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The hospital used for the study already had protocols in place to prevent patients from getting pneumonia. Published data was provided and posters were placed in all units. However, the nurses chose not to follow the protocols set forth. This is the reason the study was conducted. The nurses confessed that they felt oral care was more of a comfort to the patients than a preventative measure to pneumonia. The really did not take the time to learn that improper oral care in these patients lead to the excessive growth of bacteria which eventually found its way down the respirator tube and into the patient's lungs causing pneumonia. Once the nurses went through formal evidence-based program and followed the proper protocol, the rate of ventilator pneumonia decreased by 50%.
Providing proper training in addition to the posters displayed helped to reinforce the significance of proper oral care for their patients. The nurses adapted to the protocols because they were formally educated which removed barriers and their perceptions of the true reason behind proper oral care. Even though evidence was presented and posters were hung, the main points behind actually brushing the patient's teeth at least twice a day as opposed to using oral swabs twice daily were lost on the nurses because they had not gone through an actual evidence-based program that explained how an improperly treated mouth can gather harmful bacteria responsible for pneumonia.
Once the decision was made to educate the nurses beyond the postings...
The intensive care nurses were the first group of healthcare workers to be educated and then the change was implemented among other nurses, nurses' aids and other healthcare professionals who might play a role in the overall care of the patient. After an evaluation was done, it was discovered that at least 84% of those trained were in compliance with the oral care protocols.
This article serves as an excellent example of putting evidence-based practice to use. The hospital studied thought they had done so by displaying posters on how nurses and other hospital staff should care for the oral concerns of the patients. What they discovered was that the general assumption of the nurses was that the oral care given to the patients was more of a comfort to them than a preventative measure. Once a formal evidence-based program was put into place, the nurses saw the importance of brushing the teeth instead of using oral swabs and as a result, the incidence of pneumonia decreased dramatically. The reduction in ventilator patient pneumonia could possibly be decreased even further in the long-term. If so, it is a win-win situation for all stakeholders involved.
References
Ross, a. And Crumpler, J. (2007). The impact of an evidence-based practice education program
on the role of oral care in the prevention of ventilator-associated pneumonia. Intensive and Critical Care Nursing, 23(3), 132-136.
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