title: Nurses' oral hygiene care practices with hospitalised older adults in postacute settings.
abstract: OBJECTIVE
  The purpose of this study was to explore how nurses provide bedtime oral hygiene care, how they decide on interventions provided, and what factors influence their ability to provide oral care.
  
  
  BACKGROUND
  Current evidence links poor oral hygiene to systemic and infectious diseases such as pneumonia. Hospitalised patients, who now retain their teeth into older adulthood, often rely on nurses to provide oral hygiene care. Nurses have the potential to impact oral health outcomes and quality of life by controlling plaque. However, oral hygiene care practices of nurses in postacute hospital settings are relatively unknown.
  
  
  METHODS
  A qualitative, exploratory multiple-case study was conducted with 25 nurses working on five inpatient units at different hospitals.
  
  
  METHODS
  Nurses were accompanied on their evening rounds to observe oral care practices, the physical environment and workflow. Thematic analysis was used to analyse the case study data including transcripts of guided conversations, field notes and documents. Within-case analysis was followed by cross-case analysis.
  
  
  RESULTS
  Findings indicate that (i) nurses often convey oral hygiene care to their patients as being optional; (ii) nurses are inclined to preserve patient autonomy in oral hygiene care; (iii) oral hygiene care is often spontaneous and variable, and may not be informed by evidence; and (iv) oral hygiene care is not embedded into bedtime care routines.
  
  
  CONCLUSIONS
  Oral hygiene care is discretionary and often missed care.
  
  
  CONCLUSIONS
  Nurses need knowledge of the health benefits of oral care, and skills related to assessment and approaches to oral care. Availability of effective products and supplies facilitates provision of oral care. The evidence for oral hygiene care practices, outcomes of nurse-administered oral care and nursing's role in influencing the oral health literacy of patients require further study.
authors.affiliation: Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Esther
authors.initials: E
authors.lastname: Coker
authors.affiliation: School of Nursing, McMaster University, Hamilton, ON, Canada.
authors.forename: Jenny
authors.initials: J
authors.lastname: Ploeg
authors.affiliation: School of Nursing, McMaster University, Hamilton, ON, Canada.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kaasalainen
authors.affiliation: School of Nursing, McMaster University, Hamilton, ON, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Carter
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D009864:Ontario; D009910:Oral Hygiene / Q000451:nursing*; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data*
keywords: Yin; hospital care; nurses; older adults; oral hygiene care; qualitative case study