Improving Nurse Compliance with Evidence-Based Oral Care in Long-Term Ventilated Patients

Abstract Background: Ventilator-associated pneumonia (VAP) is one of the most prevalent hospital-acquired infections in intensive-care units (ICU). Implementation of evidence-based oral care is the most effective prevention of VAP and improves patient outcomes. Oral care compliance has led to decreased length of stay, decreased the astronomical expenditures that hospitals face, reduced the patient’s time spent away from their family, and resulted to improved oral health for patients and sustainability of the interventions. Local problem: Oral care compliance remained a problem in the local facility indicated by prolonged length of stay, increased incidences of VAP, and increased care costs. Methods: The methods for this quality improvement (QI) project included the Beck Oral Assessment Scale (BOAS) and pre- and post-implementation surveys. Interventions: The QI project was implemented for an 8-week period. Pre- and post-implementation surveys provided to staff measured changes in knowledge, attitudes, and compliance regarding oral care. Staff were educated on the appropriate use of BOAS, then assessed on return demonstrations. Staff documented BOAS and oral care completion in the electronic health record (EHR). Results: Post-implementation, oral care compliance was noted to increase from once per shift to three or more times per shift. Nursing staff demonstrated improved knowledge and attitudes toward providing oral care. Conclusions: The QI project illustrated the importance of education in improving staff knowledge, attitudes, and compliance regarding oral care for ventilated patients, as it can impact overall patient health, especially for this vulnerable population.

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Work Title Improving Nurse Compliance with Evidence-Based Oral Care in Long-Term Ventilated Patients
Access
Open Access
Creators
  1. Mary Kamau
Keyword
  1. DNP project, Nursing
License CC0 1.0 (Public Domain Dedication)
Work Type Professional Doctoral Culminating Experience
Sub Work Type Doctor of Nursing Practice Project
Program Nursing
Degree Doctor of Nursing Practice
Acknowledgments
  1. Acknowledgements First and foremost, I want to extend my deepest gratitude to the Almighty God. Your unwavering presence and guidance have been the foundation of my journey, and without You, I am nothing. To my beloved husband, Steve Maina, and our beautiful children, Sarita, Justus, and Lillian—your boundless love and encouragement have given me the perseverance to navigate this program's challenges. You are my pillars of strength, and I am eternally grateful. To my loving parents and my siblings, though miles apart, your unwavering support and encouragement have been my strength. Your belief in my determination to soar where you could not, have been a beacon of hope throughout this project. Thank you for always believing in me. To my esteemed program advisor, Dr. Halbruner, and my committee members, Dr. White and Dr. Birriel and editor Katherine Twiddle. Your guidance and support have been invaluable. Without your expertise and dedication, I would not have reached this significant milestone. Thank you for believing in my potential even when I was holding on a tiny thread. I would also like to express my deepest appreciation my wonderful facility site mentors, Stephanie Mulholland, MSN, RN, and CNO at the time, and Network Education Specialist Nadine Lewis, BSN, RN. Your unwavering support and guidance throughout the implementation of this project have been instrumental to its success. Lastly, I extend my heartfelt thanks to the incredible facility staff. Your dedication and unwavering commitment to providing the best care to these vulnerable population and persistence to this project are highly appreciated. Your teamwork, support, and willingness to adapt to the project's evolution have been crucial. This project could not have been successful without each one of you. Thank you I am eternally grateful for all the support and teamwork that has led to the mission of reaching One at a time to reach them all. With heartfelt thank you
Publisher
  1. ScholarSphere
Publication Date April 9, 2025
DOI doi:10.26207/c5xp-ys74
Deposited April 09, 2025

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Version 1
published

  • Created

    April 09, 2025 06:09 by mxk1167

  • Updated

    April 09, 2025 06:09 by [unknown user]

