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了解重症监护病房中的口腔护理:对护士护理机械通气患者的经验和做法的定性研究。

Understanding oral care in the intensive care unit: A qualitative study of nurse experiences and practices with mechanically ventilated patients.

作者信息

SuWen Li, YuYang Huang, Wei Bu

机构信息

Department of Nursing, Gannan Medical University, Ganzhou, China.

Department of Operating Room, The Fourth People's Hospital of Zigong City, Zigong, China.

出版信息

Nurs Crit Care. 2025 Mar;30(2):e13296. doi: 10.1111/nicc.13296.

Abstract

BACKGROUND

Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in the intensive care unit (ICU), often linked to poor oral care. Despite its importance, oral care is frequently neglected in ICU settings, leading to increased morbidity and health care costs.

AIM

To explore the challenges ICU nurses face in providing oral care to mechanically ventilated patients and identify their specific educational needs.

STUDY DESIGN

This study employed a qualitative descriptive design to detail oral care experiences in the ICU. Standardized qualitative research reporting protocols ensured integrity. Data collection included observational methods using video and photographic records, followed by heuristic interviews.

RESULTS

Three key themes were identified: logistical challenges in providing ICU oral care, the need for more education and better resource allocation and the importance of ethical communication in nursing. Differences in policy implementation, spatial constraints and communication barriers highlighted the need for improved education, better resource management and enhanced communication strategies while maintaining patient dignity.

CONCLUSIONS

ICU nurses encounter challenges in oral care because of spatial constraints, technical difficulties and lack of knowledge. Targeted education, resource allocation and better communication can improve oral care quality, reduce VAP incidence and enhance patient outcomes.

RELEVANCE TO CLINICAL PRACTICE

Comprehensive training programmes and addressing psychological barriers are critical to enhancing ICU nurses' effectiveness in oral care. Improved communication practices and balancing patient dignity with medical demands are essential for maintaining high standards of care.

摘要

背景

呼吸机相关性肺炎(VAP)是重症监护病房(ICU)常见的医院获得性感染,常与口腔护理不佳有关。尽管其很重要,但在ICU环境中口腔护理常常被忽视,导致发病率增加和医疗费用上升。

目的

探讨ICU护士在为机械通气患者提供口腔护理时面临的挑战,并确定他们的具体教育需求。

研究设计

本研究采用定性描述性设计来详细描述ICU中的口腔护理经历。标准化的定性研究报告方案确保了完整性。数据收集包括使用视频和照片记录的观察方法,随后进行启发式访谈。

结果

确定了三个关键主题:提供ICU口腔护理的后勤挑战、对更多教育和更好资源分配的需求以及护理中伦理沟通的重要性。政策实施、空间限制和沟通障碍方面的差异凸显了在保持患者尊严的同时,需要改进教育、更好地进行资源管理和加强沟通策略。

结论

由于空间限制、技术困难和知识缺乏,ICU护士在口腔护理方面遇到挑战。有针对性的教育、资源分配和更好的沟通可以提高口腔护理质量,降低VAP发病率并改善患者预后。

与临床实践的相关性

全面的培训计划和解决心理障碍对于提高ICU护士在口腔护理方面的有效性至关重要。改进沟通实践以及在患者尊严与医疗需求之间取得平衡对于维持高标准护理至关重要。

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