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重症监护病房护士在护理插管患者时的口腔护理实践、态度及面临的挑战:一项描述性研究

Oral Care Practices, Attitudes and Challenges Faced by Intensive Care Unit Nurses in the Care of Intubated Patients: A Descriptive Study.

作者信息

Aktan Gül Güneş, Coşkun Palaz Simge

机构信息

Zübeyde Hanım Health Science Faculty, Nursing Department, Niğde Ömer Halisdemir University, Niğde, Turkey.

Health Science Faculty, Nursing Department, Bolu Abant İzzet Baysal University, Bolu, Turkey.

出版信息

Nurs Crit Care. 2025 Jul;30(4):e70095. doi: 10.1111/nicc.70095.

Abstract

BACKGROUND

Oral care for intubated patients in intensive care units is a critical component in the prevention of serious complications such as ventilator-associated pneumonia; however, nurses' practices, attitudes and challenges may directly influence the effectiveness of care.

AIM

This study aims to investigate the oral care practices, attitudes and challenges of intensive care nurses in intubated patients.

STUDY DESIGN

This descriptive study was conducted in the intensive care units of four different hospitals in Türkiye. Data were collected from 171 nurses working in the intensive care units of four hospitals between March 1, 2024, and July 1, 2024. The study used the "Personal Information Form," the "Nurses' Oral Care Practices and Challenges Form," and the "Attitude Scale for Oral Care Practices." Data were analysed using descriptive analysis. The study followed the STROBE guidelines.

RESULTS

Nurses' attitudes towards oral care practices were found to be positive, with a mean scale score of 131.08 ± 14.18 (min: 87, max: 170), indicating above-average levels. Regarding the challenges encountered in providing oral care for intubated patients, 84% of nurses reported mild to moderate patient-related difficulties, while 91.8% reported mild self-related difficulties. The most common patient-related challenge was the inability to establish cooperation with the patient (77.8%), whereas the most common nurse-related challenge was the lack of appropriate equipment (36.3%). No significant differences or correlations were found between socio-demographic variables, the presence of challenges and attitudes towards oral care (p > 0.05). However, a significant difference was observed in the experience of oral care difficulties between male nurses (p = 0.006) and nurses working in general intensive care units (ICUs) (p = 0.002).

CONCLUSIONS

These findings highlight that although intensive care nurses have generally positive attitudes towards oral care, they face several challenges, mainly related to patient cooperation and equipment availability. Addressing these barriers through targeted interventions and resource allocation may improve the quality and consistency of oral care in intensive care settings.

RELEVANCE TO CLINICAL PRACTICE

Ensuring effective oral care for intubated patients is essential for preventing complications such as ventilator-associated pneumonia. Although intensive care nurses have positive attitudes towards oral care, challenges related to patient cooperation and equipment availability hinder optimal practice. Addressing these barriers through staff training, protocol standardization and resource allocation can improve the consistency and quality of oral care, ultimately improving patient outcomes in intensive care settings.

摘要

背景

重症监护病房中插管患者的口腔护理是预防呼吸机相关性肺炎等严重并发症的关键组成部分;然而,护士的实践、态度和挑战可能直接影响护理效果。

目的

本研究旨在调查重症监护护士对插管患者的口腔护理实践、态度和挑战。

研究设计

本描述性研究在土耳其四家不同医院的重症监护病房进行。于2024年3月1日至2024年7月1日期间,从四家医院重症监护病房工作的171名护士收集数据。该研究使用了“个人信息表”、“护士口腔护理实践与挑战表”以及“口腔护理实践态度量表”。数据采用描述性分析。该研究遵循STROBE指南。

结果

发现护士对口腔护理实践的态度积极,平均量表得分为131.08±14.18(最小值:87,最大值:170),表明处于平均水平以上。关于为插管患者提供口腔护理时遇到的挑战,84%的护士报告了轻度至中度与患者相关的困难,而91.8%的护士报告了轻度与自身相关的困难。最常见的与患者相关的挑战是无法与患者建立合作(77.8%),而最常见的与护士相关的挑战是缺乏合适的设备(36.3%)。在社会人口统计学变量、挑战的存在以及对口腔护理的态度之间未发现显著差异或相关性(p>0.05)。然而,在男性护士(p=0.006)和普通重症监护病房(ICU)工作的护士(p=0.002)之间,口腔护理困难的经历存在显著差异。

结论

这些发现突出表明,尽管重症监护护士对口腔护理总体态度积极,但他们面临一些挑战,主要与患者合作和设备可用性有关。通过有针对性的干预措施和资源分配来解决这些障碍,可能会提高重症监护环境中口腔护理的质量和一致性。

与临床实践的相关性

确保为插管患者提供有效的口腔护理对于预防呼吸机相关性肺炎等并发症至关重要。尽管重症监护护士对口腔护理态度积极,但与患者合作和设备可用性相关的挑战阻碍了最佳实践。通过员工培训、协议标准化和资源分配来解决这些障碍,可以提高口腔护理的一致性和质量,最终改善重症监护环境中的患者结局。

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