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Rukhayati, Yati
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Health Professions Nursing Public Health

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Efektivitas bahan oral care dalam upaya pencegahan ventilator-associated pneumonia (VAP) pada pasien kritis: A systematic review Utami, Mega; Martanti, Yuniar Dwi; Rukhayati, Yati; Umarmono, Umarmono; Kamaluddin, Ridlwan
Holistik Jurnal Kesehatan Vol. 19 No. 7 (2025): Volume 19 Nomor 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i7.1075

Abstract

Background: The most common nosocomial infection in Intensive Care Unit (ICU) patients on mechanical ventilators is ventilator-associated pneumonia (VAP). One recommended prevention strategy is oral care. However, the effectiveness of various oral care materials in preventing VAP remains unclear. Purpose: To assess the effectiveness of oral care materials in preventing ventilator-associated pneumonia (VAP) in critically ill patients. Method: This systematic review followed PRISMA guidelines. Articles were retrieved from PubMed, ScienceDirect, and Google Scholar databases published between 2014 and 2025. Included articles were RCTs or quasi-experimental studies that addressed oral care interventions in ventilator patients. Quality assessment was performed using CASP-JBI. Results: Based on the 10 articles reviewed, oral care materials used included chlorhexidine, hydrogen peroxide, orthodentol, lactoperoxidase, and probiotics. Oral care techniques included brushing and rinsing, performed two to three times daily. Most studies have shown a reduction in the incidence of VAP in the intervention group. Conclusion: Oral care is effective in preventing VAP, especially when performed regularly with appropriate techniques and materials. The combination of toothbrushing and antiseptics such as chlorhexidine has been shown to be optimal in reducing the risk of VAP.   Keywords: Critically Patients; Oral Care; Ventilator-Associated Pneumonia (VAP).   Pendahuluan: Infeksi nosokomial yang paling sering terjadi pada pasien di Intensive Care Unit (ICU) yang menggunakan ventilator mekanik adalah ventilator-associated pneumonia (VAP). Salah satu strategi pencegahan yang direkomendasikan adalah oral care. Namun, efektivitas berbagai bahan yang digunakan dalam oral care terhadap pencegahan VAP masih belum disepakati secara luas. Tujuan: Untuk mengkaji efektivitas bahan oral care dalam upaya pencegahan ventilator-associated pneumonia (VAP) pada pasien kritis. Metode: Penelitian systematic review yang mengikuti pedoman PRISMA. Artikel diperoleh dari database PubMed, ScienceDirect, dan Google Scholar dengan tahun terbit 2014–2025. Artikel yang disertakan adalah penelitian RCT atau quasi eksperimen yang membahas intervensi oral care pada pasien ventilator. Penilaian kualitas menggunakan CASP-JBI. Hasil: Berdasarkan 10 artikel yang dikaji, bahan oral care yang digunakan meliputi chlorhexidine, hydrogen peroxide, orthodentol, lactoperoxidase, dan probiotik. Teknik oral care yang digunakan antara lain brushing dan rinsing dengan frekuensi dua hingga tiga kali per hari. Sebagian besar studi menunjukkan penurunan kejadian VAP pada kelompok intervensi. Simpulan: Oral care efektif mencegah VAP, khususnya jika dilakukan secara teratur dengan teknik dan bahan yang tepat. Kombinasi brushing dan antiseptik seperti chlorhexidine terbukti paling optimal dalam menurunkan risiko VAP.   Kata Kunci: Oral Care; Pasien Kritis; Ventilator-Associated Pneumonia (VAP).
Pengaruh program pelatihan keperawatan terhadap penurunan kejadian ventilator associated pneumonia (VAP), peningkatan pengetahuan, praktik, dan kepatuhan perawat: Sebuah tinjauan sistematis Rukhayati, Yati; Anggraeni, Mekar Dwi
Holistik Jurnal Kesehatan Vol. 19 No. 10 (2025): Volume 19 Nomor 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i10.1623

Abstract

Background: Patients admitted to the Intensive Care Unit (ICU) and on ventilators for more than 48 hours are highly susceptible to Ventilator-Associated Pneumonia (VAP), a common clinical complication. A study showed that training critical care nurses in implementing a VAP prevention package effectively reduced the incidence of VAP. Purpose: To identify the effect of a critical care training program on the incidence of VAP and improve nurses' knowledge, practice, and adherence. Method: The literature review included a comprehensive search of academic databases for relevant studies, including PubMed, Scopus, Wiley Online Library, MJSonline, and Google Scholar. A quasi-experimental study of intensive care nurses providing care to patients on mechanical ventilators published between 2015 and 2024 was conducted. Results: Ten reviewed research articles demonstrated that a nurse training program can reduce the incidence of VAP and improve nurses' knowledge, practice, and adherence to VAP prevention protocols. Conclusion: The nurse training program reduced the incidence of VAP and improved nurses' knowledge, practice, and adherence in the intensive care unit. Suggestion: Future research should expand access to the literature, implement purposive sampling, and optimize resources to generate deeper insights and improve VAP prevention strategies in the ICU.   Keywords: Adherence; Knowledge; Nursing Training Program; Practice; Ventilator-Associated Pneumonia (VAP).   Pendahuluan: Pasien yang dirawat di Intensive Care Unit (ICU) dan menggunakan ventilator selama lebih dari 48 jam sangat rentan mengalami Ventilator-Associated Pneumonia (VAP), sebuah komplikasi klinis yang cukup umum. Sebuah studi menunjukkan bahwa, pelatihan perawat perawatan kritis dalam penerapan paket pencegahan VAP secara efektif mengurangi insiden VAP . Tujuan: Untuk mengidentifikasi pengaruh program pelatihan keperawatan terhadap kejadian VAP, peningkatan pengetahuan, praktik, dan kepatuhan perawat. Metode: Tinjauan pustaka yang melibatkan penelusuran basis data akademik daring untuk mendapatkan studi-studi relevan, termasuk PubMed, Scopus, Wiley Online Library, MJSonline, dan Google Scholar. Studi kuasi-eksperimental tentang perawat perawatan intensif yang memberikan layanan kepada pasien menggunakan ventilator mekanik yang diterbitkan antara tahun 2015 dan 2024. Hasil: Sebanyak 10 artikel penelitian yang ditinjau menunjukkan bahwa, program pelatihan perawat dapat mengurangi kejadian VAP dan meningkatkan pengetahuan, praktik, dan kepatuhan perawat terhadap protokol pencegahan VAP. Simpulan: Program pelatihan perawat mengurangi kejadian VAP dan meningkatkan pengetahuan, praktik serta kepatuhan perawat di unit perawatan intensif. Saran: Penelitian selanjutnya harus memperluas akses literatur, menerapkan seleksi objektif, dan mengoptimalkan sumber daya untuk menghasilkan wawasan yang lebih dalam dan meningkatkan strategi pencegahan VAP di ICU.   Kata Kunci: Kepatuhan; Pengetahuan; Praktik; Program Pelatihan Keperawatan; Ventilator Associated Pneumonia (VAP).
Co-Authors Martanti, Yuniar Dwi Mekar Dwi Anggraeni Ridlwan Kamaluddin Umarmono, Umarmono Utami, Mega