Impact of single-use oral care sets on reducing ventilator-associated pneumonia among intensive care unit patients: a multi-centre study.

BACKGROUND

Ventilator-associated pneumonia (VAP) is a serious hospital-associated infection among mechanically ventilated patients. Proper oral care is a critical intervention for reducing VAP incidence.

AIM: To evaluate the effectiveness of single-use oral care sets in reducing VAP incidence and assessing ICU nurses' perspectives on their use.

METHODS

A multi-centre study was conducted in the ICUs of 14 tertiary-care hospitals. Single-use oral care sets were used for cleaning patients' oral cavities following a standardized oral care protocol. VAP rates and cost of VAP antibiotic treatment were compared before and after implementing the oral care sets. ICU nurses' opinions on the oral care sets were collected using a self-administered questionnaire.

FINDINGS: Before implementing the oral care sets, there were 269 VAP cases over 34,731 ventilator-days, with a VAP rate of 7.74 per 1000 ventilator-days. The total antibiotic cost for VAP treatment was 5,137,622 Thai baht. After implementation, VAP cases decreased to 182 over 34,309 ventilator-days, with a significantly reduced VAP rate of 5.30 per 1000 ventilator-days - a 31.52% reduction (P<0.05). Antibiotic treatment costs also declined significantly to 2,101,940 Thai baht (P<0.05). Among 220 ICU nurses surveyed, 96.3% agreed or strongly agreed that the oral care sets helped prevent healthcare-associated infections (HAIs). Over 85% reported improved ease of use, increased patient comfort, and better adherence to evidence-based guidelines.

CONCLUSION

The use of single-use oral care sets within a standardized oral care protocol effectively reduces VAP incidence and associated costs. ICU nurses expressed high satisfaction with the oral care sets, highlighting their potential to enhance patient safety, improve adherence to guidelines, and reduce healthcare costs. Routine integration of single-use oral care sets into oral care protocols for mechanically ventilated patients is recommended.