Oral care measures for preventing nursing home‐acquired pneumonia

Article


Liu, Chang, Cao, Yubin, Ng, Linda, Lin, Jie, Needleman, Ian, Walsh, Tanya and Li, Chunjie. 2018. "Oral care measures for preventing nursing home‐acquired pneumonia." Cochrane Database of Systematic Reviews. 2018 (9), pp. 1-44. https://doi.org/10.1002/14651858.CD012416.pub2
Article Title

Oral care measures for preventing nursing home‐acquired pneumonia

ERA Journal ID15305
Article CategoryArticle
AuthorsLiu, Chang (Author), Cao, Yubin (Author), Ng, Linda (Author), Lin, Jie (Author), Needleman, Ian (Author), Walsh, Tanya (Author) and Li, Chunjie (Author)
Journal TitleCochrane Database of Systematic Reviews
Journal Citation2018 (9), pp. 1-44
Article NumberCD012416
Number of Pages44
Year2018
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN1469-493X
1361-6137
Digital Object Identifier (DOI)https://doi.org/10.1002/14651858.CD012416.pub2
Web Address (URL)https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012416.pub2/full
Abstract

Background: Pneumonia occurring in residents of long-term care facilities and nursing homes can be termed 'nursing home-acquired pneumonia' (NHAP). NHAP is the leading cause of mortality among residents. NHAP may be caused by aspiration of oropharyngeal flora into the lung, and by failure of the individual's defence mechanisms to eliminate the aspirated bacteria. Oral care measures to remove or disrupt oral plaque might be effective in reducing the risk of NHAP.

Objectives: To assess effects of oral care measures for preventing nursing home-acquired pneumonia in residents of nursing homes and other long-term care facilities.

Search methods: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 November 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 10), MEDLINE Ovid (1946 to 15 November 2017), and Embase Ovid (1980 to 15 November 2017) and Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1937 to 15 November 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We also searched the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, and the Sciencepaper Online to 20 November 2017.

Selection criteria: We included randomised controlled trials (RCTs) that evaluated the effects of oral care measures (brushing, swabbing, denture cleaning mouthrinse, or combination) in residents of any age in nursing homes and other long-term care facilities.

Data collection and analysis: At least two review authors independently assessed search results, extracted data, and assessed risk of bias in the included studies. We contacted study authors for additional information. We pooled data from studies with similar interventions and outcomes. We reported risk ratio (RR) for dichotomous outcomes, mean difference (MD) for continuous outcomes, and hazard ratio (HR) for time-to-event outcomes, using random-effects models.

Main results: We included four RCTs (3905 participants), all of which were at high risk of bias. The studies all evaluated one comparison: professional oral care versus usual oral care. We did not pool the results from one study (N = 834 participants), which was stopped at interim analysis due to lack of a clear difference between groups.

We were unable to determine whether professional oral care resulted in a lower incidence rate of NHAP compared with usual oral care over an 18-month period (hazard ratio 0.65, 95% CI 0.29 to 1.46; one study, 2513 participants analysed; low-quality evidence).

We were also unable to determine whether professional oral care resulted in a lower number of first episodes of pneumonia compared with usual care over a 24-month period (RR 0.61, 95% CI 0.37 to 1.01; one study, 366 participants analysed; low-quality evidence).

There was low-quality evidence from two studies that professional oral care may reduce the risk of pneumonia-associated mortality compared with usual oral care at 24-month follow-up (RR 0.41, 95% CI 0.24 to 0.72, 507 participants analysed).

We were uncertain whether or not professional oral care may reduce all-cause mortality compared to usual care, when measured at 24-month follow-up (RR 0.55, 95% CI 0.27 to 1.15; one study, 141 participants analysed; very low-quality evidence).

Only one study (834 participants randomised) measured adverse effects of the interventions. The study identified no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental staining.

No studies evaluated oral care versus no oral care.

Authors' conclusions: Although low-quality evidence suggests that professional oral care could reduce mortality due to pneumonia in nursing home residents when compared to usual care, this finding must be considered with caution. Evidence for other outcomes is inconclusive. We found no high-quality evidence to determine which oral care measures are most effective for reducing nursing home-acquired pneumonia. Further trials are needed to draw reliable conclusions.

