Details: SNPG 905 (Minor project)
Assessment 2: Rapid Review Proposal
A summary of systematic review on effectiveness of oral care with antiseptics to prevent ventilator associated pneumonia in patients on mechanical ventilation
Name: Harmanpreet kaur
Student Id: 5529062
A summary of the effectiveness of oral care with antiseptics to prevent ventilator associated pneumonia (VAP) in patients on mechanical ventilation: A rapid review protocol.
The purpose of this systematic review is to identify, analyse and summarise the effectiveness of oral care with antiseptics to prevent ventilator associated pneumonia in patients on mechanical ventilation.
Ventilator associated pneumonia, prevention of ventilator associated pneumonia, hospital acquired infection, hospital associated pneumonia, oral care, oral hygiene, mouth care, oral health, antiseptics, chlorhexidine, effectiveness of oral care, systematics review.
Ventilator Associated Pneumonia (VAP) is one of the common nosocomial infections and the mortality rate is very high (Sadasivan et al., 2018). VAP continues to be significant medical problem with mortality rate between 33% and 50% despite the recent advances in the diagnosis and treatment of VAP (Villar et al., 2016). The microorganisms causing VAP are staphylococcus aureus and Pseudomonas aeruginosa. These pathogens live in oral cavity of patients receiving critical care (Haghighi et al., 2017). As there is no oral intake of food in patients on mechanical ventilation, there is decrease in their salivary secretions. It reduces the self- cleansing of oral cavity which increases bacterial count. Hence, it results in bacterial colonisation in oropharynx (Kaya et al., 2017). The research suggests that the primary source of VAP is oropharyngeal tract.
There are various interventions to overcome this significant issue of VAP with particular focus on oral cares with antiseptics among patients on mechanical ventilation. This is because the main cause of Ventilator Acquired Pneumonia is endotracheal tube, open mouth and micro aspiration of oral secretions (Chacko et al., 2017). Yeganeh et al, 2019 revealed that lack of oral care and poor suctioning is directly associated with the increase incidence rate of VAP. The complications of ventilator pneumonia include lung abscess, bacteria and empyema. The Ventilator Associated Pneumonia is mainly development due to various risk factors related to mouth which includes development of bacterial, colonies, formation of plague and micro aspiration of oral secretions (Lev et al., 2015). Oral care is an important measure in preventing VAP by reducing the number of microorganism (Bouadma et al., 2018).The reasons above describe the need to review the oral care practices to reduce the risk of Ventilator Acquired Pneumonia. This criterion will also include definitions of key terms.
Ventilator Associated Pneumonia: According to the US disease control and prevention (CDC), It is type of pneumonia that develops within 48 hours or after in patients who are on mechanical ventilation (Batra et al., 2018).
Oral Care: Oral care is the practice which help to keep the mouth clean and free from various kind of oral cavity diseases.
Prevention: Prevention is defined as an action which help to stop something from arising or developing.
Antiseptics: Antiseptic is a kind of substance which prevent the development of micro-organism from infection.
VAP is one of the key issues due to increased hospital costs, longer hospitalisation and high Morbidity and mortality rates (Tokmaji et al., 2015). With growing emphasis on significance of oral care with antiseptics among patient on Mechanical Ventilation for more than 48 hours, there has numerous studies suggesting different interventions to minimise the risk and prevent nosocomial infections. The different studies reveal supportive and contradictory as well. Results from randomised controlled trials (RCT) and meta-analysis that analysed effect mouth care with antiseptics on VAP prevention are conflicting (Bouadma and Klompas, 2018). So, it is challenging to categorise the body of research in area of VAP. Systematic reviews and meta-analysis of research studies is becoming the preferred approach for assessing and synthesizing the evidence. Hence these are considered to provide the highest level of research evidence. The systematic review and meta-analysis with an intention-to-treat analysis of RCTs are conducted to determine the effectiveness of oral care with antiseptics in preventing VAP (Guler and Turk, 2018). A meta-analysis revealed the using 2% chlorhexidine was very effective in preventing VAP (Zhang et al., 2017). Despite various mixed results of studies re- evaluating the efficacy of chlorhexidine, it has been found to be very effective to reduce the risk of VAP (Longti et al., 2015). Systematic review of these findi…
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