Barnes Caren M
Applied and Clinical Research, Department of Dental Hygiene, Nebraska Center for Materials and Nanoscience, University of Nebraska Medical Center, College of Dentistry, Lincoln, NE 68583-0740, USA.
J Evid Based Dent Pract. 2014 Jun;14 Suppl:103-14. doi: 10.1016/j.jebdp.2014.02.002. Epub 2014 Feb 13.
Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists.
Nosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings.
A comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested.
Dental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias.
通过护士和牙科保健员之间的协作,采取有效的口腔卫生措施,可以减少困扰重症患者、老年人和长期护理居民的医院获得性肺炎和呼吸机相关性肺炎。
医院获得性肺炎,特别是老年人和体弱者的吸入性肺炎和呼吸机相关性肺炎,已成为一个主要的医疗保健问题。在医院和类似医院的设施中提供口腔护理存在挑战,可能会使患者无法获得最佳的口腔护理。一个后遗症可能是吸入性肺炎,在所有医院感染中,其死亡率排名第一,发病率排名第二。由于吸入性肺炎与牙菌斑和生物膜中的口腔细菌定植有关,现在是时候寻找创造性的解决方案,将牙科保健员的专业知识融入这些机构环境中的医疗团队了。
对与医疗保健相关肺炎的病因和患病率的文献进行了全面综述。提供了描述护士、护理人员和牙科保健员在医院和长期护理设施中提供口腔护理时面临的挑战和障碍的证据。提出了在医院和长期护理设施中提供最佳口腔护理的跨部门协作解决方案。
牙科保健员具备在医院、长期护理和居住设施中提供口腔护理的专业知识和实践经验。他们可以通过与其他医疗团队成员的跨部门协作,为解决口腔护理挑战做出贡献。然而,为了提供这种最佳护理,必须解决长期存在的系统性障碍。牙科保健员在医院和居住设施的整个医疗团队中更好地融入,可以对与吸入性肺炎相关的痛苦、发病率和死亡率产生积极影响。