Toothbrushes are commonly used in hospital settings and may harbor potentially harmful microorganisms. A peer-reviewed literature review was conducted to evaluate the cumulative state of knowledge related to toothbrush contamination and its possible role in disease transmission. A systematic review was conducted on adult human subjects through three distinct searches. The review resulted in seven experimental and three descriptive studies which identified multiple concepts related to toothbrush contamination to include contamination, methods for decontamination, storage, design, and environmental factors. The selected studies found that toothbrushes of healthy and oral diseased adults become contaminated with pathogenic bacteria from the dental plaque, design, environment, or a combination of factors. There are no studies that specifically examine toothbrush contamination and the role of environmental factors, toothbrush contamination, and vulnerable populations in the hospital setting (e.g., critically ill adults) and toothbrush use in nursing clinical practice.

Nurse researchers explored the history of Mary Breckenridge’s Frontier Nursing Service (FNS) during the years 1925 to 1965, to elicit how her experience could inform present day concerns regarding universal access to healthcare. A historical biographical approach informed by critical theory was selected as the methodology. As historical research tends to generate large volumes of data, concept mapping was selected to collect, reduce, organize and interpret data. Additionally, concept mapping can assist researchers to agree on meaning as seen in interrelationships of the data. The final aggregate concept map is a graphic, visual representation of the outcome of this historical research process. The researchers in this study found concept mapping to be an ideal tool for reducing and managing data, visualizing interconnectedness of the data and viewing significant concepts in relation to the whole. The results of this study found the FNS to be a powerful exemplar of a successful healthcare delivery system that had a major impact on the health of the residents in one of poorest regions in the country. Mary Breckenridge was able to mobilize public support and creatively generate resources, to initiate and maintain a community-based healthcare program.

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