Keywords
chlorhexidine gluconate, oral care, ventilator associated events, pneuumonia
Abstract
This dissertation investigated the clinical efficacy of chlorhexidine gluconate (CHG) oral care in mechanically ventilated adult patients between four ICU populations. Presented through three interrelated manuscripts, this study integrated clinical inquiry with reflective analysis to inform both practice and research. The first manuscript, an integrative review of 17 peer-reviewed studies, examined the impact of CHG oral care on ventilator-associated events (VAE), ICU length of stay (LOS), mechanical ventilation hours (MV hours), and hospital mortality. Once considered a gold standard to reduce ventilator-associated pneumonia (particularly among mechanically ventilated cardiac surgical patients), CHG oral cares efficacy has come under scrutiny. The second manuscript reported findings from a retrospective secondary analysis of 1,567 patients between cardiac surgical, cardiac medical, multisystem, and neurological ICU populations at a quaternary hospital in Florida. Chi-squared, ANOVA, linear and logistic regression, and mediation analyses were conducted to analyze impacts of twice daily administration of 0.12% CHG oral care on VAE rates, MV hours, LOS, and mortality. The cardiac surgical population experienced the highest VAE rate (47.13), while the neurological population experienced the lowest (5.87). Across all populations, each CHG administration was associated with 4.9% increased odds of VAE, a 0.55 day increase in ICU LOS, and 6 hour increase in MV hours. LOS was identified as a partial mediator between CHG exposure and VAE. While findings do not support immediate discontinuation of CHG oral care, they underscore a need for population-specific evaluation and consideration of alternative evidence-based oral care practices. The third manuscript offered a reflective account of conducting big data analytics (BDA). Guided by Kolb’s experiential learning framework, lessons learned from the technical, procedural, and emotional challenges of managing large scale datasets were shared. Collectively, these manuscripts critically examined the clinical utility of CHG oral care while illuminating the realities of big data research in nursing science.
Completion Date
2025
Semester
Fall
Committee Chair
Dr. Annette Bourgault
Degree
Doctor of Philosophy (Ph.D.)
College
College of Nursing
Department
Nursing
Format
Release Date
12-15-2027
Document Type
Dissertation
Campus Location
UCF Online
Subjects
Chlorhexidine; Intensive care nursing--Evaluation; Critical care medicine--Research; Dental care--Evaluation; Nursing--Research
STARS Citation
Carroll Simmons, Jennifer, "Examining the Impact of Chlorhexidine Gluconate Oral Care on Ventilator-Associated Events Between Diverse ICU Populations" (2025). Graduate Thesis and Dissertation post-2024. 545.
https://stars.library.ucf.edu/etd2024/545
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