Implementation of Oral Nursing Care Guideline for Intubated Patients With Mechanical Ventilator in an ICU in Indonesia

Abstract

The purpose of this developmental research was to implement and test the effectiveness of oral nursing care guideline for intubated patients with mechanical ventilators in an ICU, Indonesia. Twenty-eight nurse participants were recruited, and 47 patient participants were involved in this study. Roger's Diffusion of Innovation Theory guided in implementing an oral nursing care guideline for intubated patients with mechanical ventilators. Outcomes of this study include nurses' satisfaction on implementing oral nursing care guideline and accuracy of oral nursing care practice as nurses' outcomes, while the patients' outcome mainly observed the oral integrity. The accuracy of oral nursing care practice was assessed using Accuracy of Oral Nursing Care Practice Checklist (AONCPC). The nurses' satisfaction was assessed using self- reported Nurses' Satisfaction Questionnaires (NSQ). The patient's oral integrity status was assessed using Mucosal-Plaque Score (MPS). The validity test showed that the S-CVI of all above tools were 1.0 each, while the inter-rater reliability using Kappa statistics of AONCPC and MPS were .96 and .92, respectively, and the internal reliability reported with Cronbach Alpha Coefficients of NSQ was .93. Descriptive statistics were used to analyze data. The result of the study showed that the nurses' satisfaction on implementing oral nursing care guideline was at very high level (M = 92.54, SD = 7.58), the accuracy of practice ranged between 88% - 100% and the patient's oral integrity was mostly in acceptable status (n = 46, 97.87%). These results indicated that the implementation of oral nursing care guideline for intubated patients with mechanical ventilators in an ICU in Indonesia was successful and effective.