Effect of Oral Hygiene for Patients on Mechanical Ventilator in Intensive Care Unit

Abstract

Oral care for patients on the mechanical ventilator is extremely vital in intensive care units, as negligence of oral care can cause long-term oral and nosocomial diseases such as ventilator-associated pneumonia. Maintaining oral health for the critically ill patient is a fundamental nursing activity, and the condition of a patient’s mouth is considered an indicator of nursing care received. Critical care nurses can play a functional role in decreasing and preventing the occurrence of ventilator associated pneumonia, accordingly improving the patients' recovery rate and consequently reducing healthcare costs. Aim of the study: To assess the effect of oral hygiene for patients on the mechanical ventilators in the intensive care unit and nurses’ knowledge and practice regarding oral hygiene. Design: a descriptive exploratory research design was utilized. Setting: The study was carried out in intensive care units of Mansoura University Hospital. Study Subjects: Convenient sample of all available nursing staff working in ICU, including 40 nurses and a convenient sample of 60 orally intubated patients admitted to ICU who underwent mechanical ventilator. Data collection tools: Data were obtained through nurses’ knowledge questionnaire, nurses’ observational checklist, and oral assessment scale. Results: The majority of the studied nurses had an unsatisfactory level of knowledge, and about three quarters of them had an incompetent level of practice regarding oral hygiene for patients on the mechanical ventilator. Meanwhile, regarding the patients’ total oral score, it was found that about half of the mechanically ventilated patients had average oral alteration, and there was a significant relationship between oral alteration and frequency of oral care. Conclusion: there was a high statistically significant relationship between low frequency of oral care and oral alteration. Also, there was a high statistically significant relationship between ventilator-associated pneumonia occurrence and poor oral alteration. Recommendations: Designing in-service training and educational program to improve nurses’ knowledge and practice regarding oral hygiene for the patient on mechanical ventilator.