Oral care practices of nurses on ventilated patients in Kigali Intensive Care Unit

Abstract

Background: Oral care in the Intensive Care Unit (ICU) is an essential intervention proven to prevent Ventilator Associated Pneumonia (VAP). VAP results in increased morbidity and mortality, with excess hospital stay and cost. Oral care is a critical intervention that controls the accumulation of oral pathogens; however, it is viewed as a comfort measure and not a critical life-saving intervention.

Objective: To assess the oral care provided to ICU ventilated patients by nurses at a referral hospital in Kigali.

Methods: This cross-sectional design used a convenience sample of 47 nurses at a referral hospital in Kigali. Descriptive statistics were used for data analysis.

Results: The majority of nurses (89.4%) used normal saline for comprehensive mouth care on ICU patients. The majority reported they never used a toothbrush (53.2%) toothpaste (63.8%), or Chlorhexidine solution (89.4%), which are the recommendation. One third (34%) do not perform the oral assessment on admission. There is no ICU oral care protocol, and oral hygiene supplies are limited.

Conclusion: Oral care is critical care in VAP prevention. ICU nurses reported a low level of oral care practice. We recommend an oral care protocol and in-service training to improve the quality of oral care to ICU ventilated patients.

Keywords: Oral care, ICU, nurses, ventilated patients, ventilator-associated pneumonia