Oral care in the adult intensive care unit.
BACKGROUND
Nurses have not been formally trained in assessing the oral status of patients in intensive care units, and no oral care protocols for these patients are available.


OBJECTIVE
To assess the oral status of patients in an intensive care unit, evaluate the effects of a defined oral care protocol on the oral health status of patients in an intensive care unit, and compare oral assessments of a dental hygienist with those of intensive care nurses.


METHODS
A nonequivalent comparison group, longitudinal design with repeated measures was used. In phase 1, oral assessment data on the comparison group were collected by a dental hygienist. In phase 2, nurses were instructed in oral assessment and an oral care protocol. In phase 3, the oral care protocol was implemented in the treatment group, and oral assessment data were collected separately by the dental hygienist and by nurses.


RESULTS
The mean inflammation score was significantly lower (t test P = .03) in the treatment group (mean, 3.9; SEM, 3.0) than in the comparison group (mean, 12.4; SEM, 2.2). Although not significant, the mean scores of the treatment group were also lower than those of the comparison group on scales of candidiasis, purulence, bleeding, and plaque. Correlations between scores for individual items on the oral assessment tool obtained by the dental hygienist and those obtained by nurses were all greater than 0.6386.


CONCLUSIONS
Implementation of a well-developed oral care protocol by bedside nurses can improve oral health of patients in the intensive care unit.
Fitch
J A
JA
Medical College of Virginia Hospitals, Richmond, USA.
Munro
C L
CL
Glass
C A
CA
Pellegrini
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods*; D004509:Education, Nursing, Continuing / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods*; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education*; D009910:Oral Hygiene / Q000193:education / Q000379:methods / Q000451:nursing; D009911:Oral Hygiene Index