Educational Intervintion in a Nursing Team on Oral Hygiene of Critically Ill Patientes in an Intensive Care Unit Intervenção Educativa em uma Equipe de Enfermagem Sobre Higiene Bucal de Pacientes Críticos na Unidade de Terapia Intensiva

Main Article Content

Milena Rayane de Andrade Teixeira
Michelline Cavalcanti Toscano de Brito
Sabrina Sales Lins de Albuquerque
Ângelo Brito Pereira de Melo

Abstract

Ventilator-associated pneumonia (VAP) is a type of recurrent infection in critical patients admitted to the Intensive Care Unit (ICU) and has high morbidity and mortality rates. Its pathogenesis results from the introduction of oral microbiota bacilli passed from the orotracqueal tube to the lower respiratory tract, functioning as a potential reservoir of infectious material. The aim of this study is to assess the knowledge of an ICU nursing team on oral hygiene (OH) in critically ill patients under hospitalization and, from the data obtained, to elaborate an informative material on the main issues pointed out. It is an exploratory, descriptive and quantitative study carried out in two stages: the application of a questionnaire to analyze the team’s knowledge on oral hygiene methods as a measure of disease prevention; and the preparation of an educational booklet with approaches on the subject in order to inform and update the participants. We counted with the collaboration of 65 professionals, mostly female and aged between 31-40 years. As for oral hygiene in patients under mechanical ventilation, most of the participants answered that they had not received information on the subject during professional training, as well as not having knowledge of the protocol for these procedures in the institution they were working. All of them agreed that oral hygiene is important in critically ill patients. However, the majority did not associate it with the prevention of VAP. Thus, the implementation and supervision of interdisciplinary actions to promote oral health in critically ill patients under hospitalization is capable of promoting a standardized conduct, as well as better care for the individual admitted in the ICU.

Article Details

How to Cite
Rayane de Andrade Teixeira, M., Cavalcanti Toscano de Brito, M., Sales Lins de Albuquerque, S., & Brito Pereira de Melo, Ângelo. (2022). Educational Intervintion in a Nursing Team on Oral Hygiene of Critically Ill Patientes in an Intensive Care Unit . Naval Dental Jounal, 49(2), 5-17. https://doi.org/10.29327/25149.49.2-1
Section
Original Article
Author Biographies

Milena Rayane de Andrade Teixeira, Universidade Federal da Paraíba, João Pessoa, PB, Brasil

Residência Integrada Multiprofissional em Saúde Hospitalar (RIMUSH), Universidade Federal da Paraíba, João Pessoa (PB), Brasil.

Michelline Cavalcanti Toscano de Brito, Universidade Federal da Paraíba (UFPB), João Pessoa (PB), Brasil

Departamento de Odontologia, Universidade Federal da Paraíba (UFPB), João Pessoa (PB), Brasil

Sabrina Sales Lins de Albuquerque, Universidade Federal da Paraíba (UFPB), João Pessoa (PB), Brasil

Departamento de Odontologia, Universidade Federal da Paraíba (UFPB), João Pessoa (PB), Brasil.

Ângelo Brito Pereira de Melo, Universidade Federal da Paraíba (UFPB), João Pessoa (PB), Brasil

Departamento de Odontologia, Universidade Federal da Paraíba (UFPB), João Pessoa (PB), Brasil

