Abdelhafez Amal Ismael, Tolba Asmaa Atiaa
Critical Care & Emergency Nursing Department, Faculty of Nursing, Assiut University, Assiut, Egypt.
Nursing Department, College of Applied Medical Science, King Faisal University, Hofuf, Saudi Arabia.
Nurs Crit Care. 2023 May;28(3):411-418. doi: 10.1111/nicc.12736. Epub 2021 Dec 2.
Oral care is one of the fundamental nursing care procedures used to decrease oral colonization, dental plaque, respiratory infections, and patient stay and cost.
This study aimed to identify intensive care unit (ICU) nurses' self-assessment of oral care frequency, skill competency, documentation, oral care tools, and obstacles to oral care quality. In addition, it proposed exploring associations between nurses' attitudes about the importance of oral care and the priority of other interventions.
A cross-sectional descriptive study was conducted in two ICUs (trauma and general) in the main teaching hospital in Upper Egypt. Of 105 nurses selected using convenience sampling, 91 completed the questionnaire.
About 60.4% of ICU nurses did not attend any oral care training programme, 40.7% reported performing oral care four times per shift in intubated patients, 62.6% reported that their skills needed improvement, 37.4% saw themselves as competent, and 86.8% documented oral care in patients' records. Significant positive correlations were found, indicating that nurses' attitudes towards the importance of oral care showed the same tendency as the priority given to other interventions, such as eye care, bowel care, documentation, hygiene, catheters, feeding, and wound care (correlation coefficient [r] = 0.290, 0.511, 0.333, 0.425, 0.431, 0.345, and 0.337, respectively). Furthermore, a toothbrush (84.6%) was often used, while chlorhexidine was not used (90.1%). The major obstacles to the provision of oral care as perceived by the nurses were the fear of aspiration and life-threatening interventions (95.6%), inadequate nurse-patient ratios (94.5%), irregular competency evaluations (92.3%), unavailability of oral care guidelines (92.3%), and shortage of time (84.6%).
The participating nurses were mindful of the importance and priority of oral care. Many of them did not attend oral care training programmes and considered that their skills needed improvement. Moreover, ICU nurses reported many obstacles hindering oral care quality.
This research identifies the importance of developing in-service oral care training programmes to improve ICU nurses' skill competency. High-quality oral care can be provided by focusing on and overcoming obstacles that hinder nurses' oral care practice.
口腔护理是用于减少口腔定植、牙菌斑、呼吸道感染以及患者住院时间和费用的基本护理程序之一。
本研究旨在确定重症监护病房（ICU）护士对口腔护理频率、技能能力、记录、口腔护理工具以及口腔护理质量障碍的自我评估。此外，还提议探索护士对口腔护理重要性的态度与其他干预措施优先级之间的关联。
在埃及上埃及主要教学医院的两个ICU（创伤科和综合科）进行了一项横断面描述性研究。采用便利抽样法选取的105名护士中，91名完成了问卷调查。
约60.4%的ICU护士未参加任何口腔护理培训项目，40.7%的护士报告对插管患者每班进行4次口腔护理，62.6%的护士报告其技能需要改进，37.4%的护士认为自己有能力胜任，86.8%的护士在患者记录中记录了口腔护理情况。发现了显著的正相关，表明护士对口腔护理重要性的态度与给予其他干预措施（如眼部护理、肠道护理、记录、卫生、导管护理、喂养和伤口护理）的优先级呈现相同趋势（相关系数[r]分别为0.290、0.511、0.333、0.425、0.431、0.345和0.337）。此外，经常使用牙刷（84.6%），而未使用洗必泰（90.1%）。护士认为提供口腔护理的主要障碍是担心误吸和危及生命的干预措施（95.6%）、护士与患者比例不足（94.5%）、能力评估不规范（92.3%）、缺乏口腔护理指南（92.3%）以及时间不足（84.6%）。
参与研究的护士意识到口腔护理的重要性和优先级。他们中的许多人未参加口腔护理培训项目，并认为自己的技能需要改进。此外，ICU护士报告了许多阻碍口腔护理质量的障碍。
本研究确定了开展在职口腔护理培训项目以提高ICU护士技能能力的重要性。通过关注并克服阻碍护士口腔护理实践的障碍，可以提供高质量的口腔护理。
