Please cite this article in press as: Haghighi A, et al. The impact of oral care on oral health status and prevention of ventilator-associated pneumonia in critically ill patients. Aust Crit Care (2016), http://dx.doi.org/10.1016/j.aucc.2016.07.002 ARTICLE IN PRESS G Model AUCC-328; No. of Pages 5 Australian Critical Care xxx (2016) xxx–xxx Contents lists available at ScienceDirect Australian Critical Care journal homepage: www.elsevier.com/locate/aucc Research paper The impact of oral care on oral health status and prevention of ventilator-associated pneumonia in critically ill patients Abdullah Haghighi a , Vida Shafipour b,∗ , Masume Bagheri Nesami c , Afshin Gholipour Baradari d , Jamshid Yazdani Charati e a Nasibeh Nursing & Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran b Department of Medical-Surgical Nursing, Nasibeh Nursing & Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran c Department of Medical-Surgical Nursing, Mazandaran Pediateric Infectious Disease Research Center (MPIDRC), Mazandaran University of Medical Sciences, Sari, Iran d Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran e Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran a r t i c l e i n f o r m a t i o n Article history: Received 25 April 2016 Received in revised form 12 July 2016 Accepted 18 July 2016 Keywords: Intensive care unit Oral care Ventilator-associated pneumonia Oral health a b s t r a c t Background: Ventilator-associated pneumonia is one of the most common nosocomial infections which increase mortality rate and length stay of hospitalisation. Oral care would not only improve patient’s oral health and well-being, but it can also reduce the incidence rate of ventilator-associated pneumonia. Objectives: The objective of this study was to identify the impact of oral care practices on oral health status of patients in intensive care unit and the incidence rate of ventilator-associated pneumonia. Methods: This clinical trial recruited 100 participants who were randomly assigned to a control group (receiving oral care by nurses) and an intervention group (receiving systematic care by the researcher) during 2015–2016. Beck Oral Assessment Scale was used to determine the required number of times for receiving oral care with regard to patient’s oral health in the intervention group. Each care included adjusting endotracheal tube cuff pressure, brushing with toothpaste, using antiseptics and moistening the lips. The oral cavity was examined using BOAS and Mucosal-Plaque Score, and Clinical Pulmonary Infection Score was used for detecting pneumonia. Results: The BOAS scoring showed significant differences between the two groups from the first to fifth day (P < 0.001). The mucosal-plaque index was significantly different between the two groups from the third day to fifth day (P < 0.001). The incidence rate of pneumonia on the third and fifth day was 10% (5) and 14% (7) in the control group, and 4% (2) and 10% (5) in the intervention group, respectively. The Fisher test did not show significant difference (P = 0.538), however, the incidence rate in the intervention group reduced compared with the control group. Conclusion: Although following a systematic oral care program could not significantly decrease the inci- dence of ventilator-associated pneumonia in critically ill patients compared to the conventional oral care practices, it significantly improved the oral health and mucosal-plaque index. © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved. 1. Introduction Oral health care is one of the essential aspects of nursing in intensive care unit (ICU) that can improve patient’s health and ∗ Corresponding author. E-mail address: vidashafipour@yahoo.com (V. Shafipour). prevent serious complications such as pneumonia. 1 Ventilator- associated pneumonia (VAP) is an infection that occurs due to infectious agents at the time of admission an date least 48 h after hospitalisation. 2 VAP incurs high costs to the healthcare system. 3 The increasing need for mechanical ventilation (MV) has increased the risk of VAP from 9% to 40%. 4 The prevalence rate of VAP was two per 1000 days of MV in 1749 hospitals in the United stated in 2009. 5 More than 90% of pneumonia incidences in ICUs appear during MV http://dx.doi.org/10.1016/j.aucc.2016.07.002 1036-7314/© 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.