Pilot Testing of Intervention Protocols to Prevent Pneumonia in Nursing Home Residents
Pilot Testing of Intervention Protocols to Prevent Pneumonia in Nursing Home Residents
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DOI：
10.1111/j.1532-5415.2009.02311.x
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发表时间：
2009-07-01
影响因子：
6.3
通讯作者：
Tinetti, Mary
中科院分区：
文献类型：
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作者：
Quagliarello, Vincent;Juthani-Mehta, Manisha;Tinetti, Mary
目的：测试干预方案的可行性，工作人员的依从性，并有效地减少肺炎的危险因素（口腔卫生受损，吞咽困难）在nursinghome.PROCESSION前瞻性研究。设置两个nursinghome.PARTICATISF52nursinghome.INTERVRENTION30居民口腔卫生受损随机分配到手动刷牙加0.12%洗必泰口腔冲洗在不同的频率，每天。22名吞咽困难的居民被随机分配到直立进食姿势，吞咽技巧教学，或手动刷牙。所有的方案都在3个月内实施。测量方法每月评估一次，如果方案实施时间少于10分钟，则定义为高。每周评估一次依从性，如果超过75%的评估显示全体员工依从性，则定义为高依从性。在基线和3个月时，比较改善口腔卫生（减少口腔菌斑评分）和吞咽（减少吞咽时咳嗽）的有效性。每日手动刷牙+0.12%氯己定冲洗证明了高可行性，高工作人员依从性和改善口腔卫生的有效性（P
OBJECTIVESTo test intervention protocols for feasibility, staff adherence, and effectiveness in reducing pneumonia risk factors (impaired oral hygiene, swallowing difficulty) in nursing home residents.DESIGNProspective study.SETTINGTwo nursing homes.PARTICIPANTSFifty-two nursing home residents.INTERVENTIONThirty residents with impaired oral hygiene were randomly assigned to manual oral brushing plus 0.12% chlorhexidine oral rinse at different frequencies daily. Twenty-two residents with swallowing difficulty were randomly assigned to upright feeding positioning, teaching swallowing techniques, or manual oral brushing. All protocols were administered over 3 months.MEASUREMENTSFeasibility was assessed monthly and defined as high if the protocol took less than 10 minutes to administer. Adherence was assessed weekly and defined as high if full staff adherence was demonstrated in more than 75% of assessments. Effectiveness for improved oral hygiene (reduction in oral plaque score) and swallowing (reduction in cough during swallowing) was compared at baseline and 3 months.RESULTSDaily manual oral brushing plus 0.12% chlorhexidine rinse demonstrated high feasibility, high staff adherence, and effectiveness in improving oral hygiene (P