Oral Hygiene Using the 3T Principles in a Mechanically Ventilated Patient: A Case Study
DOI:
https://doi.org/10.56359/kian.v5i2.1064Keywords:
Chlorhexidine, Mechanical Ventilation, Oral Hygiene, Suction Toothbrush, Toothbrushing, Ventilator-Associated PneumoniaAbstract
Introduction: Mechanically ventilated patients often have difficulty maintaining oral hygiene because of reduced consciousness, an endotracheal tube (ETT), and sedation. These conditions can increase plaque, biofilm, bacterial colonization, and the risk of Ventilator-Associated Pneumonia (VAP). The 3T principles (Right Technique, Right Equipment, and Right Use of Antiseptic) provide a structured approach to maintaining oral hygiene in these patients.
Objective: To describe the implementation of nursing care involving oral hygiene based on the 3T principles for a patient on mechanical ventilation and to evaluate changes in oral hygiene using the Beck Oral Assessment Scale (BOAS).
Method: A descriptive case study utilizing the nursing process approach was conducted on a single patient receiving mechanical ventilation in the Intensive Care Unit (ICU) of RS Islam Jakarta Pondok Kopi. The intervention was carried out over three days using the Modified Bass Technique, a suction toothbrush, and 0.2% chlorhexidine. Evaluation was performed using the Beck Oral Assessment Scale (BOAS).
Result: Following the three-day intervention, improvements were observed in the condition of the lips, mucosa, gingiva, tongue, teeth, and saliva. The BOAS score decreased from 20 at baseline to 6 after three days of intervention, indicating an objective improvement in oral condition. “The nursing outcome based on the Indonesian Nursing Outcome Standards (SLKI) was documented at level 5 for the oral hygiene outcome at the end of the care period.”
Conclusion: Oral hygiene using the 3T principles was followed by improved oral hygiene status over three days, as shown by decreased BOAS scores. The Modified Bass Technique, suction toothbrush, 0.2% chlorhexidine according to clinical indications and hospital policy, and BOAS assessment provided a structured approach to oral care. However, this single case cannot establish a causal effect or effectiveness of the 3T approach. Further studies with larger samples and comparative designs are needed to evaluate its effectiveness and potential impact on outcomes such as VAP.
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