References

1. Maran E, Spigolon DN, Matsuda LM, Teston EF, Oliveira JLC, de Souza VS, Marcon SS. Efeitos da utilização do bundle na prevenção de pneumonia associada à ventilação mecânica: revisão integrativa. Revista Cuidarte. 2020;12(1):1-15. Disponível em: https://doi. org/10.15649/cuidarte.1110 2. Lucena PM, Oliveira Junior FC, Feitosa ANA, Nascimento JCA. Benefícios da implementação de um bundle para prevenção de pneumonia associada à ventilação mecânica na UTI. Rev Interdisciplin Saúde. 2018; 5(4): 831-848. Disponível em: http://interdisciplinaremsaude. com.br/Volume_20/Trabalho_15.pdf 3. Montini GR, Mestrinari ACR, Rodrigues AMDS, Contrin LM, Werneck AL, Beccaria LM. Adesão Ao Bundle Para Prevenção De Pneumonia Associada À Ventilação Mecânica Em Terapia Intensiva. Cuidarte Enferm. 2020; 14(2): 172-180. Disponível em: https://pesquisa.bvsalud. org › resource › biblio-1147113 4. Alves JNB, Soares LG, Baratieri T, Pitilin EB, Pelazza BB, Zanoti-Jerônimo DV, Caobianco CZ, Lentsck MH. Pneumonia in Patients Hospitalized for Trauma Under Intensive Care. J Nurs UFPE online. 2021; 15(245951): 1-15. Disponível em: https://doi.org/10.5205/1981- 8963.2021.245951 5. Nóbrega LM, Vasconcelos JM, Morais JL, Araújo CC, Ramalho Neto JM, Leite AC. Pneumonia associada à ventilação mecânica em pacientes graves de uma unidade de terapia intensiva. Enferm Foco. 2021; 12(4): 746-52. Disponível em: https://doi.org/10.21675/2357707X.2021.v12.n4.4525 6. Lopes FLAR, Barcelos AMC. The Importance Of Oral Hygiene In Patients Intubated In The Icu. Revista IberoAmericana De Humanidades, Ciências E Educação. 2022; 8(2):881–894. Disponível em: https://doi. org/10.51891/rease.v8i2.4244. 7. Cardoso MEV, Souza A. Application of a Pneumonia Prevention Bundle In a Pediatric Icu. J Nurs UFPE online. 2021; 15(245042): 1-15. Disponível em: https://doi. org/10.5205/1981-8963.2021.245042. 8. Costa RS, Motta LC, Alfradique MD. O perfil epidemiológico do paciente com pneumonia associada à ventilação mecânica. Rev Fac Med Teresopolis. 2018; 2(2): 93-112. Disponível em: https://revista.unifeso.edu.br/index.php/ faculdadedemedicinadeteresopolis/article/view/1020/0. 9. Liz JS, Gouvea PB, Silva ACA, de Araújo Sandri JV, de Paula DM, Maia SC. Cuidados multiprofissionais relacionados a prevenção da pneumonia associada à ventilação mecânica. Enfermagem em Foco. 2020; 11(2): 85-90. Disponível em: https://doi.org/10.21675/2357-707X.2020.v11.n2.2734 10. Melo MM, Santiago LMM, Nogueira DL, Vasconcelos MFP, Melo MM. Ventilator-Associated Pneumonia: the Knowledge of Health Professionals Towards Prevention and Educational Measures. Rev Fund Care Online. 2019; 11(2): 377-382. Disponível em: https://doi. org/10.9789/2175-5361.2019.v11i2.377-382 11. Zhao T, Wu X, Zhang Q, Li C, Worthington HV, Hua F. Oral hygiene care for critically ill patients to prevent ventilatorassociated pneumonia. The Cochrane database of systematic reviews. 2020; 12(12): 1-142. Disponível em: https://doi.org/10.1002/14651858.CD008367.pub4. 12. Di Paolo GB, Pereira CS, Souza Júnior AR, Machado FC, Carvalho TA. Impacts of intensive care patients’ oral hygiene on nosocomial and ventilator-associated pneumonia: integrative literature review. Research, Society and Development. 2021; 10(13): 1-12. Disponível em: https://doi.org/10.33448/rsd-v10i13.21586 13. Alecrim RX, Taminato M, Belasco AGS, Barbosa D, Kusahara DM, Fram D. Good practices in the prevention of ventilator-associated pneumonia. Acta Paulista de Enfermagem. 