Tarihin Savunusu

Year 2007, Issue: 27, 83 - 89, 30.06.2007

M. Hanefi Palabıyık Zeynep Bayram

Abstract

Çocuk yoğun bakım üniteleri her yıl binlerce çocuğun çeşitli sebeplerden dolayı bakıldığı yerlerdir. Kritik durumdaki çocukların genel durumlarının düzelmesi için bakımlarının iyi bir şekilde yapılması ve çocukların hastane enfeksiyonlarından korunması gerekmektedir. En çok görülen hastane enfeksiyonlardan birinin Ventilatörle İlişkili Pnömoni (VİP) olduğu belirtilmektedir. VİP insidansının iyi bir oral bakım ile azaltılabildiği pek çok çalışma ile gösterilmiştir. Oral bakım; diş fırçalamayı, ağzı nemlendirmeyi, gargara kullanımını ve hastanın ihtiyacına göre günlük oral değerlendirmeyi içermesine rağmen hemşirelerin çoğu diş fırçası yerine köpük çubukları ve gaz tamponu tercih etmektedir. Bunun yanı sıra bu uygulamaların sıklığı da tartışma konusudur. Yapılan araştırmalar genellikle yetişkin yoğun bakımları ile ilgili olup çok azı çocuk yoğun bakımı ile ilgilidir. Bu nedenle çocuk hastaların ağız-diş sağlığı protokolleri hakkında yeni çalışmalara ihtiyaç duyulmaktadır.

