Challenges in delivering oral care to patients: a study of nursing practices at national hospital Kandy

Abstract

Maintaining good oral health is crucial for overall well-being, yet ensuring proper care for patients can present a hidden layer of challenges. Nurses play a critical role in patient well-being, but providing quality oral care can face unexpected hurdles. Beyond the familiar tasks of medication and wound care, oral health presents unique challenges for nurses. The present study was designed with the aim to identify the possible challenges for providing quality oral health care by the nurses in National Hospital, Kandy and based on the outcome, to recommend implementation of standard oral health care nursing practices in Sri Lanka in future. This was a descriptive cross-sectional mixed-method study conducted at the National Hospital, Kandy. The quantitative component involved 228 nurses and qualitative component involved 30 nurses who worked in medical, surgical and intensive care units. A self-administered and interviewer-administered, structured questionnaire were used to collect quantitative and qualitative data respectively from the participants. In quantitative analysis, it was identified that 77.61% of the participants had challenges to provide quality oral healthcare for the patients. Most of the participants selected patients’ behaviors and physical difficulties (62.18%), and inadequate oral care instruments and materials (48.08%) as major challenges. In qualitative analysis, seven main challenges to oral care were identified as unavailability of guidelines, patients’ ineffective corporation, inadequate oral care instruments and solutions, poor supervision, heavy workload, shortage of nurses and time constraints. The nurses face patients-related, health care professional-related, and hospital administration-related challenges, which restricted them from performing effective oral care. Therefore, it is recommended to provide in-service training, awareness programs, standardized protocols, provision of oral care instruments and materials to integrate oral health care into routine patient care.