title: Consensus based clinical guideline for oral hygiene in the critically ill.
abstract: OBJECTIVE
  Oropharyngeal colonisation has been identified as a factor contributing to ventilator associated pneumonia (VAP) in the Intensive Care Unit (ICU). We sought to develop a clinical practice guideline for providing oral hygiene in the critically ill.
  
  
  METHODS
  Following a systematic literature review a prospectively derived consensus development conference was convened and sponsored by a clinical governance unit.
  
  
  RESULTS
  The consensus development conference generated 12 recommendations for tools and solutions; frequency and duration of cleaning; oral assessment tools and oral hygiene protocols. These recommendations underwent a validation process.
  
  
  CONCLUSIONS
  In light of sparse high level evidence to inform guidelines, further research is needed inform clinical practice. Oral hygiene is a critical element of nursing care and a standardised approach has the potential to improve clinical outcomes.
authors.affiliation: Intensive Care Unit, Westmead Hospital, Sydney, Australia. angela_berry@wsashs.nsw.gov.au
authors.forename: Angela M
authors.initials: AM
authors.lastname: Berry
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Lisa
authors.initials: L
authors.lastname: Nicholson
authors.forename: Carmel
authors.initials: C
authors.lastname: Pasqualotto
authors.forename: Kaye
authors.initials: K
authors.lastname: Rolls
mesh_terms: D016638:Critical Illness; D006801:Humans; D009910:Oral Hygiene / Q000451:nursing* / Q000592:standards; D053717:Pneumonia, Ventilator-Associated / Q000209:etiology / Q000517:prevention & control