Nurses’ oral hygiene care for patients with stroke: a best practice implementation project
Liliana Escada Ribeiro, Berta Augusto, Maribel Pinto, Teresa Santos, Joana Magalhães, Cláudia Rocha, Diana Santos, Daniela Cardoso, António Manuel Fernandes, Ana Filipa CardosoABSTRACT
Introduction:
Oral hygiene is associated with fewer adverse events and improved quality of life in patients with stroke. However, these patients tend to experience poor oral hygiene due to self-care limitations. Despite clinical guidelines recommending structured oral hygiene protocols, compliance remains suboptimal in hospital settings.
Objectives:
This project aimed to improve nurses’ compliance with best practice recommendations for oral hygiene in patients with stroke.
Methods:
This project followed the JBI Evidence Implementation Framework. A baseline audit and a follow-up audit were conducted through interviews, observation of nursing practices, and reviews of nursing records. The JBI Getting Research into Practice method was used to identify barriers and strategies for implementing changes in clinical practice.
Results:
The follow-up results for the four audit criteria showed significant improvements. Compliance for Criterion 1 (health care staff training on assessment and management of oral hygiene) increased from 21.8% to 100%. Compliance for Criterion 2 (patients receive oral hygiene training and resources) increased from 0% to 21.05%. Compliance for Criterion 3 (patients instructed and/or assisted to teeth brush teeth daily) increased from 8.51% to 76.6%. Compliance for Criterion 4 (caution for patients with dysphagia) increased from 12.90% to 74.19%.
Conclusions:
The project improved nurses’ compliance with oral hygiene recommendations for patients with stroke. Sustainability will be ensured through education and training, regular audits, and mentoring.