of dollars are being spent every year for incidences within hospitals that can be prevented and this study was set out to prove just that, that ventilator associated pneumonia can be prevented.  The logic was simple. That logic was to clear the mouth and airway of any harboring microorganisms that can pool in the mouth and result into an infection. The test groups were relevantly the same size and the characteristics of age, sex, APACHE scores and reasons for admissions were comparable. The conclusion was predictable in verifying that strict oral cleaning did result in a lower incidence of ventilator associated pneumonia in patients.

A.4.

During the course of this research, ethics would be addressed. Before the study had begun, the Infection Control Department had meetings with nurses and doctors of the ICU, nurse educators, anesthesiologists, emergency room staff, Materials Management and the performance improvements departments to discuss and explain this study. There would be very strict criteria in order to be enrolled into this study. This criteria was that the patient would be admitted into the medical intensive care unit and be intubated for more than 48 hours in order to be eligible. Ventilated patients would be considered a vulnerable population but there was no discussion of an informed consent for this particular study although it is normal protocol to have consent for treatment signed upon being admitted into the hospital which inadvertently may include consent for studies. This study would not do any harm to the patient per se. The first group who received no oral care would get just that, no oral care while being mechanically ventilated. Both test groups were approximate in size and all characteristics such as age, sex, APACHE score and reasons for hospitalizations were comparable. The integrity was evident in wanting to do this research as the researchers wanted to prove that improvement to outcomes would be evident with doing oral care on mechanically ventilated patients. The study showed respect towards its subjects as it did not release any names or identifiable information about the participants when the results were published.

A.5.

The study was quantitative in nature. The study clearly described the effect of oral and dental care on patients receiving mechanical ventilation. A group of 779 patients were studied before interventions were given. This particular group received no oral care which included suctioning, tooth brushing and removal of secretions from the oral cavity. A group of 759 patients were studied during the intervention as they were given a strict protocol of oral cleansing, tooth brushing and suctioning every 4-6 hours. I do not feel a qualitative method would have provided the same results as the study was not focused on a phenomenon.

B.1.

Ventilator associated pneumonia (VAP) increases hospital stays, health care costs and even mortality. I am investigating if oral care can decrease the incidence of VAP. 


  • Item #: 785656

WGU EBT Task 1 - Highly Rated Work

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