Oral Colonization in the Preterm Neonate: Effect of Oral Care

McFadden, Barbara E.

Saturday, 29 October 2011

Barbara E. McFadden, RN, MSN, NNP-BC
NICU Education, Woman's Hospital of Texas, Houston, TX

Learning Objective 1: .. explain the importance of oral care in the prevention of infection for infants that are intubated.

Learning Objective 2: .. discuss the three solutions utilized for oral care in this study and describe the changes in the cultures of the oral cavity over time.

Purpose: To determine the nature of oral flora in the neonatal population and whether there is a difference in oral colonization between three oral care interventions over time.

Research Design: This is a prospective, randomized experimental study.

Setting: a for profit hospital that specializes in the care of women and infants in a large southwestern city. The hospital averages approximately 900 deliveries a month with a high percentage of high-risk obstetrical patients. The NICU is a 34-bed unit with an average daily census of 25 and specializes in the care of preterm infants with respiratory and surgical diseases often requiring long-term intubation.

Sample: Neonates between 25 and 32 weeks gestation admitted to this NICU requiring endotracheal intubation will be eligible. Subjects will be randomized to one of three groups

Measurement Instruments: A Demographic Data Sheet will be utilized to collect personal data related to birth weight, gestational age; ethnicity; gender, mode of delivery, Apgar scores, maternal and neonatal medications respiratory support, length of time on mechanical ventilation and nutritional status Other pertinent information may include vaginal colonization, maternal history of infection and treatment.

Data Collection: On admission, mothers' of eligible infants will be consented. Once consent is signed, infants' will be randomization and a study number will be assigned. An oral buccal mucosal swab will be collected, labeled and sent to the microbiology lab for culture. The cultures will be repeated at 7 and 14 days. Oral care is provided by NICU staff every 3 to 6 hours or more often as indicated. Staff will be informed which group the subject is assigned to.

Implications for Practice: Little is known about oral care and colonization is this population. This study will provide needed information for nursing practice.

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