A Correlational Study among Critical Care Nurses Knowledge, Attitude, and Practice toward Oral Care in Patients with Oral Endotracheal Intubation

• Main Authors: Ying-Siou Lin, 林盈秀
• Other Authors: 羅美芳
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/79256795476632575075

碩士 === 國立臺灣大學 === 護理學研究所 === 96 === Effective oral care improves patient comfort and prevents oral infection. Although oral care is a common nursing practice, providing intubated patients with oral care is a challenging task. This study investigated the knowledge, attitudes, practices and factors associated with oral care of intubated patients in intensive care units (ICU) and identified predictive factors for oral care of intubated patients by ICU nurses. This study used a descriptive, cross-sectional design using purposive sampling to recruit nurses. Data were collected by structured questionnaires and observational checklist from January to April 2008 at a medical center in northern Taiwan. The observational data were the oral care procedures performed by thirty-one ICU nurses for intubated patients in six ICUs. The questionnaire examined 205 nurses'' knowledge, attitudes and practices related to care for oral intubated patients in twelve ICUs. The results showed that cotton swab and foam swab were the main oral care cleaning equipment used for oral intubated patients according to observations of ICU nurses performing oral care and self-reported questionnaires of ICU nurses. The cleaning solution was mainly dilute mouthwash. The mean correct rate was 72.4% in procedures of oral care. Due to the different characteristics of ICUs, the ICU nurses chose different cleaning equipment, cleaning solutions, methods of using cleaning solution, and oral endotracheal tube securement methods. Older age of the ICU nurses, was associated with more complete oral care. The completeness of performing oral care by the ICU nurses in medical ICU was significantly higher than that by nurses in surgical ICU. The mean correct rate about the ICU nurses’ knowledge of oral care was 51.8%. The mean rate about the ICU nurses’ attitude of oral care was 67.5%. The mean rate of ICU nurses ideally performed oral care procedure was 59.5%. Higher scores in oral care knowledge were associated with higher frequency of performing oral care. Instructions from more experienced ICU nurses was the main source of learning oral care for intubated patients. The source of learning oral care for intubated patients affected the knowledge, attitude, and practice of oral care in ICU nurses. The more sources of learning oral care for intubated patients, the better the understanding and the more positive the attitude of the ICU nurses. Older age of ICU nurses was associated with higher frequency of performing oral care. The nurses in stroke ICU performed more frequently of oral care for intubated patients than the nurses in medical ICUs. The statistical results derived by stepwise regression analysis showed that four variables - stroke ICU (β = 0.23), age of ICU nurses (β = 0.21), emergency ICU (β = 0.16), and knowledge of oral care (β = 0.14) predicted oral care practice of ICU nurses. The four variables accounted for 11.6% of the total variance in ICU nurses’ oral care practice. Based on the results of this study, we recommend that ICU nurses acquire knowledge related to oral care via various learning resources and continuous lifetime learning to advance their knowledge and attitudes regarding oral care. Additionally, ICUs must establish policies and procedures for oral care of intubated patients by characteristics of the patients. Further more, ICUs should provide on-the-job training and education of oral care in order to improve the quality of oral care in critical patients.