Oral care practices in intensive care units: a survey of 59 European ICUs.
OBJECTIVE
To explore the type and frequency of oral care practices in European ICUs and the attitudes, beliefs, and knowledge of health care workers.


METHODS
An anonymous questionnaire was distributed to representatives of European ICUs. Results were obtained from 59 ICUs (one questionnaire per ICU) in seven countries 91% of respondents were registered nurses.


RESULTS
Of the respondents 77% reported that they had received adequate training on providing oral care; most (93%) also expressed the desire to learn more about oral care. Oral care was perceived to be high priority in mechanically ventilated patients (88%). Cleaning the oral cavity was considered difficult by 68%, and unpleasant as well as difficult by 32%. In 37% of cases respondents felt that despite their efforts oral health worsens over time in intubated patients. Oral care practices are carried out once daily (20%), twice (31%) or three times (37%). Oral care consists principally of mouth washes (88%), mostly performed with chlorhexidine (61%). Foam swabs (22%) and moisture agents (42%) are used less frequently as well as manual toothbrushes (41%) although the literature indicates that these are more effective for thorough cleaning of the oral cavity. Electric toothbrushes were never used.


CONCLUSIONS
In European ICUs oral care is considered very important. It is experienced as a task that is difficult to perform, and that does not necessarily succeed in ensuring oral health in patients with prolonged intubation. Oral care consists primarily of mouth washes. The use of toothbrushes should be given more attention.
Rello
Jordi
J
Joan XXIII University Hospital, Critical Care Department, Mallafrè Guasch 4, 43007 Tarragona, Spain. jrello.hj23.ics@gencat.net
Koulenti
Despoina
D
Blot
Stijn
S
Sierra
Rafael
R
Diaz
Emili
E
De Waele
Jan J
JJ
Macor
Antonio
A
Agbaht
Kemal
K
Rodriguez
Alejandro
A
D005060:Europe; D019538:Health Care Surveys; D007362:Intensive Care Units; D009726:Nurses; D009909:Oral Health