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

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.