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首页> 外文学位 >The role of a meticulous oral hygiene program in reducing oral assessment scores, mucosal plaque scores, colonization of dental plaque and exposition to pathogen colonization that may lead to nosocomial respiratory infections in a selected ICU patient population.
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The role of a meticulous oral hygiene program in reducing oral assessment scores, mucosal plaque scores, colonization of dental plaque and exposition to pathogen colonization that may lead to nosocomial respiratory infections in a selected ICU patient population.

机译：精心的口腔卫生计划在降低口腔评估分数，粘膜斑块分数，牙菌斑定植以及暴露于病原体定植的情况下的作用，在选定的ICU患者人群中可能导致医院内呼吸道感染。

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摘要

Critical care patients, especially intubated individuals, have the greatest risk of any hospitalized patient to acquire a nosocomial respiratory infection. The research reveals that the predominantly initial site of bacterial colonization is the oropharyngeal cavity. Oral colonization precedes pulmonary colonization, which ultimately leads to pneumonia. Nosocomial pneumonia causes the greatest mortality and morbidity in the Intensive Care Unit (ICU). Prevention of colonization at the oropharyngeal site could be an effective infection control measure.; Dental plaque has been identified as a host for bacterial colonization in the mouth and has been significantly associated, (p 0.001), with subsequent nosocomial infections. Dental plaque can act as a reservoir for pathogens in ICU patients. Aerobic pathogens are not normally associated with dental plaque. However, poor oral hygiene and lack of mechanical elimination of the plaque, begins a complex cascade of biological actions by which pathogen adhesion to mucosa and teeth substrates occurs. Additionally, neglected or insufficient mouth care is the foremost predisposing factor to oral conditions such as gingivitis, mucositis, and stomatitis, which supply additional ports of entry for pathogens.; Meticulous oral hygiene is required to prevent colonization of dental plaque in ICU patients. There are only three known studies that show the type and frequency of oral hygiene required to prevent or decrease colonization and thereby reduces the incidence of nosocomial respiratory infection.; This prospective randomized trial tested the effectiveness of a comprehensive and systematic oral care program to reduce the mucosal plaque scores, the oral assessment scores, and the incidence of respiratory infections in patients in two selected medical-surgical ICU's. Additionally consistency of oral hygiene was compared between the ICU whose nursing staff followed “routine” care and the ICU whose nursing staff was given specific oral hygiene teaching by a dentist and a dental hygienist.; The results of the study showed that oral care provision in the test ICU was significantly better during the critical care stay than the control ICU, p = 0.001. Individualized oral care was determined from the results of oral assessment scores. The amount of microbiological inoculum was significantly lower in the test ICU, p = 0.0094. Beck oral assessment scores improved in the test ICU, p = 0.0342 on day three of the ICU stay. However there was no difference in the Mucosal Plaque Scores, Clinical Pulmonary Infection Scores or the amount of pathogen colonization between the two ICU's.
机译：重症监护患者，尤其是插管个体，在任何住院患者中获得医院呼吸道感染的风险最大。研究表明细菌定殖的主要起始部位是口咽腔。口腔定植先于肺部定植，最终导致肺炎。医院内肺炎在加护病房（ICU）中引起最大的死亡率和发病率。预防口咽部位的定植可能是一种有效的感染控制措施。牙菌斑已被确定为细菌在口腔中定殖的宿主，并且与随后的医院感染显着相关（p <0.001）。牙菌斑可作为ICU患者病原体的储存库。有氧病原体通常与牙菌斑无关。然而，不良的口腔卫生和缺乏对斑块的机械清除，开始了一系列复杂的生物作用，由此病原体粘附到粘膜和牙齿基质上。另外，对口腔疾病如牙龈炎，粘膜炎和口腔炎等口腔疾病的忽视是最重要的诱因，而口腔疾病的忽视或不足则为病原体提供了更多的进入途径。需要认真的口腔卫生以防止ICU患者牙菌斑的定植。只有三项已知的研究表明预防或减少定植从而减少医院呼吸道感染的发生所需的口腔卫生的类型和频率。这项前瞻性随机试验测试了一项综合而系统的口腔护理计划在降低两种选定的外科ICU患者的黏膜斑块分数，口腔评估分数以及呼吸道感染发生率方面的有效性。另外，比较了在ICU（其护理人员进行“例行”护理）和ICU（其护理人员由牙医和牙科保健师进行特定的口腔卫生教学）的情况下口腔卫生的一致性。研究结果表明，在重症监护期间，测试ICU的口腔护理服务明显好于对照ICU，p = 0.001。根据口腔评估得分的结果确定个性化口腔护理。在测试ICU中，微生物接种物的量显着降低，p = 0.0094。在ICU的测试中，贝克的口头评估得分有所提高，在ICU住院的第三天，p = 0.0342。但是，两个ICU之间的粘膜斑块评分，临床肺部感染评分或病原菌定植量没有差异。

著录项

  • 作者

    Yates, Janice Maureen.;

  • 作者单位

    George Mason University.;

  • 授予单位 George Mason University.;
  • 学科 Health Sciences Nursing.; Health Sciences Dentistry.
  • 学位 Ph.D.
  • 年度 2003
  • 页码 182 p.
  • 总页数 182
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;口腔科学;
  • 关键词

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