Oral care for intubated patients: a survey of intensive care unit nurses

AIMS: This study aimed to determine attitudes and practices of intensive care unit (ICU) nurses towards provision of oral care for intubated patients.

BACKGROUND: Oral care is as an essential nursing intervention for intubated patients to maintain patient comfort and prevent colonization of dental plaque by respiratory pathogens.

DESIGN: This was a cross-sectional study.

METHODS: Data were collected from 93 ICU nurses of a teaching hospital in the East Coast of Peninsular Malaysia using a self-administered questionnaire.

RESULTS: Some nurses agreed that oral cavity of intubated patients was difficult (40·8%) and unpleasant (16·2%) to clean, but all of them realized the importance of oral care and the majority (97·9%) would like to learn more about it. Most nurses reported providing oral care at least two times daily using various methods and products such as suction toothbrush (90·4%), manual toothbrush (49·5%), cotton swab (91·5%) and foam swab (65·7%). Chlorhexidine gluconate oral rinse was the preferred mouthwash (97·8%) and swabs (93·5%) solution although few used non-optimal products such as sodium bicarbonate (14·0%), tap water (4·3%) and hydrogen peroxide (3·2%) to wash their patients' mouths. While the majority of nurses agreed that oral care supplies and equipments were available (93·6%) and suitable (88·2%), most of them also thought they need better hospital support (88·2%).

CONCLUSIONS: The nurses' attitudes towards oral care were generally positive and most oral care methods were appropriate. However, some methods and products used were inconsistent with the current recommendations and they have mixed views about the suitability of oral care supplies and equipment provided by the hospital.

RELEVANCE TO CLINICAL PRACTICE: Recommendations were made for providing standard oral care protocols for intubated patients and oral care training programs for ICU nurses to support delivery of quality patient care.