PURPOSE
This review aimed to determine the effectiveness of oral care using Chlorhexidine Gluconate (CHX) in Ventilator-Associated Pneumonia (VAP) in the intensive care unit.
METHODS
An electronic databases search was conducted with Ovid-MEDLINE, EMBASE, CENTRAL, CINAHL and four domestic databases from July 10 to 16, 2018. Two reviewers independently selected the studies; three reviewers assessed their methodological quality and extracted relevant data. We conducted a meta-analysis of the effect of CHX oral care versus placebo using the Review Manager 5.3 software program and summarized the results of intervention from the included studies.
RESULTS
Of the 512 articles identified, 17 randomized controlled trials met the inclusion criteria for review. The incidence of VAP differed significantly between the CHX and placebo groups (Relative Risk [RR]=0.72, 95% Confidence Interval [CI]=0.63~0.84). The pooled effects of oral care using 0.12% CHX were RR=0.65 (95% CI=0.52~0.80) and RR=0.68 (95% CI=0.54~0.86) using CHX solution, which were statistically significant. When CHX oral care was performed three times a day, the size of the effect was statistically significant (RR=0.63, 95% CI=0.40~0.99). There was no significant difference in mortality between the CHX oral care and placebo groups (RR=1.08, 95% CI=0.94~1.28).
CONCLUSION
This review provides evidence that performing oral care using a 0.12% CHX solution three times a day could decrease the incidence of VAP. For improving the quality of nursing practice, the results of this review should be used as the basis for the oral care evidence-based practice guidelines for critical patients.

Citations

• Oral Hygiene Care of Endotracheal Intubated Patients in Korean Intensive Care Units : A Scoping Review
  Jungeun Lim, Dukyoo Jung, Leeho Yoo
  Journal of Korean Critical Care Nursing.2024; 17(1): 68.     CrossRef
• Effect of 2% Chlorhexidine Bathing on the Incidence of Hospital-Acquired Infection and Multidrug-Resistant Organisms in Adult Intensive Care Unit Patients: Systematic Review and Meta-Analysis
  Jisu Seo, Rhayun Song
  Journal of Korean Academy of Nursing.2021; 51(4): 414.     CrossRef

PURPOSE
The objective of this study was to examine the relationships between nurses' knowledge and performance for the prevention of intravascular catheter-related infections (ICRI) according to the strength of recommendations in evidence based guidelines (EBG).
METHODS
The total participants were 144 nurses working for medical.surgical unit and intensive care unit. Data were collected from July 12 to July 30, 2010 and analyzed by one way ANOVA and Pearson's correlation analysis.
RESULTS
The knowledge and performance mean scores were 0.80+/-0.17 and 3.04+/-0.31 for peripheral venous catheter (PVC) management, and 0.83+/-0.17 and 3.00+/-0.30 for central venous catheter (CVC) management respectively. The items of category IA had the highest knowledge score (F=44.70, p<.001) and the items of category II had the highest performance score (F=47.09, p<.001) in PVC management, while the items of category IA had the highest knowledge (F=20.04, p<.001) and performance scores (F=18.20, p<.001) in CVC management. Knowledge and performance scores were significantly correlated in CVC management (r=.24, p=.004), but not in PVC management (r=.03, p=.753).
CONCLUSION
EBG for the prevention of ICRI was not fully implemented in clinical settings. These findings emphasize that clinical professions need to develope strategies to enhance nursing practices with evidence based guideline.