Title : Preparing ICU nurses with critical knowledge of oral care
Abstract:
Introduction: The delivery of oral care in nursing practice is often neglected, attributable primarily to the lack of standardized protocols, insufficient training, and a general unawareness of its essential function in reducing the risk of aspiration pneumonia in stroke patients exhibiting oropharyngeal dysphagia. The insufficient delivery of consistent and effective daily oral hygiene for individuals suffering from oropharyngeal dysphagia can lead to aspiration pneumonia, extended hospital stays, increased healthcare costs, and a decline in patient satisfaction. Research has demonstrated that oral care has reduced adverse events in recently extubated patients diagnosed with a stroke and improved the quality of life for these individuals. A cerebrovascular accident can result in declining physical, sensory, and cognitive abilities, thereby impacting the individual's capacity for self-maintenance and safety.
Objective: Nursing professionals recognize the benefits of oral care, but documentation and evidence-based standards can be improved. This project aims to improve oral care documentation and evidence-based protocols for cerebrovascular accident patients with oropharyngeal dysphagia. Formulating an educational plan and oral care protocol employed a systematic methodology to augment documentation and the delivery of oral care. The neuro-intensive care unit was chosen for this project because of inadequacies in oral care documentation and delivery for oropharyngeal dysphagia patients, which strains the healthcare system and lowers patient satisfaction.
Methods: A complete literature review of CINAHL, PubMed, and the Cochrane Database (the Cochrane Database required using the OVID search engine) was conducted. MeSH and Boolean terms like oral care, stroke, aspiration pneumonia, prevention, patient outcomes, interventions, non-ventilator hospital-acquired pneumonia, and English-language research articles from the last five years were used to determine oral care best practices and clinical practice guidelines. Evidence-based analysis helped create the oral protocol and teaching plan titled "Preparing ICU Nurses with Critical Knowledge of Oral Care." Given critical evidence-based oral care protocols, nurses are more inclined to complete and document oral care. Roger's diffusion of innovation theory was chosen for this study because he identified five key factors influencing cross-cultural innovation. Oral care is not new, but overcoming this collective issue requires communication, temporal considerations, and social structures.
Results: The project was implemented in the neuro-intensive care unit and is ongoing. Project evaluations through chart reviews are currently still in progress. Current observations indicate that 50% of the staff has completed the educational and training portion of the project and has commenced implementing the oral care documentation piece of the protocol during their charting.
Conclusion: Implementing an oral care protocol through an educational training plan within the neuro-intensive care unit is essential for advancing health equity and enhancing compliance with documentation and oral care standards. Future recommendations for the educational teaching program “Preparing ICU Nurses for Critical Knowledge in Oral Care” should be systematically implemented throughout the intensive care units within the healthcare system to promote health equity and enhance compliance with documentation and oral care standards. The literature grounded in evidence suggests that achieving health equity and improving documentation and oral care services necessitates that nurse leaders and staff acknowledge the barriers to adherence in these areas and develop strategies to tackle the identified instances of non-compliance.
