PICO Question
Population – Mechanically ventilated intensive care patients.
Intervention – Oral care with chlorhexidine.
Comparison – Oral care with other chlorhexidine.
Outcome – Decreased oropharyngeal pathogen colonization reduces number of VAPs and lowering intubation time, hospital stay, and mortality rate Does the use of chlorhexidine oral care reduce the number of ventilator-acquired pneumonias? More specifically, determine the efficay of chlorhexidine in decontamminating the oral cavity of pathogens in mechanically ventilated intensive care patients based on published scientific literature.
Significance of the Problem Pneumonia is the second most common nosocomial infection in the United States and the leading cause of death from nosocomial infections. Critically ill patients are a vulnerable population that is more susceptible to developing nosocomial infections. Ventilator-associated pneumonia (VAP) occurs in patients treated with mechanical ventilation, and is associated with a higher incidence in patients treated with continuous ventilatory support. These patients have 8% to 25% risk of developing VAP, and the risk increases by as much as 1% per ventilator day (CDC, 2015). VAP is considered a serious problem, because it extends hospital stay by 6 days or more, has substantial cost implications of up to $40,000 per patient episode, and is associated with significant morbidity and mortality rates (CDC, 2015). Strategies for the reduction and prevention of VAP are urgently needed to help reduce hospitalization costs, incidence of mortality and improve patient outcome. Evidence identifies that VAP occurs 48 hours after intubation and because length of MV increases risk of acquiring an infection, it is divided into two categories, early-onset (4 days of MV). The development of VAP linked to increased oropharyngeal colonization and bacterial