Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 17 , ISSUE 1 ( February, 2013 ) > List of Articles


Intensive care nurses′opinions and practice for oral care of mechanically ventilated patients

Mohsen Adib-Hajbaghery, Akram Ansari, Ismail Azizi-Fini

Keywords : Critical care, mechanical ventilation, oral care, nurses′ opinions

Citation Information : Adib-Hajbaghery M, Ansari A, Azizi-Fini I. Intensive care nurses′opinions and practice for oral care of mechanically ventilated patients. Indian J Crit Care Med 2013; 17 (1):23-27.

DOI: 10.4103/0972-5229.112154

License: CC BY-ND 3.0

Published Online: 01-05-2014

Copyright Statement:  Copyright © 2013; The Author(s).


Context: Oral care is an essential aspect of critical care nursing. However, no study has been published on oral care practice of Iranian and Asian nurses. The majority of published studies were conducted in western and European countries. Aims: This study aimed to evaluate the nurses′ opinions and practice about oral care in patients under mechanical ventilation. Settings and Design: A cross-sectional study was conducted on 130 intensive care nurses from 6 intensive care units in the university hospitals of Iran. Materials and Methods: A questionnaire was used to gather the data and charts of 45 patients were evaluated. Statistical analysis: Descriptive statistical analysis are presented. Results: Oral care obtained the 7 th rank in prority and a mean score of 5.7 on a scale of 1-10. More than 21% of subjects did not perform oral care in their usual duties. High load of writing tasks and personnel shortages were the major barriers to oral care. Only 20% of the patients′ charts contained a report on oral care. Conclusions: Nurses did not consider oral care in intensive care patients as a high priority. This result highlights the need to continue education programs on oral care for improving the knowledge and attitude of intensive care nurses with respect to oral care.

PDF Share
  1. Jones H, Newton JT, Bower EJ. A survey of the oral care practices of intensive care nurses. Intensive Crit Care Nurs 2004;20:69-76.
  2. Evans G. A rationale for oral care. Nurs Stand 2001;15:33-6.
  3. DeKeyser Ganz F, Fink NF, Raanan O, Asher M, Bruttin M, Nun MB, et al. ICU nurses′ oral-care practices and the current best evidence. J Nurs Scholarsh 2009;41:132-8.
  4. Blot S, Vandijck D, Labeau S. Oral care of intubated patients. Clin Pulm Med 2008;15:153-60.
  5. Johnstone L, Spence D, Koziol-McClain J. Oral hygiene care in the pediatric intensive care unit: Practice recommendations. Pediatr Nurs 2010;36:85-96.
  6. Binkley C, Furr LA, Carrico R, McCurren C. Survey of oral care practices in US intensive care units. Am J Infect Control 2004;32:161-9.
  7. Berry AM, Davidson PM, Masters J, Rolls K. Systematic literature review of oral hygiene practices for intensive care patients receiving mechanical ventilation. Am J Crit Care 2007;16:552-62.
  8. McNeill HE. Biting back at poor oral hygiene. Intensive Crit Care Nurs 2000;16:367-72.
  9. Adib-Hajbaghery M, Ansari A, Azizi-Fini E. Oral care in ICU patients: A review of research evidence. Feyz KAUMS J 2011;15:280-93.
  10. Sole ML, Byers JF, Ludy JE, Zhang Y, Banta CM, Brummel K. A multisite survey of suctioning techniques and airway management practices. Am J Crit Care 2003;12:231-2.
  11. Grap MJ, Munro CL, Ashtiani B, Bryant S. Oral care interventions in critical care: Frequency and documentation. Am J Crit Care 2003;12:113-8.
  12. Berry AM, Davidson PM. Beyond comfort: Oral hygiene as a critical nursing activity in the intensive care unit. Intensive Crit Care Nurs 2006;22:318-28.
  13. Allen Furr L, Binkley CJ, McCurren C, Carrico R. Factors affecting quality of oral care in intensive care units. J Adv Nurs 2004;48:454-62.
  14. Jelic S, Cunningham JA, Factor P. Clinical review: Airway hygiene in the insensitive care unit. Crit Care 2008;12:209.
  15. Abidia RF. Oral care in the intensive care unit: A review. J Contemp Dent Pract 2007;8:76-82.
  16. Rello J, Koulenti D, Blot S, Sierra R, Diaz E, De Waele JJ, et al. Oral care practices in intensive care units: A survey of 59 European ICUs. Intensive Care Med 2007;33:1066-70.
  17. Hanneman SK, Gusick GM. Frequency of oral care and positioning of patients in critical care: A replication study. Am J Crit Care 2005;14:378-86.
  18. Mori H, Hirasawa H, Oda S, Shiga H, Matsuda K, Nakamura M. Oral care reduces incidence of ventilator-associated pneumonia in ICU populations. Intensive Care Med 2006;32:230-6.
  19. Adib Haj Bagheri M, Salsali M, Ahmadi F. Clinical Decision-making: A way to professional empowerment in nursing. IJME 2004;10:3-12.
  20. Garcia R, Jendresky L, Colbert L, Bailey A, Zaman M, Majumder M. Reducing ventilator-associated pneumonia through advanced oral-dental care: A 48-month study. Am J Crit Care 2009;18:523-32.
  21. Feider LL, Mitchell P. Validity and reliability of an oral care practice survey for the orally intubated adult critically ill patient. Nurs Res 2009;58:374-7.
  22. Schwartz AJ, Powell S. Brush up on oral assessment and care. Nursing 2009;39:30-2.
  23. Moore J. Assessment of nurse-administered oral hygiene. Nurs Times 1995;91:40-1.
  24. Curzio J, McCowan M. Getting research into practice: Developing oral hygiene standards. Br J Nurs 2000;9:434-8.
  25. Buerhaus PI, Staiger DO, Auerbach DI. Why are shortages of hospital RNs concentrated in specialty care units? Nurs Econ 2000;18:111-6.
  26. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA 2002;288:1987-93.
  27. Dalton JA, Carlson J, Mann JD, Blau W, Bernard S, Youngblood R. An examination of nursing attitudes and pain management practices. Cancer Pract 1998;6:115-24.
  28. Román EM, Sorribes E, Ezquerro O. Nurses′ attitudes to terminally ill patients. J Adv Nurs 2001;34:338-45.
  29. Pedreira ML, Kusahara DM, de Carvalho WB, Núñez SC, Peterlini MA. Oral care interventions and oropharyngeal colonization in children receiving mechanical ventilation. Am J Crit Care 2009;18:319-28.
  30. Munro CL, Grap MJ, Jones DJ, McClish DK, Sessler CN. Chlorhexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults. Am J Crit Care 2009;18:428-37.
  31. Fields LB. Oral care intervention to reduce incidence of ventilator-associated pneumonia in the neurologic intensive care unit. J Neurosci Nurs 2008;40:291-8.
  32. Hajibagheri A, Azizi Fini I. Oral Care in Patients Receiving Mechanical Ventilation: A Systematic Review. Nurs Midwifery Stud. 2012;1:51-61.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.