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intensiv 2022; 30(01): 35-47
DOI: 10.1055/a-1669-6518
CNE Schwerpunkt
Mundpflege bei Beatmeten

Mundpflege bei invasiv beatmeten Patienten

Christoph Firnkranz
,
Tamara Großbichler
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Eine endotracheale Intubation erhöht das Risiko für den Erwerb einer ventilatorassoziierten Pneumonie (VAP). Die Folgen einer solchen nosokomialen Pneumonie haben erhebliche Auswirkungen auf die Betroffenen und das Gesundheitssystem. Eine wichtige Maßnahme zur Prävention einer VAP ist die Mundpflege. Der folgende Beitrag beschäftigt sich ausführlich mit der Mundpflege und mit den beeinflussenden Faktoren der Umsetzung evidenzbasierter Leitlinien zur Prävention einer VAP. Die dem Beitrag zugrunde liegende Facharbeit belegte den 1. Platz beim intensiv Pflegepreis 2020.



Publication History

Article published online:
03 January 2022

© 2022. Thieme. All rights reserved.

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  • Literatur

  • 1 Lapinsky SE. Endotracheal intubation in the ICU. Crit Care 2015; 19 (01) 258
    CrossrefPubMedGoogle Scholar
  • 2 Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin e. V. Invasive Beatmung und Einsatz extrakorporaler Verfahren bei akuter respiratorischer Insuffizienz; 2020. Im Internet: bit.ly/3CyZakJ; Stand: 01.11.2021
  • 3 Safdar N, Dezfulian C, Collard HR. et al Clinical and economic consequences of ventilator-associated pneumonia: A systematic review. Crit Care Med 2005; 33 (10) 2184-93
    CrossrefPubMedGoogle Scholar
  • 4 Wei H, Yang K. Effects of different oral care scrubs on ventilator-associated pneumonia prevention for machinery ventilates patient. Medicine 2019; 98 (12) e14923
    CrossrefPubMedGoogle Scholar
  • 5 Khezri HD, Zeydi AE, Firouzian A. et al The Importance of Oral Hygiene in Prevention of Ventilator-Associated Pneumonia (VAP): A Literature Review. Int J Caring Sci 2014; 7 (01) 12-23 Im Internet: bit.ly/3jXG1BR; Stand: 01.11.2021
    Google Scholar
  • 6 Scannapieco FA, Bush RB, Paju S. Associations Between Periodontal Disease and Risk for Nosocomial Bacterial Pneumonia and Chronic Obstructive Pulmonary Disease. A Systematic Review. Ann Periodontol 2003; 8 (01) 54-69
    CrossrefPubMedGoogle Scholar
  • 7 Institute for Healthcare Improvement. How-to Guide: Prevent Ventilator-Associated Pneumonia; 2012. Im Internet: bit.ly/3w5YAc7; Stand: 01.11.2021
  • 8 Klompas M, Branson R, Eichenwald EC. et al Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals. Infect Control Hosp Epidemiol 2014; 35 (08) 915-36
    CrossrefPubMedGoogle Scholar
  • 9 Hillier B, Wilson C, Chamberlain D. et al Preventing Ventilator-Associated Pneumonia Through Oral Care, Product Selection, and Application Method. AACN Adv Crit Care 2013; 24 (01) 38-58
    CrossrefPubMedGoogle Scholar
  • 10 Berry AM, Davidson PM, Nicholson L. et al Consensus based clinical guideline for oral hygiene in the critically ill. Int Crit Care Nurs 2011; 27 (04) 180-5
    CrossrefPubMedGoogle Scholar
  • 11 Heater BS, Becker AM, Olson RK. Nursing interventions and patient outcomes: A meta-analysis of studies. Nurs Res 1988; 37 (05) 303-7
    CrossrefPubMedGoogle Scholar
  • 12 Jam R, Mesquida J, Hernández Ó. et al Nursing workload and compliance with non-pharmacological measures to prevent ventilator-associated pneumonia: A multicentre study. Nurs Crit Care 2018; 23 (06) 291-8
    CrossrefPubMedGoogle Scholar
  • 13 Ali KJ, Farley DO, Speck K. et al Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia. Infect Control Hosp Epidemiol 2014; 35 (03) S116-23