2019; 32 (1): 11-17. Disponível em: https:// doi.org/10.1590/1982-0194201900003 14. Santos MS, Santos WS, Santana TS, Santana VD. Fatores de risco para pneumonia associada à ventilação mecânica: Revisão de escopo. Research, Society and Development. 2022; 11(5): 1-14. Disponível em: http:// dx.doi.org/10.33448/rsd-v11i5.281261 15. Barletta FRC, Pérez-Ponce LJ, Barletta-Castillo JE, González Guirola MA, Sánchez-Castellanos RL, PujolPeréz M. Caracterización clínica y microbiológica de pacientes con neumonía asociada a la ventilación mecânica. Medisur. 2019; 17(4): 514-24. Disponível em: http://www. medisur.sld.cu/index.php/medisur/article/view/4131 16. Jerônimo LS, Abreu LG, Cunha FA, Lima RPE. Association Between Periodontitis and Nosocomial Pneumonia: A Systematic Review and Meta-analysis of Observational
Studies. Oral Health Prev Dent. 2020; 18(1):11-17. Disponível em: https://10.3290/j.ohpd.a44114. 17. Branco A, Lourençone EMS, Monteiro AB, Fonseca JP, Blatt CR, Caregnato RCA. Education to prevent Ventilatorassociated pneumonia in Intensive Care Unit. Rev Bras Enferm. 2020; 73(6): 1-7. Disponível em: http:// dx.doi.org/10.1590/0034-7167-2019-0477 18. Dutra LA, Esteves LO, Silva TO, Resck ZMR, Lima RS, Sanches RS. Ventilator-Associated Pneumonia: Perception Of The Nursing Staff. J Nurs UFPE online. 2019; 13(4): 884-92. Disponível em: http://doi. org/10.5205/1981-8963-v13i04a237363p884-892-2019 19. Araújo AM, Oliveira DMS, Caralho ARB, Araújo MZ, Mendes JR, Pires IR. Assistência de enfermagem na prevenção de pneumonia associada à ventilação mecânica: revisão integrativa. Journal of nursing health. 2021; 11(3): 1-16. Disponível em: https://periodicos.ufpel. edu.br/ojs2/index.php/enfermagem/article/view/17637 20. Tenório LMF, Barbosa RMS, Ferreira CVTO, Tenório LGF, Sampaio, NV, Henrique SS, Oliveira CRR. A importância do Cirurgião-Dentista na Unidade de Terapia Intensiva. Brazilian Journal of Health Review. 2021; 4(6): 2377123776. Disponível em: https:// 10.34119/bjhrv4n6-010. 21. Santos LSC, Barros SD, Ferreira MFDC, Barros BTD, Barros RLM, Souza BRB, Campos JER, Lameira MBF, Paula MC, Ferreira MNGP, Prazeres LEN, Lobato FRO, Almeida RNS, Gama ACC, Lima TFS. Nursing in the prevention and care of ventilator-associated pneumonia: An integrative review. Research, Society and Development. 2021; 10(7): 1-13. Disponível em: https:// doi.org/10.33448/rsd-v10i7.16935 22. França VGC, Lins AGA, Santos CLD, Ferreira LGDA, Silva RMD, Almeida TCDS, Silva CC, Oliveira DAL. Nursing Care: Prevention Of Pneumonia Associated With Mechanical Ventilation. Rev. enferm. UFPE on line. 2021; 15(1): 1-14. Disponível em: https://doi.org/10.5205/19818963.2021.246221. 23. Associação de Medicina Intensiva Brasileira – AMIB, Departamento de Odontologia e Departamento de Enfermagem. Procedimento Operacional Padrão (POP)- Higiene Bucal (HB) em pacientes internados em Unidades de Terapia Intensiva adulto ou pediátrica [Internet]. São Paulo: Associação de Medicina Intensiva Brasileira; 2021; 1-9. (Acesso em 10 de julho de 2022). Disponível em: https://www.amib.org.br/wp-content/uploads/2022/06/ POP_UTI_NEO-PED_AMIB_-_2021.pdf 24. Santos GEO. Cálculo amostral: calculadora on-line. 2011. (Acesso em janeiro 2017). Disponível em: http:// https://praticaclinica.com.br/anexos/ccolaborativacalculoamostral/ccolaborativa-calculo-amostral.php 25. Souza ERL, Cruz JHA, Gomes NML, Palmeira JT, Oliveira HMBF, Guênes GMT, Alves MASG, Oliveira Filho AA. Fisiopatologia da pneumonia nosocomial: uma breve revisão. Archives Of Health Investigation. 