预防老年人医院获得性肺炎(HAP)发生的住院患者口腔护理模式

Tim Sumarni, B. Santoso, Rasipin Rasipin, Lanny Sunarjo, Supriyadi Supriyadi
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摘要

医院获得性肺炎(HAP)的原因是牙菌斑细菌与其他肺部病原体定植。这种情况在口腔内建立合理的病原体呼吸,导致高危肺炎。HAP的危险人群为70岁以上,有严重合并症、营养不良、意识下降和慢性阻塞性肺疾病。预防医院感染需要采取综合和规划好的行动,以减少微生物的传播。本研究旨在建立住院患者口腔卫生保健模式,预防老年人HAP的发生。这项研究是在印度尼西亚明古鲁省Mukomuko医院的老年病房进行的。产品测试采用准实验前测和后测设计。本研究的样本为每16名调查对象,其中干预组接受牙科和口腔护理,对照组根据口腔卫生国家标准印度尼西亚Kepmenkes 2006年第284号进行治疗。结果显示,口腔护理与预防HAP相关,平均为88.4(可行)(p值0.001),与对照组相比,其应用在提高知识(p=0.000)、态度(0.000)、提高刷牙技能(p=0.000)、漱口技能(p=0.000)、降低碎屑指数评分(p=0.000)、减少CPIS应答者(p=0.000)和痰培养结果(p=0.000)方面均有效。综上所述,口腔保健可提高老年人维持口腔健康的技能,降低口腔碎片指数和CPIS(临床肺部感染评分)。
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Dental and Oral Care Model for Inpatients to Prevent the Occurrence of Hospital Acquired Pneumonia (HAP) in the Elderly in the Geriatric Room of Mukomuko Hospital Bengkulu Province
The cause of Hospital Acquired Pneumonia (HAP) is bacteria from dental plaque, colonizing with other pulmonary pathogens. This condition builds rational pathogen respiration in the oral cavity resulting in high-risk pneumonia. The risk group for HAP is over 70 years old, who have serious co-morbidities, malnutrition, decreased consciousness, and chronic obstructive pulmonary disease. Prevention of nosocomial infections requires integrated and programmed actions to reduce the transmission of organisms. This study aims to develop a model of dental and oral health care for inpatients to prevent the occurrence of HAP in the elderly. This study was conducted in the geriatric ward of Mukomuko Hospital, Bengkulu Province, Indonesia. The product test used a quasi-experimental pretest and posttest design. The sample of this study was each 16 respondents in the intervention group receiving dental and oral care and the control group receiving treatment as per the dental health national standard Indonesia Kepmenkes No.284, 2006. The results show that dental and oral care is relevant to prevent HAP with an average value of 88.4 (feasible) (p-value 0.001, and its application is effective in increasing knowledge (p=0.000) ),attitude (0.000), increased brushing skills (p = 0.000), gargle skills (p-value 0.000), decreased debris index score (p = 0.000), decreased CPIS respondents with (p = 0.000) and sputum culture results ( p = 0.000) compared to the control group. In conclusion, dental and oral health care can increase the skills of maintaining dental oral health, reduce the debris index and CPIS (Clinical Pulmonary Infection Score) for the elderly.
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