Infection Prevention and Control Through Hospital-Based Oral Care: Barriers and Facilitators to Providing and Documenting Oral Care in Acute Care Units
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Date
2018-09-11
Authors
Fimiani, Katrina
Journal Title
Journal ISSN
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Publisher
University of Waterloo
Abstract
Oral care, key component of nursing care, has a significant effect on the prevalence of hospital-acquired pneumonias. Despite the connection between oral care and hospital-acquired pneumonias, oral care nursing practices have been found to be inconsistent, not evidence-based, and not accurately reflected in documentation. The aim of this study was to examine the issues of oral care, nursing practice, and documentation from an Infection Prevention and Control approach, while identifying the key barriers and facilitators to providing and documenting oral care in an acute care hospital.
The study, in an urban hospital in Ontario, had a mixed methods design using qualitative and quantitative methods. A series of semi-structured interviews explored barriers and facilitators to providing and documenting oral care (n=18). With consent, interviews were audio-recorded, transcribed, and thematically analyzed. Oral care audits (n=127) were used to assess the quality and frequency of documentation in the medical records of patients on nine in-patient acute care units.
Interviews revealed that nursing staff experience barriers related specifically to the patient and the current methods for documenting oral care inside the patient medical record. Participants expressed concern for their patient’s well-being and the prevention of oral care associated infections. Audit data revealed that oral care provision and documentation is inconsistent within and across units, with a lack of knowledge surrounding what is considered to be adequate and appropriate oral care.
The provision of oral care is highly dependent on patient-related factors. Participants expressed concern for patient well-being and the prevention of oral care associated infections. Documentation standards need to be developed and implemented to better express accurate oral care provision. Hospitals and other care centers should endeavor to provide ongoing education for nursing staff in relation to oral care protocols and proper standards for documentation. Nursing staff should be allowed the opportunity for continuous feedback regarding the challenges of oral care provision and any difficulties or questions surrounding methods of documentation and the associated expectations for the adequate provision of oral care.
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Keywords
pneumonia, infection prevention and control, nursing care, oral care, documentation, acute care