ABSTRACT
BACKGROUND: A cross-sectional study was conducted among intensive care unit (ICU) nurses in private hospitals in India to identify knowledge and practice of ICU nurses in the prevention of ventilator-associated pneumonia (VAP). METHODS: Knowledge of 135 nurses working in ICU was tested using a questionnaire consisting of 18 questions. Fourteen forms were excluded from the statistical analysis due to incomplete data entry by the participants. The data of 121 filled questionnaires were analyzed. The information letters, consent forms, and questionnaires were handed to ICU nurses by Research assistant. Data were coded and entered into SPSS version for descriptive and inferential statistics. RESULTS: A majority of the participants perceived oral care as a necessity in all critically ill patients. Nurses were generally aware of the most likely mechanism of acquiring pneumonia. The type and frequency of oral care varied widely. Many of them stated that they had adequate supplies to provide oral care. Although a majority of nurses had some formal training in oral care, they would appreciate an opportunity to enhance and improve their knowledge and skills. CONCLUSION: The methods of oral care provided vary widely. In summary, randomized controlled trial to date has demonstrated that tooth brushing is associated with a trend toward lower rates of VAP in intubated mechanically ventilated critically ill patients. But it is also to be noted that there was no clear difference between electric and manual tooth brushing. In-house training and workshop can provide required skills needed for the betterment of the treatment provided.
Subject(s)
Pneumonia, Ventilator-Associated , Critical Care , Cross-Sectional Studies , Humans , India , Respiration, Artificial , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Various minimally invasive surgical approaches are proposed for the management of gingival recession. A modified surgical approach coined as minimally invasive coronally advanced flap (MICAF) was compared with modified coronally advanced flap (MCAF) for the management of multiple adjacent gingival recession defects. MATERIALS AND METHODS: Seven systemically healthy subjects with bilateral multiple adjacent maxillary facial gingival recession defects (Miller I) were included in this study. In each patient, MICAF performed on one side and on the other side MCAF was performed. Comparisons of the surgical sites were made with clinical measurements at 6 months follow-up. RESULTS: No statistically significant differences were observed between MICAF and MCAF sites in the change in gingival recession depth, gingival recession width, clinical attachment level, width of the keratinized tissue, mean, and complete root coverage after 6 months. However, patient reported outcomes of esthetics and postoperative morbidity were statistically significant (P <0.001) between the MICAF and the MCAF sides with better results in the MICAF side. CONCLUSIONS: Within the confines of this study, the results depicted that MICAF is more patient-friendly procedure with better patient acceptance. Further, long-term studies with more sample sizes are needed for a stronger evidence base. CLINICAL SIGNIFICANCE: Miller Class I gingival recessions can be treated with the MICAF with successful clinical outcomes and patient acceptance. This paper reports the clinical and patient reported outcomes of the MICAF and the MCAF.
