Oral status and affecting factors in Iranian ICU patients: a cross-sectional study

Arkia, Mostafa; Rezaei, Jahangir; Salari, Nader; Vaziri, Siavash; Abdi, Alireza

doi:10.1186/s12903-023-02867-6

“…However, the present study found doctors rarely participated in oral care training in the ICU. Many researchers have pointed out the importance of dental professionals providing professional guidance on oral care for ICU patients [ 10 , 12 ]. The future comprehensive oral care plan should involve nurses, nursing assistants, occupational therapists, dental experts, language medical record holders, nutritionists, and rehabilitation therapists [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…They can assist with many patient-care tasks, such as personal and oral care, which greatly support the healthcare team [ 11 ]. 55.7% of nurses delegated oral care to NAs [ 12 ]. A growing number of studies focus on the oral health status of ICU patients, but relatively few investigate the perspectives and challenges of NAs in the oral care of ICU patients.…”

Section: Introductionmentioning

confidence: 99%

Perceptions, barriers, and challenges of oral care among nursing assistants in the intensive care unit: a qualitative study

Li,

Yao,

Yang

et al. 2024

BMC Oral Health

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Background Although oral hygiene is closely related to various diseases, it is sub-optimal in the Intensive Care Unit (ICU). Oral care in the ICU is challenged by nursing workloads, low staffing, and higher acuity patients, there are few policies and written guidelines for oral care. Nurses often delegate oral care to nursing assistants (NAs) whose role is overlooked. This study is to explore the perspectives, obstacles, and challenges of NAs in the oral care of the ICU. Methods A qualitative study and semi-structured interviews were conducted with NAs in three ICU units, and Colaizzi’s phenomenological method was used to analyze the records. Results Initially, 13 NAs met the inclusion criteria, and two did not participate in this study as they refused to be recorded. Finally, 11 ICU NAs were interviewed, with three receiving face-to-face interviews and eight receiving telephone interviews. Using Colaizzi’s phenomenological method, two themes and eight subthemes emerged from the data, we examined the self-perception, barriers and challenges of NAs regarding oral care and identified the subthemes: (1) The target audience, frequency, and importance; (2) Role; (3) Evaluation; (4) Patient-related factors; (5) Oral care tools; (6) Psychology of NAs; (7) Lack of education and training; (8) Lack of team support. Conclusion Nursing assistants whose roles are overlooked by the nursing team are important members of the ICU team. Though oral care is closely related to disease prevention, it is rarely considered an essential task. Major barriers to implementing oral care in the ICU environment and patients include the psychological quality of participants, non-standard education and training, and inadequate team support. The expectation is that medical personnel will prioritize oral hygiene and recognize the significance of NAs in nursing work. Furthermore, future ICU oral care should investigate suitable tools and mouthwashes, simplified and standardized processes, standardized training, and multidisciplinary team collaboration.

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“…However, the present study found doctors rarely participated in oral care training in the ICU. Many researchers have pointed out the importance of dental professionals providing professional guidance on oral care for ICU patients [10,12]. The future comprehensive oral care plan should involve nurses, nursing assistants, occupational therapists, dental experts, language medical record holders, nutritionists, and rehabilitation therapists [31].…”

Section: Discussionmentioning

confidence: 99%

When Intensive Care Unit nurses delegate oral care to nursing assistants: A Qualitative Study

Li,

Yao,

Yang

et al. 2023

Preprint

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Background Although oral hygiene is closely related to various diseases, it is sub-optimal in the Intensive Care Unit (ICU). Oral care in the ICU is challenged by nursing workloads, low staffing, and higher acuity patients, there are few policies and written guidelines for oral care. Nurses often delegate oral care to nursing assistants (NAs) whose role is overlooked. This study is to explore the perspectives, obstacles, and challenges of NAs in the oral care of the ICU. Methods A qualitative study and semi-structured interviews were conducted with NAs in three ICU units, and Colaizzi’s phenomenological method was used to analyze the records. Results Initially, 13 NAs met the inclusion criteria, and two did not participate in this study as they refused to be recorded. Finally, 11 ICU NAs were interviewed, with three receiving face-to-face interviews and eight receiving telephone interviews. Using Colaizzi’s phenomenological method, two themes and eight subthemes emerged from the data, we examined the self-perception, barriers and challenges of NAs regarding oral care and identified the subthemes: (1) The target audience, frequency, and importance; (2) Role; (3) Evaluation; (4) Patient-related factors; (5) Oral care tools; (6) Psychology of NAs; (7) Lack of education and training; (8) Lack of team support. Conclusion Nursing assistants whose roles are overlooked by the nursing team are important members of the ICU team. Though oral care is closely related to disease prevention, it is rarely considered an essential task. Major barriers to implementing oral care in the ICU environment and patients include the psychological quality of participants, non-standard education and training, and inadequate team support. The expectation is that medical personnel will prioritize oral hygiene and recognize the significance of NAs in nursing work. Furthermore, future ICU oral care should investigate suitable tools and mouthwashes, simplified and standardized processes, standardized training, and multidisciplinary team collaboration.

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“…8 Decreased salivary flow consequent to medication administered favors the growth of oral pathogenic microorganisms, impacting oral health. 1,8 The dentist's assistance during hospitalization is important for oral health promotion. During this period, patients may present oral alterations locally originated by traumas, infections, and neoplasms or systemically originated by medications, basic diseases, and the patient's immunosuppression state, which may, in turn, influence the evolution of the patient's general health.…”

Section: Introductionmentioning

confidence: 99%

Laser photobiomodulation for chemical stomatitis in intensive care patient: Case report

Almeida,

Gominho,

Cabral

et al. 2024

j.rpemd

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Chemical stomatitis is a type of traumatic injury caused by contact of chemical substances and drugs with oral tissues, resulting in clinically significant damage. This case reports a 14-year-old male patient with chronic kidney disease on renal replacement therapy (peritoneal dialysis) and using calcium carbonate via oral capsules for treatment. Due to peritoneal dialysis complications, the patient developed bacterial peritonitis, requiring intensive care unit admission and alteration of his dialysis therapy mode to hemodialysis. During the hospitalization period, significant oral lesions developed due to inadequate calcium carbonate administration, interfering with the evolution of the patient's general health and requiring the assistance of a dental team for diagnosis and treatment. The patient was diagnosed with chemical stomatitis. During the clinical examination, ulcerated, bleeding lesions were observed on the lip, jugal mucous membranes, hard palate, and soft palate. Laser photobiomodulation was used as a treatment associated with a topical corticosteroid. Each region received ten 1 J/point, and 60 J of energy were delivered per day/session. In total, 480 J of energy were delivered with a total irradiation time of 4800 s. The patient reported considerable improvement in pain symptoms after the first laser-photobiomodulation session.After 8 sessions, the patient had improved, and laser photobiomodulation proved effective for treating oral lesions.

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Oral status and affecting factors in Iranian ICU patients: a cross-sectional study

Cited by 4 publications

References 16 publications

Perceptions, barriers, and challenges of oral care among nursing assistants in the intensive care unit: a qualitative study

Perceptions, barriers, and challenges of oral care among nursing assistants in the intensive care unit: a qualitative study

When Intensive Care Unit nurses delegate oral care to nursing assistants: A Qualitative Study

Laser photobiomodulation for chemical stomatitis in intensive care patient: Case report

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