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The Effect of an Evidence-Based Oral Care Algorithm on Oral Health of Critical Care Patients: A Randomized Controlled
Amirhossein Nasirmoghadas1, Kosar Pourhasan1, Yekta Rahimi2
1Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Introduction:
Patients in intensive care units (ICUs) have poor oral health due to several factors, such as mechanical ventilation and reduced consciousness, which can lead to serious complications.
Objective:
This study aimed to investigate the impact of a multimedia evidence-based oral care training program on the oral hygiene of ICU patients.
Methods:
This randomized controlled trial involved 60 nurses and 56 patients in two general ICUs, allocated into control and intervention groups using cluster randomization. Nurses in the intervention ICU received multimedia educational content based on an evidence-based oral care algorithm, along with face-to-face training for one month. They then provided the intervention to patients. During the next 3 months, the oral hygiene scores of newly admitted patients were evaluated using the Beck Oral Assessment Scale (BOAS) three times: upon admission to the ICU, 24 h, and 48 h after admission. The control group continued with usual oral care as before. Data were analyzed using SPSS-26 software. The Chi-square test, Fisher's Exact test, Independent T-test, Mann-Whitney U test, and repeated measures analysis of variance (ANOVA) were used.
Results:
There were no significant differences between the patients' and nurses' groups regarding baseline characteristics. Also, BOAS scores of patients upon admission did not significantly differ between groups (P = .863). In the intervention group, patients' BOAS scores significantly decreased (improved) from 12.11 ± 1.03 to 7.93 ± 1.61 (24 h after admission) and then to 6.11 ± 1.26 (48 h after admission) (P < .001). However, BOAS scores in the control group did not improve significantly within 24 or 48 h after admission.
Conclusion:
This study indicates that multimedia training of an evidence-based, comprehensive oral care algorithm improves the oral hygiene of ICU patients, especially those requiring higher levels of care.
