This is the first clinically focused nursing study published from the United Arab Emirates. It could be the first research presentation from the country at an international event. However, it is simple reflecting the beginning nature of the author.

1
This is the first clinically focused nursing
study published from the United Arab Emirates. It
could be the first research presentation from the
country at an international event. However, it is
simple reflecting the beginning nature of the
author.
2
Trained Nurses Knowledge and Reported Practice
of Mouth Care on Three Wards in Acute Care
Hospital in Abu Dhabi, UAE.

• by
• Belal M Hijji, Department of Nursing
• Mafraq Hospital, Abu Dhabi, United Arab Emirates
• Prepared for
• The Centennial Nursing Conference, Beirut, June
  30 July 2, 2005
• Published in the Online Journal of Brazilian
  Nursing
• www.uff.br/nepae/objn203hijji.htm

3
DEFINITION OF RESEARCH

• Research is a means of understanding, assessing
  and evaluating what we do as nurses (1).
• 1. BURNARD, P. MORRISON, P. Nursing research in
  action developing basic skills. London,
  Macmillan, 1990.

4
BACKGROUND

• Mouth care, an essential nursing procedure, helps
  to maintain
• a comfortable, clean, moist and infection free
  mouth.
• Poor knowledge has the potential to compromise
  the quality
• of patient care and result in unsafe practice.
  Therefore, it is
• crucial for nurses to have up-to date knowledge
  and skills of
• oral care. In the UAE, there is no evidence of
  nurses
• knowledge and practice and,thus, no baseline data
  on which
• improvement efforts may proceed.

5
AIMS OF THE STUDY

• Investigate nurses knowledge and reported
  practice of oral care.
• Identify nurses' perceived barriers to good
  practice.
• Establish an association, if any, between nurses
  knowledge and practice and their demographics.

6
METHOD

• Cross-sectional exploratory survey. All 58 nurses
  on
• three wards in a general hospital represented the
  target
• population.The questionnaire generated
  information
• about personal data, education and level of
  knowledge
• and practice of mouth care. Nurses were
  supervised
• during questionnaire completion.

7
RESULTS

• 46 nurses (79) participated in the study.
  Multiple factors interact culminating in poor
  oral care.
• Knowledge deficits
• Importance of oral assessment (Graph 1)
• Indicators of healthy mouth (Slide 13, Graph 2)
  
• Drug effects on mouth health (Table 1, Slide 22)

8
RESULTS

• Frequency of mouth care (Table 2)
• Materials ideal for mouth care (Table 3)
• 2. Practice deficits
• Deficient reported oral assessments (Graph 3)
• Limited categories of patients reported to be
  assessed (Table 4)

9
RESULTS

• Limited use of brush and paste (Table 5A5B)
• Use of materials that are ineffective or could be
  potentially harmful (Table 5A 5B)
• Lack of oral assessment guide

10
NURSES PERCEIVED BARRIERS TO GOOD MOUTH CARE

• Lack of materials (n19)
• Lack of time (n17)
• staff shortages (n 15)
• Uncooperative patients (n 16)
• Lack of assignment system (n 4)
• 17 nurses identified one barrier
• 19 nurses identified more than one barrier

11
INFLUENCE OF DEMOGRAPHICS ON KNOWLEDGE AND
PRACTICE
At 95 CI, no statistically significant
differences were detected among groups due to
small numbers of nurses having certain
demographic characteristics
12
CONCLUSION AND RECOMMENDATIONS

• Individual results of the study were communicated
  to participating wards
• Nurses urged not to use Hydrogen Peroxide 3
• Regular supply of paste and brush provided
• Resource material on oral hygiene provided to
  nurses

13
Graph (1)
14
Indicators of Healthy Mouth

• Clean teeth
• No infection
• Pink mucosa
• Pink tongue
• Moist tongue
• No dentures debris
• Normal swallow

• Moist mucosa
• Smooth lips
• Pink lips
• Moist lips
• Watery saliva
• Voice

15
Graph (2)
16
Table (1)
   
.
17
Table (2)

18
Table (3)
Nurses response of ideal equipment N Nurses response of ideal solution N
Oral care set 19 41.3 Toothpaste 18 38.1
Toothbrush 18 38.1 Hydrogen per 3 16 34.8
Tongue depressor gauze 7 15.2 Normal saline 15 32.6
Other equipment 4 8.7 Antiseptic wash 7 15.2
Betadine 4 8.7
Other solutions 8 17
19
Graph (3)
20
Table (4)
Nurses Responses
SN Patient condition N
1 Bedridden 11 42
2 Unconscious 9 35
3 Stroke 9 35
4 Oral problems 3 35
21
Table (5A)
Materials names  No. of nurses citing materials used N
Equipment
Oral care set 22 48.8
Tongue depressor gauze 17 37.8
Toothbrush 17 37.8
Dressing set 4 9
Other equipment 5 11
22
Table (5B)
Materials Used No. of nurses citing materials use N
Solutions
Hydrogen Peroxide 28 62
Normal Saline 24 53
Toothpaste 17 38
Betadine 4 9
Water 4 9
Other solutions 6 13
23
AKNOWLEDGEMENTS

• All nurses who participated in the study.
• Professor Mohammad Musaddaque Hussein, GAHS, who
  supervised the study.
• City pharmacy, Abu Dhabi, for funding the study.
• Salma Al Hanaie and Ikram Abdul Zahra for the
  time and effort the spent on data collection.
• Professor Andrea Baumann, for her comments on the
  protocol and her encouragement.
• Dr. Claes Henning, Head of Pathology and
  Laboratory, Mafraq Hospital for his advice on the
  methodology.
• Our Director of Nursing, Linda Jackson.

24
DRUGS AFFECTING MOUTH HEALTH

• Antibiotics
• Oxygen therapy
• Cytotoxic drugs
• Steroids
• Antidepressants
• Antihistamines
• Antihypertensives

• Anticholinergics
• Antipsychotic
• Anorectics
• Anticonvulsants
• Duiretics
• Sympathmimetics