EFFECT OF CONVENTIONAL AND STRUCTURED ORAL CARE ON CLINICAL PULMONARY INFECTION SCORES AMONG MECHANICALLY VENTILATED PATIENTS: A REPEATED MEASURES ANALYSIS

Abstract

Background: Ventilator associated pneumonia (VAP) is a common and serious healthcare-associated infection among mechanically ventilated patients, contributing to increased morbidity, mortality, and healthcare costs. Oral microbial colonization plays a critical role in the pathogenesis of VAP, making oral hygiene care an essential component of preventive strategies. Medicated mouthwash-based oral care has been widely recommended; however, evidence regarding its effectiveness remains inconsistent, particularly in resource-limited settings.Objective: To evaluate the effectiveness of structured medicated mouthwash oral hygiene care on Clinical Pulmonary Infection Scores (CPIS) for the prevention of ventilator-associated pneumonia among mechanically ventilated patients.Methodology: A quasi-experimental repeated measures study was conducted in the intensive care unit of a tertiary care hospital in Bahawalpur. A total of 22 mechanically ventilated patients were selected through consecutive sampling and allocated into two groups: control group (routine oral care, n=11) and intervention group (structured medicated mouthwash oral care, n=11). CPIS scores were recorded at three time points (Day 1, Day 3, and Day 6). Data were analyzed using mixed-design repeated measures ANOVA to assess within-group, between-group, and interaction effects over time.Results: At baseline, CPIS scores were comparable between groups. Over time, CPIS scores increased in the control group (Day 1: 3.73 ± 0.47; Day 6: 6.09 ± 2.26) and decreased in the intervention group (Day 1: 3.55 ± 0.52; Day 6: 3.36 ± 1.80). Repeated measures ANOVA revealed a significant effect of time (p = 0.008), group (p = 0.002), and a significant time × group interaction (p = 0.005), indicating greater improvement in the intervention group.Conclusion: Structured medicated mouthwash oral hygiene care significantly reduces CPIS scores and is effective in the prevention of ventilator-associated pneumonia among mechanically ventilated patients. The findings support the implementation of standardized oral care protocols in intensive care settings to improve patient outcomes.