The Effects of Evidence-Based Practice of Mouth Care with Breast Milk on Ventilator Associated Pneumonia Among Preterm Infants with Very Low Birth Weight

Abstract

Ventilator-associated pneumonia (VAP) is an important problem and a risk for mortality among infants with very low birth weight (VLBW). Mouth care for those using breast milk may decrease the risk. The purpose of this quasi-experimental study was to examine the effects of evidence-based practice mouth care using breast milk on the rates of VAP in VLBW infants. Participants consisted of two groups: 1) 60 infants who were born before 37 weeks of gestational age, weighted 1,000-1,500 grams, and who were on a ventilator in the newborn intensive care unit of a hospital in Ubon Ratchathani, Thailand, and 2) 13 registered nurses working in the same unit as the infants. The infants were divided into an experimental group (n = 30), whose mouths were cleaned using breast milk, and a comparison group (n = 30), whose mouths were cleaned using 0.9% NSS. The research instruments were 1) the guidelines for evidence-based practice to prevent VAP, 2) the practice record forms, 3) the VAP record forms, and 4) the satisfaction assessment questionnaire. Data analysis included descriptive and comparison statistics. The research results showed that nine infants in the experimental group (30%) developed VAP, which was lower in numbers than in the comparison group (n = 14, 46.6%). However, there was not a significant difference in the rates of VAP between the two groups at p = .05 (p = .18). This study suggests that both breast milk and 0.9% NSS can be used alternately for oral cleaning of VLBW infants on ventilators.