Oral care practices for patients in Intensive Care Units: A pilot survey

Abstract

Objective:To assess the level of knowledge and difficulties concerning hospitalized patients regarding preventive oral health measures among professionals working in Intensive Care Units (ICUs).Study Population and Methods:A cross-sectional survey was conducted among 71 health professionals working in the ICU. A self-administered questionnaire was used to determine the methods used, frequency, and attitude toward oral care provided to patients in Brazilian ICUs. The variables were analyzed using descriptive statistics (percentages). A one-sample t-test between proportions was used to assess significant differences between percentages. t-statistics were considered statistically significant for P < 0.05. Bonferroni correction was applied to account for multiple testing.Results:Most participants were nursing professionals (80.3%) working 12-h shifts in the ICU (70.4%); about 87.3% and 66.2% reported having knowledge about coated tongue and nosocomial pneumonia, respectively (P < 0.05). Most reported using spatulas, gauze, and toothbrushes (49.3%) or only toothbrushes (28.2%) with 0.12% chlorhexidine (49.3%) to sanitize the oral cavity of ICU patients (P < 0.01). Most professionals felt that adequate time was available to provide oral care to ICU patients and that oral care was a priority for mechanically ventilated patients (80.3% and 83.1%, respectively, P < 0.05). However, most professionals (56.4%) reported feeling that the oral cavity was difficult to clean (P < 0.05).Conclusion:The survey results suggest that additional education is necessary to increase awareness among ICU professionals of the association between dental plaque and systemic conditions of patients, to standardize oral care protocols, and to promote the oral health of patients in ICUs.

Oral Health and Care at Intensive Care Units

“…Performing dental procedures in hospital environments is a challenge, since this area of expertise is not yet fully acknowledged and is discriminated by the health professionals themselves, who do not believe in the effective participation of dental care in the comprehensive treatment of hospitalized patients [3,12,24,25].…”

“…Thus, their presence in multidisciplinary teams working in hospital care is essential, mainly with regard to oral health-related procedures and clinical interventions in general [10,13,25,26].…”

“…Dentistry in Intensive Care Units stands out due to the important role it plays in the comprehensive care provided to critically ill patients [24,25,[30][31][32].…”

“…Dentists do not have the opportunity to dedicate themselves to hospital environments, mainly to ICUs; therefore, is it necessary technically and scientifically preparing these professionals in order to help them providing good oral health practices to critically ill patients [17,25,30,40,44].…”

“…The oral hygiene deficiency condition found in ICUs may be the greatest issue in technical dentistry, since most ICU professionals perform oral hygiene using wooden spatulas wrapped in gauze [25,30].…”