Knowledge and attitudes of Pakistani intensive care unit nurses regarding oral care delivery to mechanically ventilated patients

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From: Journal of Pakistan Medical Association(Vol. 70, Issue 7)
Publisher: Knowledge Bylanes
Document Type: Report
Length: 2,672 words
Lexile Measure: 2150L

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Byline: Sanniya Khan Ghauri, Arslaan Javaeed, Aqsa Chaudhry, Abdus Salam Khan and Khawaja Junaid Mustafa

Keywords: Knowledge, Attitude, Intensive care unit, Nurses, Oral care. (JPMA 70: 1203; 2020)

Introduction

Intensive care unit (ICU) is the part of any hospital that handles critically ill and unconscious patients. Some of these patients would at some point in their time at the ICU require mechanical ventilation which involves taking over a patient's breathing through an endotracheal tube (ETT) that is passed through the oral cavity into the trachea. Under these circumstances, the oral care of such patients becomes a challenging issue. Oral care for these patients remains a very vital aspect of nursing care offered to such paients.1 The goal of oral care is to maintain the oral state of these patients in a clean, comfortable and moist manner that is infection-free.2 ICU patients may require oral intubation to help them maintain a patent airway. The ETT, which is often used for this role, has been strongly linked to ventilator-associated pneumonia (VAP), which is one of the most common causes of nosocomial infections among mechanically-ventilated patients in the ICU.3,4

Hospital-acquired pneumonia (HAP) is one of the commonest complications seen among ICU patients.5 VAP is a subdivision of HAP and it is defined by the American Thoracic Society as pneumonia occurring in mechanically-ventilated patients after not 20###9###11.1

Education

-Nursing Diploma###32###39.5

-Bachelor's Degree###48###59.3

-Master's Degree###1###1.2

Type of Nurses' Shift

-Day###60###74.1

-Evening###8###9.9

-Night###13###16

Type of ICU-in which nurses work

-Surgical###38###46.9

-Medical###39###48.1

-Paediatric###4###4.9

Table-2: Knowledge about the mechanism of transmission amongst study participants.

Questions###Responses N (%)

###Least likely###Not likely###Don't know###likely###Most likely

Can disease be transmitted from other patients?###18 (22.2)###2 (2.5)###16 (19.8)###23 (28.4)###22 (27.2)

Can disease be transmitted from the aspiration of contaminated secretions /from the oropharynx?###0 (0.0)###31 (38.3)###9 (11.1)###32 (39.5)###9 (11.1)

Can disease be transmitted from health care workers hands###0 (0.0)###31 (38.3)###17 (21.0)###24 (29.6)###9 (11.1)

Can disease be transmitted from contaminated respiratory equipment?###0 (0.0)###23 (28.4)###26 (32.1)###23 (28.4)###9 (11.1)

Can disease be transmitted from preadmission colonization?###0 (0.0)###13 (16.0)###17 (21.0)###34 (42.0)###17 (21.0)

Table-3: Attitude of study participants towards oral care delivery to mechanically ventilated patients.

Statements###Strongly agree###Agree###Neutral###Disagree###Strongly disagree

###N (%)###N (%)###N (%)###N (%)###N (%)

"The oral cavity is a difficult area of the body to clean."###25 (30.9)###48 (59.3)###0 (0.0)###7 (8.6)###1 (1.2)

"Oral care is a very high priority for mechanically ventilated patients"###16 (19.8)###27 (33.3)###22 (27.2)###16 (19.8)###0 (0.0)

"I find the cleaning of oral cavity to be an unpleasant task."###3 (3.7)###19 (23.5)###32 (39.5)###20 (24.7)###7 (8.6)

"No matter what I do, the mouths of most of the ventilated patients seem to

get worse the longer they are on ventilator."###5 (6.2)###22 (27.2)###14 (17.3)###40 (49.4)###0 (0.0)

"There are more important tasks to do to the unstable patients than the oral care."###5 (6.2)###10 (12.3)###2 (2.5)###54 (66.7)###10 (12.3)

Table-4: Responses of study participants in reply to the statements about practices

Statement###Strongly agree###Agree###Neutral###Disagree###Strongly disagree

###N (%)###N (%)###N (%)###N (%)###N (%)

"I have adequate time to provide oral care at least once a day"###1 (1.2)###20 (24.7)###9 (11.1)###51 (63.0)###0 (0.0)

"I have been given adequate training in providing...

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Gale Document Number: GALE|A628847580