    CrossrefPubMedGoogle Scholar
  • 14 Hassan ZM, Wahsheh MA. Knowledge level of nurses in Jordan on ventilator-associated pneumonia and preventive measures. Nurs Crit Care 2017; 22 (03) 125-32
    CrossrefPubMedGoogle Scholar
  • 15 Hugonnet S, Chevrolet JC, Pittet D. The effect of workload on infection risk in critically ill patients. Crit Care Med 2007; 35 (01) 76-81
    CrossrefPubMedGoogle Scholar
  • 16 Micik S, Besic N, Johnson N. et al Reducing risk for ventilator associated pneumonia through nursing sensitive interventions. Int Crit Care Nurs 2013; 29 (05) 261-5
    CrossrefPubMedGoogle Scholar
  • 17 Centers for Disease Control and Prevention. National Healthcare Safety Network (NHSN) Patient Safety Component Manual. Im Internet: bit.ly/3BwY2gj; Stand: 01.11.2021
  • 18 Pneumatikos IA, Dragoumanis CK, Bouros DE. Ventilator-associated Pneumonia or Endotracheal Tube-associated Pneumonia? An Approach to the Pathogenesis and Preventive Strategies Emphasizing the Importance of Endotracheal Tube. Anesthesiology 2009; 110 (03) 673-80
    CrossrefPubMedGoogle Scholar
  • 19 Browne JA, Evans D, Christmas LA. et al Pursuing Excellence: Development of an Oral Hygiene Protocol for Mechanically Ventilated Patients. Crit Care Nurs Q 2011; 34 (01) 25-30
    CrossrefPubMedGoogle Scholar
  • 20 Rycroft-Malone J. The PARIHS Framework – A Framework for Guiding the Implementation of Evidence-based Practice. J Nurs Care Qual 2004; 19 (04) 297-304
    CrossrefPubMedGoogle Scholar
  • 21 Behrens J, Langer G. Evidence-based nursing and caring: Methoden und Ethik der Pflegepraxis und Versorgungsforschung. 4., überarb. u. erg. Aufl. Bern: Hogrefe; 2016
    Google Scholar
  • 22 Bundesgesetz über Gesundheits- und Krankenpflegeberufe (GuKG). Berufspflichten. Im Internet: bit.ly/30cfJQ6; Stand: 01.11.2021
  • 23 Dudenredaktion. „Evidenz“ auf Duden online. Im Internet: bit.ly/3pUjoSE; Stand: 01.11.2021
  • 24 Bartoszek G, Dobrin-Schippers A, Gnass I. et al Einführung in Evidence-based Nursing am Beispiel der Wirksamkeitsbewertung Medizinischer Thromboembolieprophylaxestrümpfe zur Vermeidung tiefer Beinvenenthrombosen nach Schlaganfall. Pflegenetz 2010; 10 (01) 4-7
    Google Scholar
  • 25 Rycroft-Malone J, Seers K, Titchen A. et al What counts as evidence in evidence-based practice?. J Adv Nurs 2004; 47 (01) 81-90
    CrossrefPubMedGoogle Scholar
  • 26 Larrabee JH, Sions J, Fanning M. et al Evaluation of a Program to Increase Evidence-Based Practice Change. JONA: J Nurs Adm 2007; 37 (06) 302-10
    CrossrefPubMedGoogle Scholar
  • 27 Parsons S, Lee CA, Strickert D. et al Oral Care and Ventilator-Associated Pneumonia: An Integrated Review of the Literature. Dimens Crit Care Nurs 2013; 32 (03) 138-45
    CrossrefPubMedGoogle Scholar
  • 28 Booker S, Murff S, Kitko L. et al Mouth Care to Reduce Ventilator-Associated Pneumonia. Am J Nurs 2013; 113 (10) 24-30
    CrossrefPubMedGoogle Scholar
  • 29 Camargo L, Silva SN, Chambrone L. Efficacy of toothbrushing procedures performed in intensive care units in reducing the risk of ventilator-associated pneumonia: A systematic review. J Periodontal Res 2019; 54 (06) 601-11
    CrossrefPubMedGoogle Scholar
  • 30 Hua F, Xie H, Worthington HV. et al Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev 2016; 10 (10) CD008367
    PubMedGoogle Scholar
  • 31 Haghighi A, Shafipour V, Bagheri-Nesami M. et al The impact of oral care on oral health status and prevention of ventilator-associated pneumonia in critically ill patients. Aust Crit Care 2016; 30 (02) 69-73
    CrossrefPubMedGoogle Scholar
