Application of improved Beck oral score in oral care of burn patients with mechanical ventilation

Abstract

Objective: To explore the application effect of improved Beck oral score in oral care of burn patients with mechanical ventilation, to provide practical basis for oral care of such patients.

Methods: A total of 42 patients with tracheotomy and mechanical ventilation in the Department of Burn Surgery of Baogang Hospital in Inner Mongolia from January 2021 to December 2022 were selected as the study objects, and the patients were randomly divided into observation group and control group, with 21 cases in each group. The control group was given routine oral care, and the observation group was given oral care according to improved Beck oral score. The following were compared between the two groups: Age, total burn area, third-degree burn area, acute physiological and chronic health assessment scores, as well as improved Beck oral scores; the incidence of oral odor, plaque index, mouth ulcer and ventilator-associated pneumonia (VAP) after 7 days; the detection of microorganism in oral secretions.

Results: After 7 days, the oral condition of patients in observation group was effectively improved, and the oral comfort level was significantly improved. The incidence of oral odor (2.57±1.59), dental plaque index (2.62±1.47), oral ulcer evaluation (2.24±1.09), VAP incidence (9.52%) and improved Beck oral score (8.09±1.92) in observation group were all lower than those in control group, which was (3.95±1.82), (3.57±1.21), (3.14±1.24), (38.09%), and (9.90±2.21) respectively. The difference was statistically significant (p <.05). The oral normal florain observation group (71.43%) was higher than that in control group (28.57%), and the difference was statistically significant (p <.05). The oral gram-positive bacteria (19.05%) and Gram-negative bacteria (23.81%) in observation group were lower than those in control group, which was 52.38% and 57.14% respectively, and the difference was statistically significant (p <.05).

Conclusions: The application of the improved Beck oral assessment method in dynamic oral care can effectively reduce the content of oral pathogens, lower the incidence of pulmonary infection, and improve the quality of life of patients.

Keywords

Improved Beck oral score / Tracheotomy / Burns / Oral care

References

[1] Li S, Zhou Q, Gou J, et al. Early prognosis assessment of patients with extensive burn combined with inhalation injury. Chinese Journal of Emergency Resuscitation and Disaster Medicine. 2022; 17(9): 1186-1189.

[2] Xie Z, Guo G, Yang Z, et al. Comparative study of three scores in predicting the risk of death in severe burn patients. Chinese Journal of Burn and Wound Repair. 2022; 38(2): 184-189.

[3] Yang F, Fang Y, Han Z. Effect of improved oral care on oral health status and incidence of ventilator-associated pneumonia inpatients with mechanical ventilation. Journal of the Third Military Medical University. 2020; 42(02): 215-219.

[4] Wang S, Ma C, Lu H, et al. Construction and application of cluster management scheme for lung care of batch burn patients. Chinese Journal of Burn. 2020; 36(8): 665-670.

[5] Ma X, Xiao Y, Chen T, et al. Prediction value of anatomical score combined with physiological score for multiple organ dysfunction syndrome inpatients with severe trauma. Chinese Journal of Burn. 2016; 32(2): 105-108.

[6] Man M, Gan M. Effect of quality control circle nursing model based on Beck score on oral health status, self-efficacy and self-care ability of patients with nasopharyngeal carcinoma. International Journal of Nursing. 2022; 41(23): 4342-4346.

[7] Wang H, Fan L, Liu W, et al. Interpretation of the 2016 ISBI Burn Management Practice Guidelines. Nursing Research. 2019; 33(5): 729-733.

[8] Cheng Y, Meng M, Chen L, et al. Summary of the best evidence for tracheotomy management in burn patients with inhalation injury. Chinese Journal of Nursing. 2020; 55(7): 1084-1090.

[9] Zhu Q, Lu Y, Wang Z. Effect of quality control circle nursing based on Beck score on oral health status of patients with nasopharyngeal carcinoma. Journal of Practical Stomatology. 2018; 34(6): 774-777.

[10] Song S, Lu Y. Effect of cognitive behavioral therapy on the loss rate of adhesive points of orthodontic brackets and oral hygiene in adolescents. Medical Theory and Practice. 2002; 35(15): 2675-2678.

[11] Tang J, Dong L, Wang Y. Effect of calcium folinate solution at 2-8℃ on prevention of oral ulcer caused by high-dose methotrexate chemotherapy inpatients with central malignant lymphoma. Journal of Military Medicine. 2019; 43(9): 719-720.

[12] Xiao D. Comparative analysis of different oral nursing methods in patients with oral catheterization. Clinical Nursing Research. 2022; 31(22): 137-139.

[13] Yan Y, Ding J, Liu C, et al. Summary of best evidence for airway management in critically ill adults. Journal of Nursing. 2021; 28(3): 39-45.

[14] Su L, Yan J, Zhang L, et al. Application of dynamic nursing strategy based on improved Beck oral score combined with HC visual laryn- goscope in oral nursing of coma patients in EICU. Journal of North Sichuan Medical College. 2018; 33(5):799-802.

[15] Gong S, Liao C, Liu J, et al. Interpretation of expert Consensus on oral care in adult intensive care unit. Journal of Nursing Research. 2023; 37(3): 388-391.

[16] Huang C, Lu L, Lu Y, et al. Application of improved flushing tooth- brush in oral care of patients with oral tube intubation. Heilongjiang Medical Journal. 2022; 46(5): 622-626.

[17] Pang Y, Ye S. Application of cluster nursing model in ventilator support patients in ICU. Clinical Medical Engineering. 2022; 29(12): 1737-1738.

[18] Jiang Y, Wang K, Wang B, et al. Epidemiological characteristics and outcome analysis of 266 patients with inhalation injury with combined burn area less than 30% of total body surface area. Chinese Journal of Burn. 2021; 37(4): 340-349.

[19] Lin Y, Gan Z, Lin Y, et al. Application of improved cluster intervention strategy in the prevention of ventilator-associated pneumonia in patients with mechanical ventilation in ICU. Fujian Journal of Medicine. 2022; 44(06): 132-134.

[20] Qin L, Yun W, Hang Z. Risk factors analysis of tracheal intubation- related stress injury in ICU patients. Journal of Advanced Nursing. 2020; 35(12): 1105-1108.