Keywordsrandomized controlled-trial; institutionalized elderly-people; ventilator-associated pneumonia; health-care; risk-factors; aspiration pneumonia; older-adults; community; residents; metaanalysis
ANZSRC Field of Research 2020420503. Community and primary care
Public Notes

File reproduced in accordance with the copyright policy of the publisher/author.

Byline AffiliationsSichuan University, China
University of Queensland
University College London, United Kingdom
University of Manchester, United Kingdom
Institution of OriginUniversity of Southern Queensland
Permalink -

https://research.usq.edu.au/item/q5232/oral-care-measures-for-preventing-nursing-home-acquired-pneumonia

Download files


Published Version
  • 229
    total views
  • 117
    total downloads
  • 3
    views this month
  • 3
    downloads this month

Export as

Related outputs

Scoping review of systematic reviews of nursing interventions in a neonatal intensive care unit or special care nursery
Foster, Jann, Pathrose, Sheeja Perumbil, Briguglio, Laura, Trajkovski, Suza, Lowe, Patricia, Muirhead, Renee, Jyoti, Jeewan, Ng, Linda, Bray, Nicole, Spence, Kaye, Chetty, Natasha and Broom, Margaret. 2024. "Scoping review of systematic reviews of nursing interventions in a neonatal intensive care unit or special care nursery ." Journal of Clinical Nursing. 33 (6), pp. 2123-2137. https://doi.org/10.1111/jocn.17053
Mental health and coping strategies among international health science students during the COVID-19 pandemic: A cross-sectional study
Nair, Ambili, Kalembo, Fatch, Zhou, Huaqiong, Ng, Linda, Hawley, Glenda, Grogan, Aaron, Ng, Leo, Chen, Wai, Daire, Judith and Lim, Eric. 2024. "Mental health and coping strategies among international health science students during the COVID-19 pandemic: A cross-sectional study." Teaching and Learning in Nursing. 19 (1), pp. e208-e216. https://doi.org/https://doi.org/10.1016/j.teln.2023.10.022
Exploring nursing students’ perceptions on usefulness, ease of use, and acceptability of using a simulated Electronic Medical Record: A descriptive study
Ng, Linda, Osborne, Sonya, Eley, Rob, Tuckett, Anthony and Walker, Jan. 2024. "Exploring nursing students’ perceptions on usefulness, ease of use, and acceptability of using a simulated Electronic Medical Record: A descriptive study ." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 31 (2), pp. 120-127. https://doi.org/https://doi.org/10.1016/j.colegn.2023.12.006
Assessment of the performance of alkali-activated slag/fly ash using liquid and solid activators: early-age properties and efflorescence
Gong, Jihao, Ma, Yuwei, Wang, Yanru, Cao, Yubin, Fu, Jiyang and Wang, Hao. 2024. "Assessment of the performance of alkali-activated slag/fly ash using liquid and solid activators: early-age properties and efflorescence." Journal of Sustainable Cement-Based Materials. 13 (2), pp. 300-310. https://doi.org/10.1080/21650373.2023.2266837
Embedding numeracy and medication management across the new Bachelor of Nursing curriculum to improve performance on clinical placement
Stolic, S., Ng, L. and Sheridan, G.. "Embedding numeracy and medication management across the new Bachelor of Nursing curriculum to improve performance on clinical placement." 18th Higher Education Research and Development Society of Australasia Annual Conference (HERDSA 1995). Rockhampton, Australia 04 - 08 Jul 1995
Intrinsic sulfuric acid resistance of C-(N)-A-S-H and N-A-S-H gels produced by alkali-activation of synthetic calcium aluminosilicate precursors
Wang, Yanru, Cao, Yubin, Zhang, Zuhua, Zhang, Peng, Ma, Yuwei, Wang, Aiguo and Wang, Hao. 2023. "Intrinsic sulfuric acid resistance of C-(N)-A-S-H and N-A-S-H gels produced by alkali-activation of synthetic calcium aluminosilicate precursors." Cement and Concrete Research. 165. https://doi.org/10.1016/j.cemconres.2022.107068
