Professional organizations are now recognizing
comprehensive oral care as key to addressing VAP and HAP.
Institute for Healthcare Improvement (IHI)
Prevent Ventilator-Associated Pneumonia - How-to Guide
Ventilator Bundle:
- Elevation of the Head of the Bed
- Daily "Sedation Vacations" and Assessment of Readiness to Extubate
- Peptic Ulcer Disease Prophylaxis
- Deep Venous Thrombosis Prophylaxis
- Daily Oral Care with Chlorhexidine
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APIC 2009 GUIDE TO THE ELIMINATION OF
VENTILATOR-ASSOCIATED PNEUMONIA1
Key prevention strategies:
- Perform routine antiseptic mouth care
Example mouth care and documentation
form includes the following:
- Brush teeth q12°
- Provide oral care every 2 to 4 hours with antiseptic
- Apply mouth moisturizer to oral mucosa and lips
- Suction orally as necessary
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SOCIETY FOR HEALTHCARE EPIDEMIOLOGY OF
AMERICA (SHEA)2
A Compendium of Strategies to Prevent Healthcare-
Associated Infections in Acute Care Hospitals
Strategies to Prevent Ventilator-Associated Pneumonia
in Acute Care Hospitals
"Perform regular antiseptic oral care in accordance with product guidelines"* †
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CDC Guidelines for Preventing Healthcare--Associated Pneumonia, 2003
CDC, MMWR. March 26, 2004;53(RR03);1-36.
Download Oral Hygiene Excerpt (.pdf*)
View full text
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AACN Procedure Manual for Critical Care — Oral Care Interventions, 20053,*
"Assess oral cavity and lips every 8 hours, and perform oral care every 2 to 4 hours and as needed.† With oral care, assess for buildup of plaque on teeth or potential infection related to oral abscess."
"Perform oral hygiene, using pediatric or adult (soft) toothbrush, at least twice a day. Gently brush patient’s teeth to clean and remove plaque from teeth."†
"In addition to brushing twice daily, use oral swabs with a 1.5% hydrogen peroxide solution to clean mouth every 2 to 4 hours."†
"With each cleansing, apply a mouth moisturizer to the oral mucosa and lips to keep tissue moist."†
"Suction oral cavity/pharynx frequently."††
"Antiseptic oral rinses (chlorhexidine, cetylpyridinium chloride (CPC), added after brushing or done in conjunction with comprehensive oral care did achieve elimination of VAP. (Level B)"
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