2020; 9(5): 485– 492. Disponível em: https://doi.org/10.21270/archi.v9i5.4728 26. Fonseca ABA, Farias IF, Ferreira MS, Mendonça RP. Protocolos Utilizados para Higienização Bucal de Pacientes em Unidades De Terapia Intensiva: Uma Revisão Sistemática. Revista Saúde. 2022; 16 (1):54-69. Disponível em: doi:10.33947/1982-3282-v16n1-4545. 27. Güler EK. e Türk G. Oral Chlorhexidine Against Ventilator-Associated Pneumonia and Microbial Colonization in Intensive Care Patients. West J Nurs Res. 2019; 41(6):901-919. Disponível em: https://doi. org/10.1177/0193945918781531. 28. Eom JS, Lee MS, Chun HK, Choi HJ, Jung SY, Kim YS, Yoon SJ et. al. The impact of a ventilator bundle on preventing ventilator-associated pneumonia: a multicenter study. Am J Infect Control. 2014 Jan;42(1):34-7. Disponível em: https://doi.org/10.1016/j.ajic.2013.06.023 29. De Cristofano A, Peuchot V, Canepari A, Franco V, Perez A, Eulmesekian P. Implementation of a Ventilator - Associated Pneumonia Prevention Bundle in a Single PICU. Pediatr Crit Care Med. 2016 May;17(5):451-6. Disponível em: doi: 10.1097/PCC.0000000000000714. 30. Blum DF, Silva JAS, Baeder FM, Bona AD. The practice of dentistry in intensive care units in Brazil. Rev Bras Ter Intensiva. 2018;30(3):327-332. Disponível em: https://doi. org/10.5935/0103-507X.20180044 31. Rabello F, Araújo VE, Magalhães S. Effectiveness of oral chlorhexidine for the prevention of nosocomial pneumonia and ventilator-associated pneumonia in intensive care units: Overview of systematic reviews. International journal of dental hygiene. 2016; 16(4): 441–449. Disponível em: https://doi.org/10.1111/idh.12336 32. Karatas M, Saylan S, Kostakoglu U, Yilmaz G. An assessment of ventilator-associated pneumonias and risk factors identified in the intensive care unit. Pakistan Journal of Medical Sciences. 2016; 32(4): 817–822. Disponível em: https://doi.org/10.12669/pjms.324.10381 33. Li Y, Liu C, Xiao W, Song T, Wang S. Incidence, Risk Factors, and Outcomes of Ventilator-Associated
Pneumonia in Traumatic Brain Injury: A Meta-analysis. 2020; 32(1): 272–285. Disponível em: https://doi. org/10.1007/s12028-019-00773-w 34. Pazzos CP, Soares FMM, Barroso LC, Sousa GMC, Rodrigues GIS, Mesquita KKB, Freitas JG, Andrade IRC. Good Nursing Practices For Patients On Mechanical Ventilation. J Nurs UFPE on line. 2020; 14(242958): 1-9. Disponível em: https:// doi.org/10.5205/1981- 8963.2020.242958 35. Costa BERN, Silva DL, Varejão LC. The dentist facing the prevention of Pneumonia Associated with Mechanical Ventilation (PAVM) in the Intensive Care Unit (ICU). Research, Society and Development. 2021; 10 (13): 1-9. Disponível em: https://doi.org/10.33448/rsd-v10i13.21426 36. Deschepper M, Waegeman W, Eeckloo K, Vogelaers D, Blot S. Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study. Intensive care medicine. 2018; 44(7):1017–1026. Disponível em: https://doi.org/10.1007/s00134-018-5171-3 37. Leite AC, Silva MPB, Sousa GMR, Silva ML, Santos SL, Sousa MVA, et al. Risk factors for developing ventilator - associated pneumonia in patients admitted to the Intensive Care Unit. Research, Society and Development. 2021;10(17): 1-18. Disponível em: https:// doi.org/10.33448/rsd-v10i17.23343 38. Ferreira JF, Cruz ICF. What is the best digital technology for the keep in ventilation with mechanical ventilation nursing intervention in ICU - Systematic Literature Review. Journal of Specialized Nursing Care. 2022; 14(1):110. Disponível em: http://www.jsncare.uff.br/index.php/ jsncareurn:nbn:de:19834152jsncare.v14i1.34585