Mariana Davies Ribeiro Bersaneti, Renata Desordi Lobo, Thais Bianca Brandão, Regina Claudia Silva Souza, Vanessa de Brito Poveda
{"title":"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。","authors":"Mariana Davies Ribeiro Bersaneti, Renata Desordi Lobo, Thais Bianca Brandão, Regina Claudia Silva Souza, Vanessa de Brito Poveda","doi":"10.1097/XEB.0000000000000413","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A175.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Oral hygiene in critically ill patients at a tertiary hospital in São Paulo, Brazil: a best practice implementation project.\",\"authors\":\"Mariana Davies Ribeiro Bersaneti, Renata Desordi Lobo, Thais Bianca Brandão, Regina Claudia Silva Souza, Vanessa de Brito Poveda\",\"doi\":\"10.1097/XEB.0000000000000413\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>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.</p><p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A175.</p>\",\"PeriodicalId\":48473,\"journal\":{\"name\":\"Jbi Evidence Implementation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-03-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jbi Evidence Implementation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/XEB.0000000000000413\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jbi Evidence Implementation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/XEB.0000000000000413","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
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.