The impact of an evidence-based practice education program on the role of oral care in the prevention of ventilator-associated pneumonia.
BACKGROUND
Despite strong evidence in the literature on the role of oral care in the prevention of ventilator-associated pneumonia (VAP), nurses continue to view oral care as a comfort measure with low priority and utilise foam swabs rather than toothbrushes. Although an evidence-based oral care protocol existed and best-practice oral care tools were available, the VAP rates had not significantly decreased even though nurses reported providing oral care.


OBJECTIVE
The aim of the study was to determine if an evidence-based practice (EBP) educational programme would improve the quality of oral care delivered to mechanically ventilated patients; thereby, reducing the VAP rate.


RESULTS
Improvement in oral health was demonstrated by a decrease in median scores on the Oral Assessment Guide (pre (11.0), post (9.0)). A t-test analysis revealed a statistically significant difference (p=0.0002). The frequency of oral care documentation also improved as demonstrated by a positive shift to the more frequent timeframes. The VAP rates have decreased by 50% following the EBP education intervention.


CONCLUSIONS
The implementation of an EBP educational programme focused on patient outcome rather than a task to be performed improved the quality of oral care delivered by the nursing staff.
Ross
Amelia
A
Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston Salem, NC 27157, United States. amross@wfubmc.edu <amross@wfubmc.edu>
Crumpler
Janet
J
D001291:Attitude of Health Personnel; D003422:Critical Care / Q000379:methods*; D004282:Documentation; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009720:Nurse Clinicians / Q000458:organization & administration; D024802:Nurse's Role; D009730:Nursing Assessment / Q000458:organization & administration; D009731:Nursing Audit; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D009737:Nursing Records; D009741:Nursing Staff, Hospital / Q000193:education* / Q000523:psychology; D009910:Oral Hygiene / Q000193:education / Q000451:nursing; D017063:Outcome Assessment, Health Care; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015397:Program Evaluation; D011787:Quality of Health Care; D015144:Southeastern United States / Q000453:epidemiology; D017749:Total Quality Management / Q000458:organization & administration