Impact of an Educational Intervention Aimed at Nursing Staff on Oral Hygiene Care on the Incidence of Ventilator-Associated Pneumonia in Adults Ventilated in Intensive Care Unit.

This was a before-and-after comparison, not randomised, and the two patient groups differed: the later group had more cardiopathy, lower PAFI, more phenytoin use, and less high ureic nitrogen. The analysis included 171 patients, but ventilator-associated pneumonia cases were few: 9 before and 2 after, so the primary outcome was not statistically significant. The adjusted 65% reduction in the ventilator-associated pneumonia rate was not supported by confidence intervals or significant probability values. VAP cases were confirmed clinically and not by tracheal secretion cultures, so microbiological comparison was not possible. Oral care was measured from records and staff follow-up, and the paper notes a possible Hawthorne effect. The intervention included multiple components at once: education workshops, demonstrations, teaching aids, work models, supervised practice, supplies, and follow-up, so no single component can be separated.

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Do not conclude that nurse education alone reduced ventilator-associated pneumonia. The primary VAP incidence and rate changes were not significant, and the adjusted 65% reduction was not supported by confidence intervals or significant probability values. The intervention also included workshops, demonstrations, teaching aids, work models, supervised practice, supplies, and follow-up, so no single component can be credited.