Volume 41, Issue 2 p. 132-138

ICU Nurses’ Oral-Care Practices and the Current Best Evidence

Freda DeKeyser Ganz RN, PhD

Freda DeKeyser Ganz RN, PhD

Pi , Head, Master's Program, Hadassah-Hebrew University School of Nursing, Jerusalem, Israel

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Naomi Farkash Fink RN, MHA

Naomi Farkash Fink RN, MHA

Nursing Research Coordinator, Rabin Medical Center, Petach Tikva, Israel

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Ofra Raanan RN, MA

Ofra Raanan RN, MA

Instructor, Sheba-Tel Hashomer Medical Center, Tel Hashomer, Israel

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Miriam Asher RN, BA

Miriam Asher RN, BA

Rabin Medical Center, Petach Tikva, Israel

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Madeline Bruttin RN, MA

Madeline Bruttin RN, MA

Instructor, Recanati School of Health Professions, Ben Gurion University, Beer Sheva, Israel

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Maureen Ben Nun RN, BSN

Maureen Ben Nun RN, BSN

Kaplan Medical Center, Rehovot, Israel

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Julie Benbinishty RN, BA

Julie Benbinishty RN, BA

Instructor, Hadassah Hebrew University School of Nursing, Jerusalem, Israel

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First published: 01 June 2009
Citations: 49
Correspondence
DeKeyser Ganz, Hadassah-Hebrew University School of Nursing, Kiryat Hadassah, P.O. Box 12000, Jerusalem. E-mail: [email protected]

Abstract

Purpose: The purpose of this study was to describe the oral-care practices of ICU nurses, to compare those practices with current evidence-based practice, and to determine if the use of evidence-based practice was associated with personal demographic or professional characteristics.

Design: A national survey of oral-care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004–05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral-care practices. Nurses rated their perceived level of priority concerning oral care on a scale from 0 to 100. A score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the current best evidence. This score was then statistically analyzed using ANOVA to determine differences of EBP based on demographic and professional characteristics.

Findings: The most commonly used equipment was gauze pads (84%), followed by tongue depressors (55%), and toothbrushes (34%). Chlorhexidine was the most common solution used (75%). Less than half (44%) reported brushing their patients’ teeth. The majority performed an oral assessment before beginning oral care (71%); however, none could describe what assessment tool was used. Only 57% of nurses reported documenting their oral care. Nurses rated oral care of intubated patients with a priority of 67±27.1. Wide variations were noted within and between units in terms of which techniques, equipment, and solutions were used. No significant relationships were found between the use of an evidence-based protocol and demographic and professional characteristics or with the priority given to oral care.

Conclusions: While nurses ranked oral care a high priority, many did not implement the latest evidence into their current practice. The level of research utilization was not related to personal or professional characteristics. Therefore attempts should be made to encourage all ICU nurses to introduce and use evidence-based, oral-care protocols.

Clinical Relevance: Practicing ICU nurses in this survey were often not adhering to the latest evidence-based practice and therefore need to be educated and encouraged to do so in order to improve patient care.