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A5146 - A Novel Approach to Manage Airway Secretions and Oral Hygiene in Mechanically Ventilated Patients - ICU Experience and User Feedback
Author Block: V. K. Kakani1, N. Chintamani2, M. Morthala2; 1CLINICAL INNOVATIONS, COEO LABS PVT LTD, Bangalore, India, 2Anaesthesiology, OMNI Hospitals, Hyderabad, India.
Introduction
Secretion management and oral hygiene, the two important aspects of patient-care in mechanically ventilated patients still pose a challenge owing to lack of standard guidelines, equipment, shortage of staff and lack of knowledge among nursing staff leading to increased rates of Ventilator Associated Pneumonia (VAP).
Currently secretions are removed from three different areas viz. oral, oropharyngeal, endotracheal and from the space above endotracheal cuff by various methods. Oropharyngeal secretion removal is still neglected in most parts of world. Oral hygiene protocols are poorly implemented in many intensive care units. There is a definite need for integrating and automatization of secretion and oral hygiene management that can improve quality of patient care. Here we present the initial ICU experience and performance of new medical device (VAPCare), the innovative system, an automated and integrated secretion and oral hygiene management.
Methods
This is Single arm prospective study. Blinding is not possible. Sample size was not calculated as only descriptive parameters are captured. 50-100 patients will be recruited for study. Interim analysis is planned after 5 patients.
A survey is conducted among 15 experienced nurses regarding safety, benefits to patients and benefits to nursing staff.
Results
Interim analysis showed average secretions of 272.44ml/day are collected with good clearance of secretions. Oral lavage was given automatically every 4 hours. There is no evidence of tissue injury during use of device and there are no adverse events reported.
Conclusion
Automated secretion and oral hygiene management system combines all the elements of oral care in intubated patients and provides uniformity in patient care eliminating skill dependency. There is no incidence of VAP in patients from initial phase of study. VAPCare lowers incidence of VAP thereby reducing ICU stay, hospital cost and reduce work burden on staff. Cumulatively this improves patient care. Additional patient data is required regarding the performance in terms of final patient outcomes.
Nursing staff 100% of nursing staff opined that the device is beneficial to patients and saves their time for documentation of secretions and improves overall patient care