If we develop it, will they stay?
Ng, Linda. 2023. "If we develop it, will they stay?" 45th Higher Education Research and Development Society of Australasia Annual Conference (HERDSA 2023). Brisbane, Australia 09 Jun - 05 Jul 2023 Australia.
Thermal stability of limestone calcined clay cement (LC3) at moderate temperatures 100–400 °C
Cao, Yubin, Wang, Yanru, Zhang, Zuhu, Ma, Yuwei and Wang, Hao. 2023. "Thermal stability of limestone calcined clay cement (LC3) at moderate temperatures 100–400 °C ." Cement and Concrete Composites. 135, pp. 1-15. https://doi.org/10.1016/j.cemconcomp.2022.104832
Oral care measures for preventing nursing home-acquired pneumonia (Review)
Cao, Yubin, Liu, Chang, Lin, Jie, Ng, Linda, Needleman, Ian, Walsh, Tanya and Li, Chunjie. 2022. "Oral care measures for preventing nursing home-acquired pneumonia (Review)." Cochrane Database of Systematic Reviews. 2022 (11), pp. 1-46. https://doi.org/10.1002/14651858.CD012416.pub3
Implementation of the Electronic Medical Record into the Bachelor of Nursing program: A descriptive study
Ng, Linda, Osborne, Sonya and Walker, Jan. 2022. "Implementation of the Electronic Medical Record into the Bachelor of Nursing program: A descriptive study." 44th Higher Education Research and Development Society of Australasia Annual Conference (HERDSA 2022). Melbourne, Australia 27 - 30 Jun 2022 Australia.
Educating the educators: Implementing cultural safety in the nursing and midwifery curriculum
Best, Odette, Cox, Leonie, Ward, Aletha, Graham, Coralie, Bayliss, Luke, Black, Barbara, Burton, Lucinda, Carey, Melissa, Davis, Teresa, Derrington, Kate, Elliott, Jessie, Jayasinghe, Thenuja, Luyke, Trish, Maher, Dianne, McGregor, Rowena, Ng, Linda, O'Malley, Lee, Roderick, Geraldine, Sheridan, Georgina, ..., Walker, Jan. 2022. "Educating the educators: Implementing cultural safety in the nursing and midwifery curriculum." Nurse Education Today. 117, pp. 1-6. https://doi.org/10.1016/j.nedt.2022.105473
Electronic medication administration records and nursing administration of medications: An integrative review
Stolic, Snezana, Ng, Linda and Sheridan, Georgina. 2022. "Electronic medication administration records and nursing administration of medications: An integrative review." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 30 (1), pp. 163-189. https://doi.org/10.1016/j.colegn.2022.06.005
Medication errors by nursing students on clinical practice: an integrative review
Stolic, Snezana, Ng, Linda, Southern, Joanne and Sheridan, Georgina. 2022. "Medication errors by nursing students on clinical practice: an integrative review." Nurse Education Today. 112, pp. 1-9. https://doi.org/10.1016/j.nedt.2022.105325
Study of acidic degradation of alkali-activated materials using synthetic C-(N)-A-S-H and N-A-S-H gels
Wang, Yanru, Cao, Yubin, Zhang, Zuhua, Huang, Jizhong, Zhang, Peng, Ma, Yuwei and Wang, Hao. 2022. "Study of acidic degradation of alkali-activated materials using synthetic C-(N)-A-S-H and N-A-S-H gels." Composites Part B: Engineering. 230, pp. 1-14. https://doi.org/10.1016/j.compositesb.2021.109510
Interventions for colorectal cancer survivors: a systematic review of intervention reviews
Ralph, Nicholas, Arthur, Thomas, McDonald, Suzanne, Ng, Linda, Singh, Kamal, Elliott, Jessica and Gow, Jeffery. 2021. "Interventions for colorectal cancer survivors: a systematic review of intervention reviews." PROSPERO: International Prospective Register of Systematic Reviews. 24 May 2021, pp. 1-4.
Integration of an Academic Electronic Medical Record into the Bachelor of Nursing program: A pilot project
Ng, Linda, Osborne, Sonya and Walker, Jan. 2021. "Integration of an Academic Electronic Medical Record into the Bachelor of Nursing program: A pilot project." Sigma's 32nd International Nursing Research VIRTUAL Congress. Toowoomba, Australia 21 - 23 Jul 2021 Toowoomba, Australia.
