Objectives:
The purpose of our project is to examine if we may affect a reduction in respiratory infections in a pediatric long term care facility by institution of a comprehensive oral care program.
Hypothesis:
We wish to base our project on work such as of Yoneyama etal 2002, which hypothesized and showed that “silent” aspiration of oropharyngeal contents is a causative factor in development of respiratory infection in elderly institutionalized clients.
It was found that an advanced oral hygiene program greatly reduced the incidence of respiratory infection. Although no similar research projects were found to have involved children, we hope that a similar program of oral care will allow us to likewise reduce the incidence of respiratory infection among the pediatric clients in our facility.
Methods:
We propose to examine two groups of children which are fed by gastrostomy feedings only. One group will continue to receive oral care as performed today. The study group will have their teeth brushed three times a day by the nursing staff by using a suction connected toothbrush, daily examination of the oropharynx by the nursing staff, and use of chlorhexidine varnish or another suitable antibacterial agent(such as 1% iodine solution) in the oropharynx.
We will retrospectively examine our records (a 12 month period) for febrile days with cough, antibiotic use and hospitalization days due to respiratory causes.
We will then compare these to the febrile days with cough, antibiotic use and hospitalizations to the 12 month period [post implementation of the oral care program. |