巴西圣保罗一家三级医院重症患者的口腔卫生:最佳实践实施项目。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2024-03-21 DOI:10.1097/XEB.0000000000000413
Mariana Davies Ribeiro Bersaneti, Renata Desordi Lobo, Thais Bianca Brandão, Regina Claudia Silva Souza, Vanessa de Brito Poveda
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引用次数: 0

摘要

目标:该项目旨在推广与巴西重症监护病房重症患者口腔健康相关的循证实践:机械通气患者的口腔卫生是护理质量的重要组成部分,明确的指导方针可确保提供适当的护理。机械通气与呼吸机相关肺炎的风险有关,而呼吸机相关肺炎会增加死亡率、住院时间、机械通气时间和医院成本:该项目以 JBI 循证实施框架为指导,包括七个阶段:(1)确定要改变的实践领域;(2)变革推动者的参与;(3)背景评估和变革准备;(4)根据循证审计标准审查实践;(5)实施实践变革;(6)使用后续审计重新评估实践;(7)考虑实践变革的可持续性:结果:制定了四项审计标准,以评估最佳做法的合规性。在后续审计中,标准 1、2 和 3 的合规率≥ 80%。因此,就标准 1 而言,所有机械通气时间超过 24 小时的患者都接受了口腔医疗团队的评估,因此达标率为 100%。标准 2 "适当的口腔卫生措施 "的达标率为 80%。对于标准 3,39 名专业人员(90.7%)参加了与危重病人口腔健康协议相关的教育活动,达标率为 90.7%。标准 4 涉及患者在接受任何口腔健康护理前接受评估,但改进率较低(仅为 50%),表明需要进一步改进:该最佳实践项目改善了护理人员的专业实践,提高了危重病人口腔健康最佳实践的依从性。西班牙文摘要:http://links.lww.com/IJEBH/A175。
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Oral hygiene in critically ill patients at a tertiary hospital in São Paulo, Brazil: a best practice implementation project.

Objectives: This project aimed to promote evidence-based practices relat. ed to the oral health of critically ill patients in an intensive care unit in Brazil.

Introduction: The oral hygiene of patients on mechanical ventilation is an essential component of nursing care quality, and well-defined guidelines ensure appropriate care. Mechanical ventilation is associated with the risk of ventilator-associated pneumonia, which can increase mortality, length of stay, time on mechanical ventilation, and hospital costs.

Methods: This project was guided by the JBI Evidence Implementation Framework, which consists of seven stages: (1) identification of the area of practice to be changed, (2) involvement of change agents, (3) context assessment and readiness for change, (4) review of practices against evidence-based audit criteria, (5) implementation of practice changes, (6) reassessment of practices using a follow-up audit and (7) consideration of the sustainability of changes in practice.

Results: Four audit criteria were developed to evaluate compliance with best practices. In the follow-up audit, Criteria 1, 2, and 3 obtained compliance of ≥ 80%. Thus, for Criterion 1, all the patients on mechanical ventilation for more than 24 hours were evaluated by the oral medicine team, resulting in 100% compliance. For Criterion 2 on appropriate oral hygiene measures, a compliance rate of 80% was achieved. For Criterion 3, 39 professionals (90.7%) participated in educational activities related to the oral health protocol for critically ill patients, obtaining 90.7% compliance. For Criterion 4 regarding patients being evaluated before receiving any oral health care, improvement was low (only 50%), revealing the need for further improvement.

Conclusion: This best practice project improved the professional practice of nursing staff and increased compliance with best practices for the oral health of critically ill patients.

Spanish abstract: http://links.lww.com/IJEBH/A175.

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CiteScore
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13.00%
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23
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