Fresh and hardened properties of alkali-activated fly ash/slag binders: effect of fly ash source, surface area, and additives
Wang, Yanru, Cao, Yubin, Ma, Yuwei, Xiao, Shanshan, Hu, Jie and Wang, Hao. 2021. "Fresh and hardened properties of alkali-activated fly ash/slag binders: effect of fly ash source, surface area, and additives." Journal of Sustainable Cement-Based Materials. https://doi.org/10.1080/21650373.2021.1932637
Turning sandstone clay into supplementary cementitious material: activation and pozzolanic reactivity evaluation
Cao, Yubin, Wang, Yanru, Zhang, Zuhua, Ma, Yuwei and Wang, Hao. 2021. "Turning sandstone clay into supplementary cementitious material: activation and pozzolanic reactivity evaluation." Composites Part B: Engineering. 223, pp. 1-12. https://doi.org/10.1016/j.compositesb.2021.109137
Recent progress of utilization of activated kaolinitic clay in cementitious construction materials
Cao, Yubin, Wang, Yanru, Zhang, Zuhua, Ma, Yuwei and Wang, Hao. 2021. "Recent progress of utilization of activated kaolinitic clay in cementitious construction materials." Composites Part B: Engineering. 211, pp. 1-19. https://doi.org/10.1016/j.compositesb.2021.108636
Influence of Elevated Temperatures and Cooling Method on the Microstructure Development and Phase Evolution of Alkali-Activated Slag
Fu, Hua, Mo, Rui, Wang, Penggang, Wang, Yanru, Cao, Yubin, Guang, Wentao and Ding, Yao. 2022. "Influence of Elevated Temperatures and Cooling Method on the Microstructure Development and Phase Evolution of Alkali-Activated Slag." Materials. 15 (6). https://doi.org/10.3390/ma15062022
Recycled sand from sandstone waste: A new source of high-quality fine aggregate
Cao, Yubin, Wang, Yanru, Zhang, Zuhua and Wang, Hao. 2022. "Recycled sand from sandstone waste: A new source of high-quality fine aggregate ." Resources, Conservation and Recycling. 179, pp. 1-11. https://doi.org/10.1016/j.resconrec.2021.106116
Address an unmet need: establishing the prevalence of metabolic syndrome in Darling Down region
Gardiner, P., Aung, N., Ng, L., Stolic, S., Bliss, E., Gyawali, P. and Roberts, M.. 2022. "Address an unmet need: establishing the prevalence of metabolic syndrome in Darling Down region." Toowoomba, Darling Downs Health Services Research Symposium.
Investigation of sandstone by-products as supplementary cementitious materials and fine aggregate
Cao, Yubin. 2022. Investigation of sandstone by-products as supplementary cementitious materials and fine aggregate. PhD by Publication Doctor of Philosophy (DPHD). University of Southern Queensland. https://doi.org/10.26192/w8w6z
Facilitating neonatal MARSI evidence into practice: investigating multimedia resources with Australian neonatal nurses – a participatory action research project
August, Deanne, Chapple, Lynette, Flint, Andrea, Macey, Judith, Ng, Linda and New, Karen. 2021. "Facilitating neonatal MARSI evidence into practice: investigating multimedia resources with Australian neonatal nurses – a participatory action research project." Journal of Neonatal Nursing. 27, pp. 291-297. https://doi.org/10.1016/j.jnn.2020.12.001
Telling it like it is: What do we really know about replacing clinical practice with simulation?
Bogossian, F., Cant, R., Ballard, E., Cooper, S., Levett-Jones, T., McKenna, L., Ng, L. and Seaton, P.. 2019. "Telling it like it is: What do we really know about replacing clinical practice with simulation?" 8th International Clinical Skills Conference (ICSC 2019). Prato, Italy 19 - 22 May 2019
Talking the talk and walking the walk: Are patient safety priorities addressed by simulation-based education?
