Development and application of high risk assessment scale for oral complications in critically ill patients_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Xiaomin ¹ , LI Minling ¹ , LI Huiling ¹ , SONG Ye ¹ , LI Ning ¹ ,  LU Jun ²

1. Emergency Department, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;
2. Clinical Research Center, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;

Corresponding author：

LU Jun, Email: lujun2006@xjtu.edu.cn

Keywords：

Oral cavity; Risk; Evaluation; Scale; Reliability; Validity; Screening

DOI：

10.7507/1672-2531.201610082

Video：

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Objective To develop an evaluation tool for the screening of high risk population for oral complications in critically ill patients, which can be performed accurately and scientifically. Methods Basing on the related foreign oral assessment scale, combined with the method of brainstorming, expert consultation, method of clinical status and so on, the item pool of the assessment scale was determined. Five nursing experts and two oral experts assessed the content validity and 50 ICU nurses were tested. Then, the screening accuracy of the assessment scale was proved by application in 100 critically ill patients selected randomly. Results The Cronbach’s a coefficient of final version of the High Risk Assessment Scale for Oral Complications in Critically Ill Patients (including seven parts contents of oral health assessment and oral pH value test) was 0.815, the content validity index (Sr-CVI/Ave) was 0.932. The results of 50 nurses to the 91.2% assessment items of the assessment scale were very important and important. For screening related indicators of oral complications in high-risk patients, the sensitivity of the assessment scale was 97.53%, the specificity was 94.11%, the positive predictive value was 98.75%, the negative predictive value was 88.89%, and the crude agreement was 95%. Conclusion There are good reliability, validity and a high accuracy of screening test in the High Risk Assessment Scale for Oral Complications in Critically Ill Patients. It can be used for screening patients at high risk for oral complications in critically ill patients, and help clinical nurses to complete the oral health status of the critically ill patients quickly.

Citation： LIU Xiaomin, LI Minling, LI Huiling, SONG Ye, LI Ning, LU Jun. Development and application of high risk assessment scale for oral complications in critically ill patients. Chinese Journal of Evidence-Based Medicine, 2017, 17(1): 108-112. doi: 10.7507/1672-2531.201610082 Copy

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2.	孙正, 主编. 口腔常见病诊疗手册.第三版. 北京: 人民卫生出版社, 2000: 130-192.
3.	张志愿, 余光岩. 口腔科学. 第八版. 北京: 人民卫生出版社, 2013: 3.
4.	张绮, 谢蟪旭, 何瑶, 等. 国内部分三甲医院危重疾病患者口腔护理情况调查. 中国循证医学杂志, 2010, 10(6): 665-669.
5.	史宗道, 余京儒, 罗勇, 等. 口腔护理作用的系统评价. 中国循证医学杂志, 2004, 4 (12): 837-858.
6.	Prendergast V, Kleiman C, King M. The Bedside Oral Exam and the Barrow Oral CareProtocol: Translating evidence-based oral care intopractice. Intensive Crit Care Nurs, 2013, 29(5): 282-290.
7.	Ames NJ, Sulima P, Yates JM,et al. Effects of SystematicOral Care in Critically Ill Patients: A Multicenter Study. Am J Crit Care, 2011, 20(5): 103-114.
8.	Kayser-Jones J, Bird WF, Paul SM,et al. An instrument to assess the oral healthstatus of nursing home residents. Gerontologist, 1995, 35(6): 814-824.
9.	Chalmers JM, King PL, Spencer AJ,et al. The oral health assessment toolvalidity and reliability. Aust Dent J, 2005, 50(3): 191-199.
10.	Fitch JA, Munro CL, Glass CA,et al. Oral Care in theAdult Intensive Care Unit. Am J Crit Care, 1999, 8(5): 314-318.
11.	Eilers J, Berger AM, Petersen MC. Development, testing, andapplication of the oral assessment guide. Oncol Nurs Forum, 1988, 15(3): 325-330.
12.	Hallberg IR, Andersson P. Oral health and oral assessment. In: Reuschenbach B, Mahler C, editors. International handbook of assessment tools for nursing and health care research. Bern: Verlag Hans Huber, 2011: 253-270.
13.	Treloar DM, Stechmiller JK. Use of a clinical assessment tool for orally intubated patients. Am J Crit Care, 1995, 4(5): 355-360.
14.	Iida H, Kato S, Sekino Y,et al. Early effects of oral administration of omeprazole and roxatidine on intragastric pH. J Zhejiang Univ Sci B. 2012, 13(1): 29-34.
15.	田耘, 杨明, 袁凤仪. 口腔并发症患者口腔 pH 值变化及护理探讨. 护士进修杂志, 2002, 17(3): 171-172.
16.	裘爱萍. 522 例护理评估质量分析与探讨. 医学理论与实践, 2001, 14(8): 805.
17.	张文彤. SPSS11.0 统计分析教程(高级篇). 第一版. 北京: 北京希望电子出版社, 2002: 191, 213-217.
18.	George D, Mallery P. SPSS for Windows stepby step: Asimple guide and reference 14.0 update. 4^th ed. Boston: Allyn& Bacon, 2003: 222-228.
19.	Kline P. The handbook of psychological testing. 2^nd ed. London: Routledge, 1999: 30, 32.
20.	Lynn MR. Determination and quantification of content validity. Nurs Res, 1986, 35(6): 382-385.

