| Summary: | A research report submitted to the
Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
In partial fulfilment of the requirements for the degree
of
Master of Science in Nursing
Johannesburg, 2018. === Background: evidence-based oral care prevents ventilator associated pneumonia. However, not all intensive care nurses provide this level of care. Although several studies have been undertaken to identify factors that affect the provision of oral care, none of these studies looked at the situation in South Africa.
Aim: the purpose of this study was to explore and describe the factors that affect intensive care nurses in providing oral care in the intensive care units of a public sector hospital in Johannesburg.
Design: an explorative - descriptive qualitative and contextual design was used.
Methods: participants were recruited by convenience maximum variation sampling, from the population of certified intensive care nurses working in four (n=4) adult intensive care units of one public sector hospital in Johannesburg. Data was collected by audiotaping nineteen (n=19) participants using semi-structured one-to-one interviews. Verbatim transcripts were analysed by Braun and Clarke’s thematic analysis; trustworthiness ensured following the criterion of Lincoln and Guba; ethical considerations were applied.
Results: this study reveals oral care education is perceived by senior nurses to have been completed in basic nursing school and not meant for specialist training. Oral care for the intubated patient is based on common sense. There is lack of knowledge on the characteristics of lotions used, prevention of complications during oral care and preventive strategies for ventilator associated pneumonia. Even though participants acknowledge the goal for oral care to be preventing ventilator associated pneumonia, contextual factors greatly affect its provision.
Recommendations: improved human and material resources is required to facilitate the process involved in nurses’ provision of oral care for intubated patients to prevent ventilator associated pneumonia. Improved staffing, facilitation of learning and the development of specific intensive care nursing skill for oral care on the intubated patient through multi-strategy education and clinical research is recommended.
Conclusion: the attitude of nurses and the hospital management to oral care is a strong determinant to its provision in the intensive care unit. === LG2018
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