STUDI LITERATUR: UPDATE PELAKSANAAN ORAL CARE PADA PASIEN YANG TERPASANG VENTILASI MEKANIK DI RUANG ICU
DOI:
https://doi.org/10.52020/jkwgi.v4i1.1496Keywords:
ICU, intubasi trakea, oral care, oral hygieneAbstract
Pasien dengan ventilasi mekanik akan mengalami stress oral seperti hilangnya substansi protektif gigi, gangguan fungsi mukosiliari dan perubahan komposisi flora oral. Masalah kesehatan mulut tersebut berpotensi terjadinya kolonisasi bakteri penyebab Ventilator-associated pneumonia(VAP), padahal VAP menjadi salah satu penyebab terbesar mortalitas di ICU. Untuk mengidentifikasi hasil penelitian terbaru tentang pelaksanaan oral care pasien terpasang ventilasi mekanik. Penelaahan dilakukan berdasarkan content analysis. Pencarian dibatasi pada artikel yang dipublish dari tahun 2009-2017 dengan jenis penelitian Randomised-controlled trial(RCT) maupun kuasi eksperimen dalam bahasa inggris. Database yang digunakan adalah CINAHL, pubmed, MEDLINE, Proquest dan Sciencedirect dengan kata kunci oral care, oral hygiene, mouth care, mechanically ventilated, intubated, critical care dan intensive care. Didapatkan sepuluh artikel tentang efektifitas Chlorhexidine gluconate(CHX) sebagai agen antimikroba dengan konsentrasi dan volume yang bervariasi. Teknik pelaksanaan oral care yang paling efektif adalah dengan cara toothbrushing dengan frekuensi sesuai dengan skor pengkajian mulut. Selain itu, direkomendasikan pemberian moisturizer untuk menjaga integritas mukosa. Beberapa alat pengkajian kesehatan mulut yang dapat digunakan adalah Oral Assessment Guide(OAG), Beck Oral Assessment Scale(BOAS) atau Mucosal-Plaque Score(MPS). Pelaksanaan oral care secara komprehensif dapat memperbaiki kesehatan mulut pasien dengan ventilasi mekanik, sehingga kolonisasi bakteri penyebab VAP dapat dicegah. Oleh karena itu, perawat perlu memahami dan mengaplikasikan instrumen pengkajian mulut sebagai dasar pemberian intervensi.
Kata kunci : ICU, intubasi trakea, oral care, oral hygiene
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