A Clinical Study On The Prevention Of Ventilator-associated Pneumonia By A Modified Oral Care Model

OBJECTIVE: To evaluate the effect of modified oral care model in clinical application by comparing the effects of conventional oral care and modified oral care models on the prevention of ventilator-associated pneumonia,and to provide scientific guidance for the development of clinical ventilator-associated pneumonia prevention programs.Limits reduce the incidence of ventilator-associated pneumonia.METHODS: From October 2016 to March 2017,60 patients undergoing orotracheal intubation(Mechanical ventilation through the air-pipe intubation)were hospitalized in our intensive care unit(ICU)and met the inclusion criteria.The random number table was randomly divided into experimental group(31 cases)and control group(29cases),which were given modified oral care and routine oral care.The oral complications,oral hygiene,APACHE II scores,oral secretions before and after nursing were compared between the two groups of patients.Bacterial culture,incidence of ventilator-associated pneumonia,and comparison of treatment status were analyzed to analyze the influencing factors of ventilator-associated pneumonia.The data involved in the study were statistically analyzed.Results:(1)Before care,the two groups of patients had more oral complications of different types,and the difference in incidence was not statistically significant(P>0.05).After nursing,the oral complications of both groups were improved.The incidence of halitosis and oral ulcers in the experimental group was significantly lower than that in the control group(P<0.05).(2)The difference in oral cleanliness and APACHE II between the experimental group and the control group before intubation care was small(P>0.05);on the 7th day after nursing,the oral cleanliness and APACHE II were significantly lower in the experimental group than in the control group(P< 0.05).(3)The number of oral secretions before oral care in the experimental group and the control group was slightly different(P>0.05).The number of colony-cold secretions in the experimental group on the 7th day after nursing was significantly lower than that in the control group.The difference was statistically significant.Significance(P < 0.05).(4)Before nursing,there was little difference in the positive rate of qualitative swab culture results between the two groups(P>0.05).The positive rate of the experimental group after nursing was significantly lower than that of the control group(P<0.05).).(5)The mortality rate was 12.90%(4/31)in the experimental group and 17.24%(5/29)in the control group.There was no significant difference in mortality between the two groups(P>0.05);but in the experimental group The Mechanical ventilation through the air-pipe intubation time and ICU stay were significantly shorter than those of the control group,with a significant difference(P<0.05).(6)The incidence of ventilator-associated pneumonia in the experimental group was 3.25%(1/31),which was significantly lower than that in the control group(17.24%(5/29).The difference was statistically significant(P<0.05).(7)The univariate and multivariate regression analysis showed that the occurrence of ventilator-associated pneumonia was influenced by the oral cleaning score,the number of oral secretion colonies,and the Mechanical ventilation through the air-pipe intubation time.The oral cleaning score and the number of oral secretion colonies independently affected the primers.Conclusion: Improved oral care for Mechanical ventilation through the air-pipe intubation patients can improve oral hygiene,improve oral cleanliness,reduce oral complications,improve patient condition,control infections,reduce the incidence of ventilator-associated pneumonia,optimize the clinical treatment effect of patients,and shorten the Mechanical ventilation through the air-pipe intubation time.,ICU stay time,reduce mortality,the effect is ideal,promotion and application of high value.