University of Central Florida College of Nursing Interim Dean and Orlando Health Distinguished Professor Mary Lou Sole, PhD, RN, CCNS, FAAN, FCCM, discusses her NIH-funded research to determine if regular removal of fluids that accumulate in the mouth and the back of the throat can help prevent aspiration.
Q: Describe the nursing protocol youre using in your research that studies care for patients on ventilators?
Sole: The protocol is testing a deep oropharyngeal suctioning intervention every four hours. The current standard of care is suctioning with swabs or a tonsil suction device. Oral care is done to prevent ventilator-associated pneumonia or similar events. Were using an oropharyngeal catheter which is about 9 inches long; its longer length allows us to reach secretions in the back of the throat. Our hypothesis is that by removing more secretions on a regular basis, theres a reduced aspiration risk, and secondarily a reduced infection risk.
How much similar nursing research has been done on this topic?
Sole: Research has been limited. Theres a lot about tooth brushing and antiseptics used to clean the mouth. The basis of my study comes from quality-improvement studies that found when deep oropharyngeal suction is used, patients have an improved outcome. So that led to the question: What is the best way to remove secretions to
How will you implement the protocol in the hospital setting?
Because this is a randomized, NIH-funded clinical trial, we must follow a strict protocol delivered to patients by my study team of about 20 people, the majority of whom are RNs. We also have physicians, a lab manager, two project co-managers and a nurse researcher. Well have to cover shifts around the clock to give the care every four hours.
Patients who are enrolled in the study are randomized to get the swab or the deep suction care. Were doing all the care every four hours, oral cleansing and removal of secretions per protocol, both for the control group and the study group.