Bogossian, Fiona, Seaton, Philippa, Levett-Jones, Tracy, Cant, Robyn, Cooper, Simon, Kelly, Michelle and Ng, Linda. 2019. "Talking the talk and walking the walk: Are patient safety priorities addressed by simulation-based education?" 8th International Clinical Skills Conference (ICSC 2019). Prato, Italy 19 - 22 May 2019
Is a successful research career compatible with scholarship in nursing education?
Cooper, S., Seaton, P., Absalom, I., Bogossian, F., Cant, R., Levett-Jones, T. and Ng, L.. 2018. "Is a successful research career compatible with scholarship in nursing education?" 7th International Nurse Education Conference: Research, Scholarship and Evaluation: Ensuring Nursing Leadership in Education Practice and Healthcare. Banff, Canada 06 - 09 May 2018 United States.
Exploring facilitators and barriers to nurses’ uptake of postgraduate education in Australia
Ng, L., Tuckett, A. and Eley, R.. 2018. "Exploring facilitators and barriers to nurses’ uptake of postgraduate education in Australia." 7th International Nurse Education Conference: Research, Scholarship and Evaluation: Ensuring Nursing Leadership in Education Practice and Healthcare. Banff, Canada 06 - 09 May 2018 United States.
Effective Utilization of Waste Glass as Cementitious Powder and Construction Sand in Mortar
Wang, Yanru, Cao, Yubin, Zhang, Peng and Ma, Yuwei. 2020. "Effective Utilization of Waste Glass as Cementitious Powder and Construction Sand in Mortar." Materials. 13 (3), pp. 1-21. https://doi.org/10.3390/ma13030707
Enhancing students’ confidence, competence and knowledge with Integrated Skills Challenge
Ng, L. and Bogossian, F.. 2017. "Enhancing students’ confidence, competence and knowledge with Integrated Skills Challenge." 2017 Australian & New Zealand Association for Health Professional Educators Conference (ANZAHPE 2017). Adelaide, South Australia 11 - 14 Jul 2017 Australia.
Exploring registered nurses’ attitudes towards postgraduate education
Ng, Linda, Eley, Rob and Tuckett, Anthony. 2016. "Exploring registered nurses’ attitudes towards postgraduate education." 24th Australian College of Neonatal Nurses National Conference. Melbourne, Victoria Sep 2016
Exploring factors affecting registered nurses’ pursuit of postgraduate education in Australia
Ng, Linda, Eley, Robert and Tuckett, Anthony. 2016. "Exploring factors affecting registered nurses’ pursuit of postgraduate education in Australia." Nursing and Health Sciences. 18 (4), pp. 435-441. https://doi.org/10.1111/nhs.12289
Oral care measures for preventing nursing home-acquired pneumonia (Protocol)
Li, Chunjie, Zhang, Qi, Ng, Linda, Needleman, Ian, Lin, Jie and Walsh, Tanya. 2016. "Oral care measures for preventing nursing home-acquired pneumonia (Protocol)." Cochrane Database of Systematic Reviews. 2016 (10), pp. 1-12. https://doi.org/10.1002/14651858.CD012416
Exploring registered nurses’ attitudes towards post graduate education in Australia: a pilot study
Ng, L., Tuckett, A., Fox-Young, S., Kain, V. and Eley, R.. 2015. "Exploring registered nurses’ attitudes towards post graduate education in Australia: a pilot study." 25th International Nursing Research Congress. Hong Kong, China 24 - 28 Jul 2014 Indianapolis, IN, United States.
NATPGE: understanding registered nurses’ attitudes towards post graduate education
Ng, Linda, Fox-Young, Stephanie, Tuckett, Anthony, Eley, Robert and Kain, Victoria. 2015. "NATPGE: understanding registered nurses’ attitudes towards post graduate education." 3rd Annual Worldwide Nursing Conference. Singapore 29 - 30 Jun 2015 https://doi.org/10.5176/2315-4330_WNC15.10
Content and validity testing of the Nurses’ Attitudes Towards Postgraduate Education (NATPGE) tool in Australia
Ng, Linda and Tuckett, Anthony. 2014. "Content and validity testing of the Nurses’ Attitudes Towards Postgraduate Education (NATPGE) tool in Australia." 9th Annual ACNN Conference. Adelaide, Australia 18 - 20 Sep 2014 Camperdown, NSW, Australia.
