Ferreira Salomé, Lima Andreia, Araújo Paula, Carneiro Silvia, Moreira Teresa, Cardoso Ana Filipa
Escola Superior de Saúde, Instituto Politécnico de Viana do Castelo, Portugal.
Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.
JBI Evid Implement. 2025 Jan 14. doi: 10.1097/XEB.0000000000000487.
People with stroke are at risk of poor oral hygiene caused by neurological deficits, which can be motor, sensory, or cognitive. Good oral hygiene has been shown to reduce adverse events and improve the patient's quality of life. Although nurses recognize the benefits of oral hygiene, evidence shows that this area of care is frequently overlooked.
This evidence implementation project aimed to improve oral hygiene in stroke patients through the application of best practices.
This project was conducted in a stroke unit in a hospital in northern Portugal. The project followed the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit process. Four audit criteria were used in the baseline and follow-up audits. Observation of nursing care and analysis of nursing records were used to assess current practice against best practice recommendations. Nurses were engaged in the project through brainstorming to identify barriers, co-create strategies to address the barriers, and ensure project sustainability.
The baseline audit revealed low compliance with the four audit criteria. The follow-up audit showed increased compliance, with Criterion 1 improving from 0% to 100%, with all nurses receiving training on oral hygiene assessment and management. Compliance increased by 40% for Criterion 2 and 36.7% for Criteria 3 and 4, respectively.
The project successfully promoted compliance with best practice recommendations and increased evidence-based practice for oral hygiene in patients with stroke in a stroke unit.
中风患者因神经功能缺损(可能是运动、感觉或认知方面的)而面临口腔卫生不良的风险。良好的口腔卫生已被证明可减少不良事件并提高患者的生活质量。尽管护士认识到口腔卫生的益处,但有证据表明这一护理领域经常被忽视。
本证据实施项目旨在通过应用最佳实践来改善中风患者的口腔卫生。
该项目在葡萄牙北部一家医院的中风单元开展。项目遵循JBI证据实施框架,该框架基于审核、反馈和重新审核流程。在基线审核和后续审核中使用了四项审核标准。通过观察护理过程和分析护理记录,对照最佳实践建议评估当前做法。护士通过头脑风暴参与项目,以识别障碍、共同制定解决障碍的策略并确保项目的可持续性。
基线审核显示对四项审核标准的依从性较低。后续审核显示依从性有所提高,标准1从0%提高到100%,所有护士都接受了口腔卫生评估和管理方面的培训。标准2的依从性提高了40%,标准3和标准4的依从性分别提高了36.7%。
该项目成功促进了对最佳实践建议的依从性,并增加了中风单元中中风患者口腔卫生的循证实践。