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Intensive care nurses fail to translate knowledge and skills into practice: A mixed-methods study on perceptions of oral care
Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).ORCID-id: 0000-0002-4381-4288
Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).ORCID-id: 0000-0001-7082-6834
Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).ORCID-id: 0000-0002-2667-4025
2019 (engelsk)Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 52, s. 51-62Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objectives: To identify intensive care nurses’ perceptions of oral care according to Coker et al.'s (2013) conceptual framework and to contribute to the knowledge base of oral care in intensive care. Design/methods: This was a concurrent embedded mixed-methods design, with more weight given to the quantitative part. Participants responded to the Nursing Care related to Oral Health questionnaire, including perceptions of oral care antecedents (18 items), defining attributes (17 items), and consequences (6 items) and two open-ended questions. The data were analysed with descriptive and correlation statistics and qualitative content analysis. Setting: Intensive care nurses (n = 88) in six general intensive care units. Results: Intensive care nurses perceived that an important part of nursing care was oral care, especially to intubated patients. They perceived that the nursing staff was competent in oral care skills and had access to different kinds of equipment and supplies to provide oral care. The oral cavity was inspected on a daily basis, mostly without the use of any assessment instruments. Oral care seemed to be task-oriented, and documentation of the patients’ experiences of the oral care process was rare. Conclusions: The antecedents, knowledge and skills are available to provide quality oral care, but intensive care nurses seem to have difficulties translating these components into practice. Thus they might have to shift their task-oriented approach towards oral care to a more person-centred approach in order to be able to meet patients’ needs. © 2018 Elsevier Ltd

sted, utgiver, år, opplag, sider
Churchill Livingstone , 2019. Vol. 52, s. 51-62
Emneord [en]
Conceptual framework, Intensive care nurses, Mixed-method, Oral care, adult, article, content analysis, controlled study, documentation, female, human, intensive care unit, language, major clinical study, male, mouth cavity, mouth hygiene, nursing care, nursing staff, perception, quantitative analysis, questionnaire, skill, statistics
HSV kategori
Forskningsprogram
Omvårdnad
Identifikatorer
URN: urn:nbn:se:kau:diva-70243DOI: 10.1016/j.iccn.2018.09.006PubMedID: 30297151Scopus ID: 2-s2.0-85054505634OAI: oai:DiVA.org:kau-70243DiVA, id: diva2:1265111
Merknad

Conflict of interest statement: https://doi.org/10.1016/j.iccn.2019.02.001

Tilgjengelig fra: 2018-11-22 Laget: 2018-11-22 Sist oppdatert: 2019-05-28bibliografisk kontrollert
Inngår i avhandling
1. Oral care quality in intensive care units and short-term care units: Nursing staff and older people's perspectives
Åpne denne publikasjonen i ny fane eller vindu >>Oral care quality in intensive care units and short-term care units: Nursing staff and older people's perspectives
2019 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

The overall aim of this thesis was to investigate oral care and its quality through the perspectives of nursing staff in intensive care units and short-term care units and from the perspectives of older people in short-term care units. Methods: The mix-method study (I) had a concurrent embedded design and was cross-sectional. Eighty-eight intensive care nurses (response rate (RR) 40%) responded to the Nursing Care related to Oral Health questionnaire, and the data were analysed with analytic statistics and qualitative content analysis. The quantitative studies (II-IV), which were also cross-sectional, included 432 nursing staff in intensive care and short-term care (RR 51–52%) and 391 older people (RR 77%) in short-term care units. Participants responded to the modified version of the Quality from Patients’ Perspective instrument and provided information about person-related conditions. Descriptive and analytical statistics were used. Main results: Intensive care nurses perceived having the antecedents, knowledge, and skills to provide optimal oral care quality, but the result indicated that they were having difficulties putting these into practice (I). Areas for improvement in oral care quality were identified in both care environments (II). Older people preferred personalised information about oral health and oral care (III). Nursing staff as well as older people’s perceptions of oral care quality and its humanity aspects, seemed to be related to person-related conditions and differed between the two care environments. In short-term care, nursing staff’s preferences for the humanity aspects of oral care quality were higher compared to older people’s preferences (IV). Conclusion: Oral care is complicated and proactive and requires registered nurses’ and other nursing staff’s attention as well as educational and organisational initiatives. Many older people were assessed to have oral health problems. With early identification and optimal oral care, unnecessary suffering might be prevented. The identified quality improvement areas might guide RNs, nurse managers, and other nursing staff to further oral care quality development.

Abstract [en]

Oral care is complex and multifaceted, and knowledge about nursing staff and older people’s perceptions of oral care quality are limited. The overall aim was to investigate oral care and its quality through the perspectives of nursing staff in intensive care units and short-term care units and from the perspectives of older people in short-term care units.

Intensive-care nurses perceived having the antecedents, knowledge, and skills needed to provide optimal oral care quality, but the result indicated that they were having difficulties putting these into practice. Areas for improvement in oral care quality were identified in both care environments. Older people preferred personalised information about oral health and oral care. Perceptions of oral care quality and its humanity aspects, seemed to be related to person-related conditions, and differed between nursing staff in different units and older people.

Oral care is complicated and proactive and requires registered nurses’ and other nursing staff’s attention as well as educational and organisational initiatives. Many older people were assessed to have oral health problems. With early identification and optimal oral care, unnecessary suffering might be prevented. The identified quality improvement areas might RNs, nurse managers, and other nursing staff to guide further oral care quality development.

sted, utgiver, år, opplag, sider
Karlstads universitet, 2019. s. 114
Serie
Karlstad University Studies, ISSN 1403-8099 ; 2019:14
Emneord
Oral care, quality of care, intensive care, short-term care, older people’s perceptions, nursing staff’s perceptions, person-related conditions
HSV kategori
Forskningsprogram
Omvårdnad
Identifikatorer
urn:nbn:se:kau:diva-71820 (URN)978-91-7867-020-8 (ISBN)978-91-7867-025-3 (ISBN)
Disputas
2019-06-14, 1A305, Lagerlöfsalen, 10:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2019-05-16 Laget: 2019-04-11 Sist oppdatert: 2019-10-09bibliografisk kontrollert

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Andersson, MariaWilde-Larsson, BodilPersenius Wentzel, Mona

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