1. 邱蔚六, 主编. 实用口腔疾病诊治图谱. 第一版. 济南: 山东科学技术出版社, 1997: 115-140.
2. 孙正, 主编. 口腔常见病诊疗手册.第三版. 北京: 人民卫生出版社, 2000: 130-192.
3. 张志愿, 余光岩. 口腔科学. 第八版. 北京: 人民卫生出版社, 2013: 3.
4. 张绮, 谢蟪旭, 何瑶, 等. 国内部分三甲医院危重疾病患者口腔护理情况调查. 中国循证医学杂志, 2010, 10(6): 665-669.
5. 史宗道, 余京儒, 罗勇, 等. 口腔护理作用的系统评价. 中国循证医学杂志, 2004, 4 (12): 837-858.
6. Prendergast V, Kleiman C, King M. The Bedside Oral Exam and the Barrow Oral CareProtocol: Translating evidence-based oral care intopractice. Intensive Crit Care Nurs, 2013, 29(5): 282-290.
7. Ames NJ, Sulima P, Yates JM,et al. Effects of SystematicOral Care in Critically Ill Patients: A Multicenter Study. Am J Crit Care, 2011, 20(5): 103-114.
8. Kayser-Jones J, Bird WF, Paul SM,et al. An instrument to assess the oral healthstatus of nursing home residents. Gerontologist, 1995, 35(6): 814-824.
9. Chalmers JM, King PL, Spencer AJ,et al. The oral health assessment toolvalidity and reliability. Aust Dent J, 2005, 50(3): 191-199.
10. Fitch JA, Munro CL, Glass CA,et al. Oral Care in theAdult Intensive Care Unit. Am J Crit Care, 1999, 8(5): 314-318.
11. Eilers J, Berger AM, Petersen MC. Development, testing, andapplication of the oral assessment guide. Oncol Nurs Forum, 1988, 15(3): 325-330.
12. Hallberg IR, Andersson P. Oral health and oral assessment. In: Reuschenbach B, Mahler C, editors. International handbook of assessment tools for nursing and health care research. Bern: Verlag Hans Huber, 2011: 253-270.
13. Treloar DM, Stechmiller JK. Use of a clinical assessment tool for orally intubated patients. Am J Crit Care, 1995, 4(5): 355-360.
14. Iida H, Kato S, Sekino Y,et al. Early effects of oral administration of omeprazole and roxatidine on intragastric pH. J Zhejiang Univ Sci B. 2012, 13(1): 29-34.
15. 田耘, 杨明, 袁凤仪. 口腔并发症患者口腔 pH 值变化及护理探讨. 护士进修杂志, 2002, 17(3): 171-172.
16. 裘爱萍. 522 例护理评估质量分析与探讨. 医学理论与实践, 2001, 14(8): 805.
17. 张文彤. SPSS11.0 统计分析教程(高级篇). 第一版. 北京: 北京希望电子出版社, 2002: 191, 213-217.
18. George D, Mallery P. SPSS for Windows stepby step: Asimple guide and reference 14.0 update. 4^th ed. Boston: Allyn& Bacon, 2003: 222-228.
19. Kline P. The handbook of psychological testing. 2^nd ed. London: Routledge, 1999: 30, 32.
20. Lynn MR. Determination and quantification of content validity. Nurs Res, 1986, 35(6): 382-385.

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