Vucelić Vesna, Bratić Vesna, Negovetić Vranić Dubravka, Tambić Andrašević Arjana, Degoricija Vesna, Mihaljević Zlatan, Ramić Snježana, Piteša Košutić Ivana, Šimunović Luka, Špiljak Bruno, Brailo Vlaho
Intensive Care Unit of the University Department of Medicine, Clinical Hospital Centre "Sestre milosrdnice".
Clinic for Anesthesiology and Intensive Care, University Clinical Hospital Centre Zagreb.
Acta Stomatol Croat. 2024 Mar;58(1):85-93. doi: 10.15644/asc58/1/8.
This study assesses the knowledge, practices, and attitudes of medical staff in intensive care units (ICUs) regarding oral hygiene care for critically ill, bedridden patients.
A cross-sectional study included 65 employees from the Intensive Care Units of the Sestre Milosrdnice Clinical Hospital Centre (CHC SM) and the Clinic for Anesthesiology and Intensive Care at the University Clinical Hospital Centre Zagreb (CHC ZG). A self-administered questionnaire was used to assess knowledge, methods, frequency, and attitudes towards oral care for mechanically ventilated patients. The data were examined through descriptive statistical methods, presented in terms of proportions (percentages). For the purpose of comparing the feedback across the two hospital centers and different educational backgrounds, the Chi-square and Fisher's exact tests were employed.
Results of a survey of 65 participants (18 from CHC SM and 47 from CHC ZG) revealed a notable disparity in oral hygiene knowledge, with graduate nurses displaying the highest proportion of adequate knowledge (100%) and regular nurses showing the least (30.3%) (p<.001). Although the execution of oral care practices did not vary significantly among the groups, graduate nurses performed oral care more frequently (80% vs. baccalaureate technicians 33.33% and nurses 57.6%, three or more times a day) and demonstrated better proficiency in both mechanical (p=.005) and chemical (p<.001) biofilm management compared to their counterparts. No significant difference was observed in the delivery of oral care to orotracheally intubated patients across different educational levels (p=.127). However, a marked difference was noted in the perception of being adequately trained for such care, with nurses feeling less prepared (12.1%, p<.001). Despite these variances, all respondents recognized the importance of oral hygiene, thus showing a strong dedication to oral health care. This study highlights variability in ICU oral hygiene practices and points to the importance of standardized care protocols and improved training for healthcare staff.
本研究评估重症监护病房(ICU)医护人员对重症卧床患者口腔卫生护理的知识、实践和态度。
一项横断面研究纳入了来自斯雷斯特·米洛什尔尼察临床医院中心(CHC SM)重症监护病房以及萨格勒布大学临床医院中心麻醉与重症监护诊所(CHC ZG)的65名员工。采用自填式问卷评估对机械通气患者口腔护理的知识、方法、频率和态度。数据通过描述性统计方法进行分析,以比例(百分比)呈现。为比较两个医院中心和不同教育背景的反馈,采用卡方检验和费舍尔精确检验。
对65名参与者(18名来自CHC SM,47名来自CHC ZG)的调查结果显示,口腔卫生知识存在显著差异,研究生护士具备充分知识的比例最高(100%),普通护士最低(30.3%)(p<0.001)。尽管各群体之间口腔护理实践的执行情况差异不显著,但研究生护士进行口腔护理的频率更高(80%,而本科技术员为33.33%,护士为57.6%,每天三次或更多次),并且与同行相比,在机械(p = 0.005)和化学(p<0.001)生物膜管理方面表现出更高的熟练度。不同教育水平的医护人员在对经口气管插管患者进行口腔护理方面未观察到显著差异(p = 0.127)。然而,在认为接受过此类护理充分培训的认知方面存在显著差异,护士感觉准备不足(12.1%,p<0.001)。尽管存在这些差异,但所有受访者都认识到口腔卫生的重要性,因此对口腔保健表现出强烈的敬业精神。本研究强调了ICU口腔卫生实践的变异性,并指出了标准化护理方案以及加强医护人员培训的重要性。