Keywords

Pediyatrik yoğun bakım, ağız sağlığı, protocol, diş sağlığı

References

• 1. Çakar N, Tütüncü A. The cause of hospitalization, invasive interventions and the problem of infection. Clin J 1996;9(1):3-5.
• 2. Serrant-Green L. Uniting health care quality and equity:the challange of measurement. Qual Prim Care 2010;18(5):293-5.
• 3. Aytaç N, Naharcı N, Öztunç G. The levels of nurse’s information about hospital infections in Adana Education-Research Hospitals. ADU Medical Faculty J 2008; 9(3):9-15.
• 4. Institute for Healthcare Improvements (IHI). IHI campaign to save 100,000 lives, pediatric node: Preventing ventilator associated pneumonia, Available at: http://www.chca.com/mm/webcasts/ 2005/20050720_vap_webcast.pdf, Accessed July 20,2005.
• 5. Terezakis E, Needleman I, Kumar N, Moles D, Agudo E. The impact of hospitalization on oral health: a systematic review. J Clin Periodontol 2011;38(7):628-36.
• 6. Elward AM, Warren DK, Fraser VJ. Ventilator-associated pneumonia in pediatric intensive care unit patients: risk factors and outcomes. Pediatrics 2002;109(5):758-64.
• 7. Peltola P, Vehkalahti MM, Simoila R. Effects of 11-month interventions on oral cleanliness among the long-term hospitalised elderly. Gerodontology 2007;24(1):14-21.
• 8. Pear S. The role of oral care in the prevention of hospital-acquired pneumonia. Infection Control Today 2007;11(10):1- 3.
• 9. McNeill HE. Biting back at poor oral hygiene. Intensive Crit Care Nurs 2000;16(6):367-72.
• 10. Titler MG, Kleiber C, Steelman VJ, Rakel BA, Budreau G, Everett LQ, Buckwalter KC, Tripp-Reimer T, Goode CJ. The Iowa model of evidence-based practice to promote quality care. Crit Care Nurs Clin North Am 2001;13(4):497- 509.
• 11. Browne JA, Evans D, Christmas LA, Rodriguez M. Pursuing excellence: development of an oral hygiene protocol for mechanically ventilated patients. Crit Care Nurs Q 2011;34(1):25-30.
• 12. Sjögren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc 2008;56(1):2124-30.
• 13. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in paediatric intensive care units in the United States. National Nosocomial Infection Surveillance System. Pediatrics 1999;103(4):e39.
• 14. Fourrier F, Cau-Pottier E, Boutigny H, Roussel-Delvallez M, Jourdain M, Chopin C. Effects of dental plaque antiseptic decontamination on bacterial colonization and nosocomial infections in critically ill patients. Intensive Care Med 2000;26(9):1239-47.
• 15. Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J Periodontol 2006;77(1):1465-82.
• 16. Sjögren P. Hospitalisation associated with a deterioration in oral health. Evid Based Dent 2011;12(2):48.
• 17. Didilescu AC, Skaug N, Marica C, Didilescu C. Respiratory pathogens in dental plaque of hospitalized patients with chronic lung diseases. Clin Oral Investig 2005;9(3):141-7.
• 18. Flodgren G, Conterno LO, Mayhew A, Omar O, Pereira CR, Shepperd S. Interventions to improve professional adherence to guidelines for prevention of device-related infections. Cochrane Database Syst Rev 2013;28(3):CD006559.
• 19. Millikan J, Tait GA, Ford-Jones EL, Mindorff CM, Gold R, Mullins G. Nosocomial infections in a pediatric intensive care unit. Crit Care Med 1998;16(3):233- 7.
• 20. Scannapieco FA, Stewart EM, Mylotte JM. Colonization of dental plaque by respiratory pathogens in medical intensive care patients. Crit Care Med 1992; 20(6):740-5.
• 21. Fourrier F, Duvivier B, Boutigny H, Roussel-Delvallez M, Chopin C. Colonization of dental plaque: a source of nosocomial infections in intensive care unit patients. Crit Care Med 1998;26(2):301- 8.
• 22. Scannapieco FA. Role of oral bacteria in respiratory infection. J Periodontol 1999; 70(7):793-802.
• 23. Pineda LA, Saliba RG, El Solh AA. Effect of oral decontamination with chlorhexidine on the incidence of nosocomial pneumonia: a meta-analysis. Crit Care 2006;10(1):R35.
• 24. Scannapieco FA, Yu J, Raghavendran K, Vacanti A, Owens SI, Wood K, Mylotte JM. A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients. Crit Care 2009;13(4):R117.
• 25. Johnstone L, Spence D, Koziol-McClain J. Oral hygiene care in the pediatric intensive care unit: practice recommendations. Pediatr Nurs 2010; 36(2):85-96.
• 26. Bowsher J, Boyle S, Griffiths J. Oral care. Nurs Stand 1999;13(37):31.
• 27. Abidia RF. Oral care in the intensive care unit: a review. J Contemp Dent Pract 2007;8(1):76-82.
• 28. Needleman I, Hyun-Ryu J, Brealey D, Sachdev M, Moskal-Fitzpatrick D, Bercades G, Nagle J, Lewis K, Agudo E, Petrie A, Suvan J, Donos N, Singer M. The impact of hospitalization on dental plaque accumulation: an observational study. J Clin Periodontol 2012;39(11):1011-6.
• 29. Munro CL, Grap MJ. Oral health and care in the intensive care unit: state of the science. Am J Crit Care 2004;13(1):25-34.
• 30. Pearson LS. Hutton JL. A controlled trial to compare the ability of foam swabs and toothbrushes to remove dental plaque. J Adv Nurs 2002;39(5):480-9.
• 31. Franklin D, Senior N, James I, Roberts G. Oral health status of children in a paediatric intensive care unit. Intensive Care Med 2000;26(3):319-24.
• 32. Kite K. Pearson L. A rationale for mouth care: The integration of theory with practice. Intensive Crit Care Nurs 1995;11(2):71-6.
• 33. Shay K, Scannapieco FA, Terpenning MS, Smith BJ, Taylor GW. Nosocomial pneumonia and oral health. Spec Care Dentist 2005;25(4):179-87.
• 34. O’Reilly M. Oral care of the critically ill: a review of the literature and guidelines for practice. Aust Crit Care 2003;16(3):101- 10.
• 35. Houston S, Hougland P, Anderson JJ, La Rocco M, Kennedy V, Gentry LO. Effectiveness of 0.12% chlorhexidine gluconate oral rinse in reducing prevalence of nosocomial pneumonia in patients undergoing heart surgery. Am J Crit Care 2002;11(6):567-70.
• 36. Hayes J, Jones C. A collaborative approach to oral care during critical illness. Dental Health 1995;34(3):6-10.
• 37. Blevins JY. Oral health care for hospitalized children. Pediatr Nurs 2011;37(5):229- 35.
• 38. McNeill HE. Biting back at poor oral hygiene. Intensive Crit Care Nurs 2000; 16(6):367-72.
• 39. Adams, R. Qualified nurses lack adequate knowledge related to oral health, resulting in inadequate oral care of patients on medical wards. J Adv Nurs 1996;24(3):552-60.
• 40. O’Reilly, M. Oral care of the critically ill: A review of the literature and guidelines for practice. Aust Crit Care 2003;16(3):101-9.
• 41. Marinho VC, Higgins JP, Sheiham A, Logan S. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003;(1):CD002278.
• 42. Grap MJ, Munro CL, Elswick RK, Sessler CN, Ward KR. Duration of action of a single, early oral application of chlorhexidine on oral microbial flora in mechanically ventilated patients: A pilot study. Heart and Lung 2004;33(2):83-91.
• 43. DeRiso AJ, Ladowski JS, Dillon TA,Justice JW, Peterson AC. Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonprophylactic systemic antibiotic use in patients undergoing heart surgery. Chest 1996;109(6):1556- 61.
• 44. Fourrier F, Dubois D, Pronnier P, Herbecq P, Leroy O, Desmettre T, Pottier-Cau E, Boutigny H, Di Pompéo C, Durocher A, Roussel-Delvallez M. Effect of gingival and dental plaque antiseptic decontamination on nosocomial infections acquired in the intensive care unit: a double-blind placebo-controlled multicenter study. Crit Care Med 2005;33(8):1728-35.
• 45. Grap MJ, Munro CL, Ashtiani B, Bryant S. Oral care interventions in critical care: frequency and documentation. Am J Crit Care 2003;12:113-8.
• 46. Fitch JA, Munro CL, Glass CA, Pellegrini JM. Oral care in the adult intensive care unit. Am J Crit Care 1999;8(5):314-8.
• 47. American Association of Critical-Care Nurses. Oral care in the critically ill, Available at: http://www.aacn.org/WD/ practice/docs/oral_care_in_the_critically_ill.pdf, Accessed October 10, 2007.
• 48. Ames NJ, Sulima P, Yates JM, McCullagh L, Gollins SL, Soeken K,Wallen GR. Effects of systematic oral care in critically ill patients: a multicenterstudy. Am J Crit Care 2011;20(5):e103-14.