Technical and contextual barriers to oral care: New insights from intensive care unit nurses and health care professionals

Abstract

Oral care for intubated patients in the intensive care unit (ICU) is known to reduce bacterial colonization in oropharyngeal cavities decrease development of ventilator associated pneumonia (VAP) and the associated costs of managing this complication (1-4). Provision of oral hygiene by nurses is a fundamental aspect of care in the ICU (5). However, such a basic nursing activity can be devalued or rendered invisible by nurses when there is a greater emphasis on managing and maintaining biotechnology and/or a failure to underpin practice with research evidence that demonstrates the importance of fundamental care (5). A Canadian study by Dale and colleagues (6) to explore clinicians' knowledge of, and experiences with, delivering oral care in intubated patients is a timely reminder that the complexity of performing oral care in the ICU should not be underestimated or undervalued.

Keywords: Evidence-based practice; Institutional ethnography; Intensive care unit; Intubated patients; Nursing; Oral care; Qualitative; Ventilator associated pneumonia.