  • Updated Degree, Program, Description, and 2 more Show Changes

    April 09, 2025 06:12 by mxk1167

    Degree
    • Doctor of Nursing Practice
    Program
    • Nursing
    Description
    • Abstract
    • Background: Ventilator-associated pneumonia (VAP) is one of the most prevalent hospital-acquired infections in intensive-care units (ICU). Implementation of evidence-based oral care is the most effective prevention of VAP and improves patient outcomes. Oral care compliance has led to decreased length of stay, decreased the astronomical expenditures that hospitals face, reduced the patient’s time spent away from their family, and resulted to improved oral health for patients and sustainability of the interventions.
    • Local problem: Oral care compliance remained a problem in the local facility indicated by prolonged length of stay, increased incidences of VAP, and increased care costs.
    • Methods: The methods for this quality improvement (QI) project included the Beck Oral Assessment Scale (BOAS) and pre- and post-implementation surveys.
    • Interventions: The QI project was implemented for an 8-week period. Pre- and post-implementation surveys provided to staff measured changes in knowledge, attitudes, and compliance regarding oral care. Staff were educated on the appropriate use of BOAS, then assessed on return demonstrations. Staff documented BOAS and oral care completion in the electronic health record (EHR).
    • Results: Post-implementation, oral care compliance was noted to increase from once per shift to three or more times per shift. Nursing staff demonstrated improved knowledge and attitudes toward providing oral care.
    • Conclusions: The QI project illustrated the importance of education in improving staff knowledge, attitudes, and compliance regarding oral care for ventilated patients, as it can impact overall patient health, especially for this vulnerable population.
    Sub Work Type
    • Doctor of Nursing Practice Project
    Publication Date
    • 2025-04-09
  • Updated Acknowledgments Show Changes

    April 09, 2025 06:13 by mxk1167

    Acknowledgments
    • Acknowledgements First and foremost, I want to extend my deepest gratitude to the Almighty God. Your unwavering presence and guidance have been the foundation of my journey, and without You, I am nothing. To my beloved husband, Steve Maina, and our beautiful children, Sarita, Justus, and Lillian—your boundless love and encouragement have given me the perseverance to navigate this program's challenges. You are my pillars of strength, and I am eternally grateful. To my loving parents and my siblings, though miles apart, your unwavering support and encouragement have been my strength. Your belief in my determination to soar where you could not, have been a beacon of hope throughout this project. Thank you for always believing in me. To my esteemed program advisor, Dr. Halbruner, and my committee members, Dr. White and Dr. Birriel and editor Katherine Twiddle. Your guidance and support have been invaluable. Without your expertise and dedication, I would not have reached this significant milestone. Thank you for believing in my potential even when I was holding on a tiny thread. I would also like to express my deepest appreciation my wonderful facility site mentors, Stephanie Mulholland, MSN, RN, and CNO at the time, and Network Education Specialist Nadine Lewis, BSN, RN. Your unwavering support and guidance throughout the implementation of this project have been instrumental to its success. Lastly, I extend my heartfelt thanks to the incredible facility staff. Your dedication and unwavering commitment to providing the best care to these vulnerable population and persistence to this project are highly appreciated. Your teamwork, support, and willingness to adapt to the project's evolution have been crucial. This project could not have been successful without each one of you. Thank you I am eternally grateful for all the support and teamwork that has led to the mission of reaching One at a time to reach them all. With heartfelt thank you
  • Added Creator Mary Kamau

    April 09, 2025 06:13 by mxk1167

  • Added Original Manuscript 3-9-2025-FINAL.docx

    April 09, 2025 06:14 by mxk1167

  • Updated

    April 09, 2025 06:15 by mxk1167

  • Updated License, Keyword Show Changes

    April 09, 2025 06:23 by mxk1167

    License
    • http://creativecommons.org/publicdomain/zero/1.0/
    Keyword
    • DNP project, Nursing
  • Published Publisher Show Changes

    April 09, 2025 06:23 by mxk1167

    Publisher
    • ScholarSphere
  • Updated

    April 09, 2025 22:04 by [unknown user]