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Ustna higiena pri intubiranih bolnikih : diplomsko delo
ID Trgalović, Jasmina (Author), ID Djekić, Bernarda (Mentor) More about this mentor... This link opens in a new window

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MD5: 2038ECA29328360348D4DACF1BDE9C82
PID: 20.500.12556/rul/06c999d4-2550-4140-9f9f-274e13003772

Abstract
Uvod: Higiena ustne votline je ključna za zagotavljanje varnosti pri intubiranih bolnikih, saj lahko zmanjša tveganje za poškodbe ustne sluznice ter pojav bolezni, kot je pljučnica ob umetnem predihavanju. Medicinske sestre so odgovorne za načrtovanje in izvajanje individualno prilagojene higiene ustne votline intubiranih bolnikov. Namen: Namen diplomskega dela je predstaviti posebnosti higiene ustne votline pri intubiranih bolnikih v enotah intenzivnega zdravljenja, s poudarkom na vlogi medicinske sestre. Cilj diplomskega dela je ugotoviti na dokazih podprt najustreznejši način čiščenja ustne votline in prikazati posamezne korake pri ustni higieni intubiranega bolnika z zdravo ustno sluznico. Metode dela: Uporabljena je bila deskriptivna metoda, ki je temeljila na sistematičnem pregledu domače in tuje znanstvene in strokovne literature iz časovnega obdobja od leta 2007 do leta 2017. Iskanje je potekalo v bazah CINAHL in Medline ter preko COBIB.SI. V kvalitativno analizo je bilo vključenih 10 člankov. Rezultati: Ugotovljeno je bilo, da so priporočila za izbor ustreznih pripomočkov za čiščenje ustne votline pri intubiranih bolnikih različna. Mehke aspiracijske zobne ščetke so učinkovitejše pri odstranjevanju zobnih oblog kot gobice iz pene. Uporaba klorheksidina zmanjša bakterijsko obremenitev ustne votline in s tem nevarnost pljučnice ob mehanskem predihavanju. Razprava in sklep: Zagotavljanje higiene ustne votline pri intubiranih bolnikih je kompleksna in večplastna naloga medicinske sestre. Smernice in prakse higiene ustne votline se razlikujejo od države do države, od bolnišnice do bolnišnice. Protokoli za usmerjanje higiene ustne votline so neusklajeni in preskopo oblikovani. Kljub številnim mednarodnim smernicam, ki temeljijo na dokazih za preprečevanje pljučnice ob umetnem predihavanju, v pregledani slovenski literaturi ni bilo protokola zdravstvene nege, ki bi vključeval način in pogostost higiene ustne votline za intubirane bolnike. Potrebno je strokovno izpopolnjevanje medicinskih sester, ciljano raziskovanje ter oblikovanje nacionalnih protokolov z natančno določenimi koraki izvajanja higiene ustne votline.

Language:Slovenian
Keywords:kritično bolni, pljučnica ob umetnem predihavanju, aspiracijske zobne ščetke, protokoli, smernice
Work type:Bachelor thesis/paper
Organization:ZF - Faculty of Health Sciences
Year:2017
PID:20.500.12556/RUL-98381 This link opens in a new window
COBISS.SI-ID:5367915 This link opens in a new window
Publication date in RUL:29.11.2017
Views:4020
Downloads:786
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Secondary language

Language:English
Title:Oral hygiene of intubated patiens : degree work
Abstract:
Introduction: Careful oral hygiene is essential for ensuring the safety of intubated patients as it can reduce the risk of injury to the oral cavity and the onset of a disease such as ventilator-associated pneumonia. Nurses are responsible for planning and implementation of personalized oral care to intubated patients. Purpose: Purpose is to describe oral care practices performed by critical care nurses for orally intubated critically ill patients. The goal of the diploma work is determined in an evidence-based way the most appropriate way of cleaning the oral cavity and to show the individual steps in the oral hygiene of an intubated patient with a healthy oral mucosa. Methods: Descriptive method is based on a systematic review of domestic and foreign scientific and professional literature in the period 2007-2017 using the databases Medline and CINAHL and the COBIB.SI. 10 articles were included in the qualitative analysis. Results: Analyzed articles show that oral care protocols are inconsistency. Soft aspiration toothbrushes are more effective in removing toothbrush than foam sponges. The use of chlorhexidine reduces the bacterial load of the oral cavity and the risk of pneumonia with mechanical ventilation. Discussion and conclusion: The provision of mouth care for orally intubated patients is a complex, multifaceted practice of nurses. Oral care policies and practices vary from state to state, hospital to hospital. Protocols and practices of oral care are inconsistency and lacking altogether. Despite the numerous international evidence-based guidelines for preventing ventilator-associated pneumonia, no protocol for oral care that includes the type, frequency and duration of oral care practices for orally intubated critically ill adults has been presented guidelines in Slovenian literature. It is necessary to carry out professional training of nurses, targeted research and design of national protocols with precisely determined steps of performing oral hygiene.

Keywords:criticaly ill, ventilator-associated pneumonia, aspiration toothbrushes, protocols, guidelines

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