Locating “gold standard” evidence for simulation as a substitute for clinical practice in prelicensure health professional education: A systematic review
Bogossian, Fiona E., Cant, Robyn P., Ballard, Emma L., Cooper, Simon J., Levett-Jones, Tracy L., McKenna, Lisa G., Ng, Linda C. and Seaton, Philippa C.. 2019. "Locating “gold standard” evidence for simulation as a substitute for clinical practice in prelicensure health professional education: A systematic review ." Journal of Clinical Nursing. 28 (21-22), pp. 3759-3775. https://doi.org/10.1111/jocn.14965
Exploring registered nurses’ attitudes towards postgraduate education in Australia: an overview of literature
Ng, Linda C., Tuckett, Anthony G., Fox-Young, Stephanie K. and Kain, Victoria J.. 2014. "Exploring registered nurses’ attitudes towards postgraduate education in Australia: an overview of literature." Journal of Nursing Education and Practice. 4 (2), pp. 162-170. https://doi.org/10.5430/jnep.v4n2p162
Water absorption and chloride diffusivity of concrete under the coupling effect of uniaxial compressive load and freeze-thaw cycles
Wang, Yanru, Cao, Yubin, Zhang, Peng, Ma, Yuwei, Zhao, Tiejun, Wang, Hao and Zhang, Zuhua. 2019. "Water absorption and chloride diffusivity of concrete under the coupling effect of uniaxial compressive load and freeze-thaw cycles." Construction and Building Materials. 209, pp. 566-576. https://doi.org/10.1016/j.conbuildmat.2019.03.091
Exploring registered nurses’ attitudes towards postgraduate education in Australia: an overview of the literature
Ng, Linda, Tuckett, Anthony, Fox-Young, Stephanie and Kain, Victoria. 2014. "Exploring registered nurses’ attitudes towards postgraduate education in Australia: an overview of the literature." Journal of Nursing Education and Practice. 4 (2), pp. 162-170. https://doi.org/10.5430/jnep.v4n3p20
Oral hygiene care for critically ill patients to prevent ventilator associated pneumonia
Shi, Zongdao, Xie, Huixu, Wang, Ping, Wu, Yan, Chen, E., Ng, Linda, Worthington, Helen, Singer, Mervyn and Needleman, Ian. 2010. "Oral hygiene care for critically ill patients to prevent ventilator associated pneumonia." Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD008367
Exploring the extent to which simulation-based education addresses contemporary patient safety priorities: a scoping review
Seaton, Philippa, Levett-Jones, Tracy, Cant, Robyn, Cooper, Simon, Kelly, Michelle A., McKenna, Lisa, Ng, Linda and Bogossian, Fiona. 2019. "Exploring the extent to which simulation-based education addresses contemporary patient safety priorities: a scoping review." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 26 (1), pp. 194-203. https://doi.org/10.1016/j.colegn.2018.04.006
Transition to practice programs: what Australian and New Zealand nursing and midwifery graduates said. A Graduate eCohort Sub-Study
Tuckett, Anthony, Eley, Robert and Ng, Linda. 2017. "Transition to practice programs: what Australian and New Zealand nursing and midwifery graduates said. A Graduate eCohort Sub-Study." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 24 (2), pp. 101-108. https://doi.org/10.1016/j.colegn.2015.10.002
Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia
Shi, Zongdao, Xie, Huixu, Wang, Ping, Zhang, Qi, Wu, Yan, Chen, E., Ng, Linda, Worthington, Helen V., Needleman, Ian and Furness, Susan. 2013. "Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia." Cochrane Database of Systematic Reviews. 2013 (8). https://doi.org/10.1002/14651858.CD008367.pub2
Are nurses using best practice in tracheal suctioning of artificial airways?
Ng, Linda C. H. and Chang, Anne M.. 2009. "Are nurses using best practice in tracheal suctioning of artificial airways?" Asia Pacific Critical Care 2008 Congress. Sydney, Australia 30 Oct - 02 Nov 2008 United States. https://doi.org/10.1016/j.aucc.2008.12.028