ABSTRACT

Background: Tracheal intubated patients are at risk of developing a variety of oral health problems due to impaired natural airway defense, loss of protective tooth substance, and changes of normal flora oral composition. These oral health problems can increase the risk of Ventilator-associated pneumonia (VAP). One strategy for preventing VAP in intubated patients is oral care, but the procedure for its implementation is still very diverse. Therefore, become important to identify evidence-based about oral care practice for intubated patients to prevent VAP. Objective: To identify the evidence of oral care practice for intubated critically ill patients. Methods: Literature review based on content analysis. The search was limited to articles published from 2011-2017 with Randomized-controlled trial (RCT) or quasi-experimental research design. The databases used CINAHL, MEDLINE, PubMed, Proquest and Sciencedirect with the keywords were oral care, oral hygiene, mouth care, mechanically ventilated, intubated, critical care and intensive care. Results: Eight articles were obtained regarding the oral care technique using swabs, toothbrushing or a combination of swabs and toothbrushing on the teeth, gingiva, and tongue using chlorhexidine gluconate. The frequency of implementation depends on the oral health assessment score and was done at least every 12 hours a day. Also, it was recommended that moisturizers be given to the oral mucosa and lips to maintain the mucosa integrity.

Conclusion: Oral care practice was adjusted to the oral health assessment of each patient, so that the oral health status may be improved because it was following the patient’s needs. Therefore, nurses in the critical care setting need to conduct oral health assessment as basic guidance giving oral care which is one of the VAP bundle care strategies.

Keywords: ICU, intubated patient, oral care.