Li SuWen, Wang Fengzhen
Department of Nursing, Gannan Medical University, Ganzhou, CHN.
Department of Critical Care, Gannan Medical University, Ganzhou, CHN.
Cureus. 2024 Dec 8;16(12):e75310. doi: 10.7759/cureus.75310. eCollection 2024 Dec.
Background Ventilator-associated pneumonia (VAP) is a common and severe hospital-acquired infection, and oral care is an effective preventive measure. However, the compliance and quality of oral care among intensive care unit (ICU) nurses need improvement. Methods This quasi-experimental study was conducted in two ICUs at the first affiliated hospital of Gannan Medical University, Ganzhou, China, involving 74 ICU nurses. The participants were allocated to either a micro-course education group or a conventional education group. Of these, 32 nurses were from the General ICU, and 42 were from the Cardiac ICU. Both groups received oral care education, with the micro-course group receiving video-based instruction, and the conventional group receiving PowerPoint-based training (Microsoft® Corp., Redmond, WA, USA). Data on oral care compliance and levels of Knowledge, Attitudes, and Practices (KAP) were collected at baseline and during follow-ups over one month. Statistical analysis was conducted using a mixed-effects model to compare outcomes between the groups, highlighting variations in ICU nurses' oral care practices across different ICU settings. Results Both education methods had statistically significant effects. The micro-course education group showed earlier and more pronounced improvements in oral care compliance. Quantitatively, the micro-course group experienced a mean increase in compliance of 0.281 (p = 0.032) at the third follow-up, whereas the conventional group saw a mean increase of 0.261 (p = 0.042) at the fifth follow-up. Additionally, KAP levels in both groups improved significantly (p < 0.001). Conclusion This study demonstrates that micro-course education has a statistically significant impact on ICU nurses' oral care compliance and levels of KAP in the short term. Although there was no significant difference in oral care compliance between the micro-course and conventional education methods, the micro-course showed certain advantages in teaching quality. Long-term studies are needed to evaluate the sustainability of these improvements. Promoting micro-course education in ICU nursing practice may enhance oral care practices and potentially reduce the incidence of VAP.
背景 呼吸机相关性肺炎（VAP）是一种常见且严重的医院获得性感染，口腔护理是一种有效的预防措施。然而，重症监护病房（ICU）护士的口腔护理依从性和质量有待提高。方法 本准实验研究在中国赣州赣南医学院第一附属医院的两个ICU进行，涉及74名ICU护士。参与者被分配到微课程教育组或传统教育组。其中，32名护士来自综合ICU，42名来自心脏ICU。两组均接受口腔护理教育，微课程组接受基于视频的指导，传统组接受基于PowerPoint的培训（美国华盛顿州雷德蒙德微软公司）。在基线和为期一个月的随访期间收集口腔护理依从性以及知识、态度和实践（KAP）水平的数据。使用混合效应模型进行统计分析以比较两组结果，突出不同ICU环境下ICU护士口腔护理实践的差异。结果 两种教育方法均有统计学显著效果。微课程教育组在口腔护理依从性方面表现出更早且更显著的改善。从数量上看，微课程组在第三次随访时依从性平均提高0.281（p = 0.032），而传统组在第五次随访时平均提高0.261（p = 0.042）。此外，两组的KAP水平均显著提高（p < 0.001）。结论 本研究表明，微课程教育在短期内对ICU护士的口腔护理依从性和KAP水平有统计学显著影响。虽然微课程和传统教育方法在口腔护理依从性方面没有显著差异，但微课程在教学质量方面显示出一定优势。需要进行长期研究以评估这些改善的可持续性。在ICU护理实践中推广微课程教育可能会改善口腔护理实践并有可能降低VAP的发生率。
