Dimensions of oral care management in Texas hospitals

There is a growing body of evidence that suggests improved oral health can help patient outcomes in hospitals. Yet there are indicators that oral care in hospitals is less than ideal. This study was conducted to quantify and qualify the dimensions of oral care in Texas hospitals with a focus on the dental knowledge, attitudes and practices of nurses and barriers to providing such care.

A random sample of 582 registered nurses, licensed and employed in Texas, was surveyed about oral care attitudes, practices and knowledge. Frequencies and Spearman correlations were used to describe and analyze the data with SPSS.

Ninety-eight respondents returned surveys for a 16.8% response rate. Of these, 52% reported their nursing education did not ("minimally/not at all") prepare them for oral care management. However, they felt oral health was important (95%), felt responsible for oral care (79%) and assessed the oral cavity of their patients (78.6%). Although they reported being "knowledgeable" or "very knowledgeable" about oral health management (67%), their score on the knowledge questions was low (mean=51%, sd=0.132). There was not a significant correlation between the knowledge scores and education levels (ρ=0.136, p>0.05) or knowledge scores and work areas (ρ=-0.080, p>0.05). They also reported such barriers as low priority for oral care, lack of time, no mandate and the need for more resources.

This study revealed that nurses experienced a disconnect between feeling responsible yet somewhat incapable and/or ill-prepared to provide adequate oral care for their patients. This suggests a possible need for revising nurse education, hospital requirements and protocols for performing oral care and employing dental professionals in hospitals.