Nurses Practices and Experiences of Providing Oral Care to Critically Ill Patients at Intensive Care Unit, Muhimbili National Hospital, Dar Es Salaam, Tanzania

Abstract

Background of the study: Oral care is a vital procedure for critically ill patients in the Intensive Care Unit (ICU) to promote oral hygiene that decreases microbial colonization in the oropharynx and dental plaque as well as reduce aspiration of contaminated saliva. Despite available evidence of significant oral care to critically ill patients, ICU nurses' knowledge of oral care does not reflect their practice. Nevertheless, there are high mortality rates attributable to the complication of poor oral hygiene in Tanzania for patients admitted to ICU in the tertiary referral hospitals. Objective: This study aimed to explore nurse practices and experiences of providing oral care to critically ill patients at the intensive care unit, Muhimbili National Hospital, Dar Es Salaam, Tanzania Materials and methods: An explorative descriptive qualitative design was employed to 18 registered nurses from medical ICU at Muhimbili National Hospital. An in-depth interview guide with open ended question was used to collect data from registered who were recruited purposively for an interview. To complement the interview, eighteen observations were conducted to the same participants to observe nurses' practice regarding oral care to critically ill patients. Thematic analysis using the deductive approach was performed by using pre-set thematic questions to guide analysis. Results: Three themes emerged from the analysis of interview. “Oral care as nursing intervention in ICU patient” emerged as a theme describing key nursing intervention in provision of oral care to critically ill patient. Also, “prevention of potential risk of complication from oral disease and improve patient well-being” this theme indicates implication of oral care to critically ill patient. Lastly was the “Limiting factor for good oral care practice in ICU” this theme describes the obstacles or barrier faced by nurses when providing oral care to critically ill patients. Conclusion: The study highlighted the most important and unique experiences of providing oral care to critically ill patients. Besides, nurses face some of the barrier when practice oral care to critically ill patient. Therefore, finding revealed crucial role especially a nursing intervention on preventing oral diseases to improve quality of life among critically ill patients at MNH.