Nurse-led intervention to improve oral mucosal health of intubated patients in the intensive care unit: A prospective study

Am J Infect Control. 2024 Jan 30:S0196-6553(24)00053-1. doi: 10.1016/j.ajic.2024.01.014. Online ahead of print.

Abstract

Background: This prospective study aimed to explore the effectiveness of an oral care intervention with Tegaderm on the oral mucosal health of intubated patients.

Methods: A total of 70 intubated patients were included and randomly assigned to 1 of 3 groups, clean water brushing teeth (n = 23), brushing teeth combined with mouthwash (BTM) (n = 23), and brushing teeth combined with mouthwash and Tegaderm (BTMT) (n = 24). The Oral Mucositis Assessment Scale (OMAS) was applied to evaluate the patient's oral mucosal health before and after oral care intervention.

Results: The BTMT group had lower OMAS scores in almost all regions of the oral cavity, compared to the brushing teeth and BTM groups. The general linear model for repeated measurement indicated the BTMT group had the lowest total OMAS scores from Day 2 to Day 4 after the initiation of baseline OMAS evaluation. Of the 3 intervention groups, the BTMT group had the shortest length of endotracheal intubation. The BTMT group had the lowest incidence rate of ventilator-associated pneumonia; however, no significant between-group differences were found.

Conclusions: BTMT effectively reduced the decline in oral mucosal health that was caused by endotracheal intubation and shortened the length of endotracheal intubation.

Keywords: Endotracheal intubation; Oral Mucositis Assessment Scale; Oral care intervention; Tegaderm; Ventilator-associated pneumonia.