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Evidence-Based Practice Paper of Oral Care

Oral care is a significant component in a set of nursing care activities provided for critically ill ventilator patients, and it needs to be discussed in detail because the provision of effective oral care influences the comfort of patients and their mucosal status. In spite of a range of approaches to oral care in critically ill ventilator patients, it is important to focus on the most effective technique in order to increase the overall quality of health care and contribute to the patients’ health status. Current oral care methods are often time-efficient, but they are not appropriate to improve the status of ventilator patients because it is necessary to propose high-quality oral care protocols that are oriented to reducing the risk of infections and to increasing the effectiveness of ventilation (MacIntyre, 2013, p. 1075). The implementation of oral care protocols and feedback systems in the work with critically ill ventilator patients can be discussed as an effective approach to increase the quality of oral care and the effectiveness of nurses’ activities.

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Currently, oral care protocols are numerous and often underdeveloped to address the needs of critically ill ventilator patients (Hsu, Liao, Li, & Chiou, 2011, p. 1045). In this context, oral care protocols need to be implemented along with feedback systems in order to increase the quality of the concrete procedures and make the oral care systematized. Appropriately developed oral care protocols are important to reduce the risk for aspiration for critically ill ventilator patients and improve the effectiveness of the whole oral care procedure. The reason is that oral care protocols differ from separate oral care practices and performed by nurses in a system (Ames, Sulima, Yates, McCullagh, & Gollins, 2011, p. e105). Added with feedback systems, oral care protocols are more effective because feedback systems like adaptive support ventilation are more efficient than conventional ventilation methods, and they can be used to predict any respiratory failure while increasing the quality of ventilation (Iotti et al., 2010).

The focus on oral care protocols and feedback systems is significant to nursing practice because this systematic approach is more advantageous in comparison with separate tooth brushing practices for patients or other separate oral care practices that are not dependent on protocols. When oral care protocols are used along with feedback systems, the care becomes improved, and the risks for critically ill ventilator patients to become infected or develop severe conditions associated with the mucosal status decrease. The reason is that in comparison to traditional approaches or conventional modes, oral care protocols implemented along with feedback systems can guarantee that the intubation period can become shorter, less clinical intervention is required, acute respiratory failure is avoided, and the state of the critically ill patient becomes fully controlled (Conley, McKinsey, Graff, & Ramsey, 2013, p. 19). As a result, the quality of nursing care increases significantly.

In order to change the approach to oral care in health care facilities, it is important to implement the changes following certain steps. The first step is associated with integrating developed oral care protocols in the nurses’ work with critically ill ventilator patients. The second step is the assessment of the results. The next step includes the implementation of the feedback systems in order to guarantee that the oral care is provided in complex with all the available effective procedures (MacIntyre, 2013, p. 1077). The final step is the assessment of the systems’ work in their combination with the oral care protocols.

As a result of focusing on the oral care as a complex procedure for critically ill ventilator patients, it is possible to achieve the significant increases in the quality of nursing care. Both oral care protocols and feedback systems are important to control the process of ventilation and make the procedure safe for the critically ill patients. It is also possible to expect the positive changes in the nursing work and compliance with care quality standards.

References

Ames, N., Sulima, P., Yates, J., McCullagh, L., & Gollins, S. (2011). Effects of systematic oral care in critically ill patients: A multicenter study. American Journal of Critical Care, 20(5), e103-e114.

Conley, P., McKinsey, D., Graff, D., & Ramsey, A. (2013). Does an oral care protocol reduce VAP in patients with a tracheostomy? Nursing, 18(6), 18-23.

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Hsu, S., Liao, C., Li, C., & Chiou, A. (2011). The effects of different oral care protocols on mucosal change in orally intubated patients from an intensive care unit. Journal of Clinical Nursing, 20(7-8), 1044-1053.

Iotti, G., Polito, A., Belliato, M., Pasero, D., Beduneau, G., Wysocki, M., … Slutsky, A. (2010). Adaptive support ventilation versus conventional ventilation for total ventilatory support in acute respiratory failure. Intensive Care Medicine, 36(8), 1371-1379.

MacIntyre, N. (2013). The ventilator discontinuation process: An expanding evidence base. Respiratory Care June, 58(6), 1074-1086.

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