Oral Care in Patients With Invasive Airway Management in the ICU: A Prospective Observational Study

Intensive care unit (ICU) patients often have compromised oral health due to their overall condition and intensive treatment. Oral hygiene is a crucial nursing intervention, particularly for preventing ventilator-associated pneumonia. In the Czech Republic, intensive care is provided in standard ICUs for critically ill but relatively stable patients requiring continuous monitoring, and in anesthesiology and resuscitation units, which provide the most advanced and intensive supportive interventions for patients at immediate risk of life-threatening deterioration (such as cardiac arrest). The aim is to investigate professional and situational factors affecting the quality of oral care in ICU patients with invasive airway management. A prospective observational study was conducted over 5 months (August 2023 to January 2024) in 6 ICU units. Data were collected via participant observation of health care professionals. Statistical analysis used the chi-square test (P < .05) in SPSS 28.0. Preparation for oral care was insufficient in all areas. Personal protective equipment was used by 70% of health care professionals, 62.1% placed patients in Fowler's position, 9.2% assessed the oral cavity, and 73.3% suctioned oral secretions before cleaning the mouth. Only 36 of 87 health care professionals (41.38%) performed dental care correctly. The most used tools were disposable foam swabs (41.38%), toothbrushes (31.03%), and suction toothbrushes (8.05%). Proper rinsing and suction were completed by 14.94%, and tongue, palate, and mucosa care were properly done by 64.37%. Oral care for ICU/critical care unit patients, particularly those with invasive airway management, remains insufficient due to limited attention to and assessment of the oral cavity. These findings are clinically relevant for nursing research and practice, as they highlight gaps in routine nursing care and emphasize the need for standardized, evidence-based oral care protocols and improved adherence to support better patient outcomes.