  • 32 Özden D, Türk G, Düger C. et al Effects of oral care solutions on mucous membrane integrity and bacterial colonization: Oral care in patients connected to mechanical ventilator. Nurs Crit Care 2014; 19 (02) 78-86
    CrossrefPubMedGoogle Scholar
  • 33 Sole L, Talbert S, Yan X. et al Impact of deep oropharyngeal suctioning on microaspiration, ventilator events, and clinical outcomes: A randomized clinical trial. J Adv Nurs 2019; 75 (11) 3045-57
    CrossrefPubMedGoogle Scholar
  • 34 Muramatsu K, Matsuo K, Kawai Y. et al Comparison of wiping and rinsing techniques after oral care procedures in critically ill patients during endotracheal intubation and after extubation: A prospective cross-over trial: Oral care for critical patients. Jpn J Nurs Sci 2018; 16 (01) 80-7
    CrossrefPubMedGoogle Scholar
  • 35 Eilers J, Berger AM, Petersen MC. Development, testing, and application of the oral assessment guide. Oncol Nurs Forum 1988; 15 (03) 325-30
    PubMedGoogle Scholar
  • 36 Jam R, Mesquida J, Hernández Ó. et al Nursing workload and compliance with non-pharmacological measures to prevent ventilator-associated pneumonia: A multicentre study. Nurs Crit Care 2018; 23 (06) 291-8
    CrossrefPubMedGoogle Scholar
  • 37 Jansson MM, Syrjälä HP, Talman K. et al Critical care nurses’ knowledge of, adherence to, and barriers toward institution-specific ventilator bundle. Am J Infect Control 2018; 46 (09) 1051-6
    CrossrefPubMedGoogle Scholar
  • 38 Aloush SM, Abdelkader FA, Al-Sayaghi K. et al Compliance of Nurses and Hospitals With Ventilator-Associated Pneumonia Prevention Guidelines: A Middle Eastern Survey. J Nurs Care Qual 2018; 33 (03) e8-14
    CrossrefPubMedGoogle Scholar
  • 39 Madhuvu A, Endacott R, Plummer V. et al Nurses’ knowledge, experience and self-reported adherence to evidence-based guidelines for prevention of ventilator-associated events: A national online survey. Intensive Crit Care Nurs 2020; 59: 102827
    CrossrefPubMedGoogle Scholar
  • 40 Atashi V, Yousefi H, Mahjobipoor H. et al (). The barriers to the prevention of ventilator-associated pneumonia from the perspective of critical care nurses: A qualitative descriptive study. J Clin Nurs 2018; 27 5–6 e1161-70
    CrossrefPubMedGoogle Scholar
  • 41 Kiyoshi-Teo H, Cabana MD, Froelicher ES. et al Adherence to Institution-Specific Ventilator-Associated Pneumonia Prevention Guidelines. Am J Crit Care 2014; 23 (03) 201-15
    CrossrefPubMedGoogle Scholar
  • 42 Nasiriani K, Torki F, Jarahzadeh M. et al The Effect of Brushing with a Soft Toothbrush and Distilled Water on the Incidence of Ventilator-Associated Pneumonia in the Intensive Care Unit. Tanaffos 2016; 15: 101-7
    PubMedGoogle Scholar
  • 43 de Lacerda Vidal CF, de Lacerad Vidal AK, de Moura Monteiro JG. et al Impact of oral hygiene involving toothbrushing versus chlorhexidine in the prevention of ventilator-associated pneumonia: A randomized study. BMC Infect Dis 2017; 17 (01) 112
    CrossrefPubMedGoogle Scholar
  • 44 Yao LY, Chang CK, Maa SH. et al Brushing Teeth With Purified Water to Reduce Ventilator-Associated Pneumonia. J Nurs Res 2011; 19 (04) 289-97
    CrossrefPubMedGoogle Scholar
  • 45 Gray R, Wykes T, Gournay K. From compliance to concordance: A review of the literature on interventions to enhance compliance with antipsychotic medication. J Psychiatr Ment Health Nurs 2002; 9 (03) 277-84
    CrossrefPubMedGoogle Scholar
  • 46 Grap MJ, Munro C, Martin B. Oral Care for Acutely and Critically Ill Patients. Crit Care Nurs 2017; 37 (03) e19-21
    CrossrefPubMedGoogle Scholar