Strategies to Prevent Ventilator- Associated Pneumonia (Vap) in Intensive Care Unit (Icu): an Experimental Study.

3176 Words May 29th, 2013 13 Pages
CONTENT
Title ………………………………………………………………………………..……….P.2
Research Question………………………………………………………………...……...P.2
Aims…………………………………………………………………………………………P.2
Introduction…………………………………………………………………..…………….P.3
Theoretical perspective…………………………………………………………...………P.4
Literature Review…………………………………………………………….……………P.5
Methodology…………………………………………………………………….………..P.11
Methods……………………………………………………………………..…………….P.12
Sample and Access to sample/ data…………………………………………………...P.13
Data collection…………………………………………………………….……………...P.16
Data analysis……………………………………………………………………………..P.19
Ethical issues……………………………………………………………….…………….P.19
Rigour…………………………………………………………………………..…………P.21
Limitations…………………………………………………………………..…………….P.23
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Microbial flora is a complex environmental niche of interdependent microorganisms embedded in bacterial and salivary product, which are concentrated in dental plaque (Munro et al, 2004). Thus, dental plaque may serve as a reservoir for pathogens in patients with poor oral hygiene (Blot et al, 2008), and critically ill patients may have preexisting poor oral health as their oral health may be compromised by medical conditions or treatment, ICU equipments, and their inability to attend oral care by their own (Tantipong et al, 2008).

Regarding the relationship between oral health status and the development of VAP, Scannapieo and colleagues found in 1992 that bacteria that normally cause pneumonia in hospitalised patients colonises the dental plaque and oral mucosa of the ICU patients and may occur in large number. Although it may be considered as outdated study and selection bias may be suspected while recruiting participants from two different health status for comparison, similar result were found by Munro and colleagues in 2006. They performed a nonexperimental, longitudinal descriptive study on 66 patients, the study criteria included oral health status and the Clinical Pulmonary Infection Score (CPIS) assessed at baseline, determined at day 4 and day 7 post intubation. Patients having history of intubation during the current hospitalisation were excluded for avoiding selection bias,

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