Survey on status of oral care practices and factors associated with confidence in oral care skills in ward nurses at an acute hospital in Japan.

backgroundSince it has been widely acknowledged that oral care is effective in improving physical conditions, ward nurses are increasingly providing oral care for hospitalized patients in Japan. However, the current status of oral care practices and nurses' self-confidence in oral care skills has not been previously investigated. This study aimed to clarify these aspects among ward nurses.

methodsA questionnaire survey was conducted in an acute care hospital, involving 18 ward departments and 644 nurses. The survey investigated the status of oral care implementation among the wards and nurses, and nurses' confidence levels regarding oral care skills. The impact of environmental factors within the wards on the implementation of oral care and nurses' confidence was analyzed through group comparisons. Additionally, multiple regression analysis was performed to identify factors associated with nurses' confidence.

resultsResponses were obtained from 16 wards and 189 nurses. Data from 160 nurses working in the 16 wards with environmental information were analyzed. Most nurses (91.9%) reported performing oral care daily. When wards were categorized into high- and low-need groups based on the proportion of patients requiring oral care, nurses in high-need wards were more likely to perform tongue cleaning, mouth wiping, oral mucosa care, moisturizing, and massage of perioral muscles. Furthermore, nurses working in the wards with an oral care manual and a designated core member for oral care reported higher confidence in their skills of oral care practices for patients with various oral problems, unconsciousness, and intubation. Additional multiple regression analysis of total self-confidence scores identified the presence of a core member, years of nursing experience, and experience of oral care training as factors positively associated with self-confidence.

conclusionsNurses in high-need wards reported providing more comprehensive oral care. The availability of oral care manuals, assignment of core members for oral care, and provision of oral care training were effective in enhancing nurses' confidence in their oral care skills. These findings suggest that, to further promote oral care practices by nurses, dental professionals are required to closely collaborate with nurses, especially core members, and provide guidance and training regarding oral care practices.