Abstract            Ventilator Associated Pneumonia (VAP) is a hospital-acquired pneumonia and common complication that occurs with patients in the Intensive Care Unit (ICU). VAP mortality can reach 87%, extend the length of stay, and therefore cause an increased operational cost greater than $40,000 per patient/or event. VAP costs health-care systems millions of dollars annually.            The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) defined core measures for VAP prevention on mechanically ventilated patients. These measures include: deep venous thrombosis prophylaxis, peptic ulcer disease prophylaxis, daily interruption of sedative drug infusions, and use of semi-recumbent positioning with head-of-bed elevated at an angle greater/or equal to 30 degrees. In the intubated patient, leakage around the endotracheal tube cuff allows for bacteria-laden secretions to access the respiratory tract. An intervention that has proven beneficial is the use of endotracheal tubes to allow for continuous aspiration of accumulated subglottic secretions.
           Recent multiple studies have addressed the importance of oral care in maintaining a bacteria controlled environment. The objective is to utilize frequent oral care as a measure to prevent the incidence of VAP by decreasing the presence of plaque and bacteria growth, thus decreasing the amount of bacteria in the secretions hidden around the subglottic area.            Utilizing the Stetler model of evidence based practice implementation, this research utilization project will implement oral care guidelines and maintenance for mechanically ventilated patients in the critical care setting, which includes tooth brushing for plaque and bacteria control.

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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)