Better late than never - Bring back oral care in nursing: Bring back oral care in nursing

Aim: To explore patients’ and healthcare professionals’ experiences of oral care during hospitalization to identify needs and challenges.
Background: Daily oral care is important to patients’ health and well-being, to prevent diseases in the oral cavity, systemic infections and increased morbidity, which subsequently can lead to prolonged hospitalization and, at worst, increased mortality. Despite this knowledge, oral care is a neglected part of nursing practice. Studies do not clearly identify barriers regarding oral care, as the existing knowledge is inadequate.
Design: A qualitative study exploring participants’ experiences to gain new in-depth knowledge of oral care among hospitalized patients.
Methods: A phenomenological-hermeneutic approach was applied. Participant observations were conducted on five hospital wards, combined with individual semi-structured interviews with 16 patients and 15 healthcare professionals. Data analysis was based on Ricoeur’s theory of narrative and interpretation.
Results: Four themes describing the challenges regarding oral care emerged: Oral care as a gut feeling; oral care fades into the background; even self-reliant patients need help with oral care; and the mouth reflects the life lived.
Conclusions: The identified challenges show there is a need for improvement in the health professional approach to oral care in nursing practice. Focus on increasing healthcare professionals’ knowledge, skills and competences can increase their nursing agency and support patients’ self-care capacity.
Impact: Investigation of oral care during hospitalization revealed four main challenges concerning both patients’ and healthcare professionals’ lack of knowledge and awareness of oral care. Thus, patients and healthcare professionals should be included in developing solutions to improve oral care in nursing practice.
Reporting methods: The COREQ criteria for reporting qualitative research were adhered to.
Patient contribution: A patient representative was involved in the discussion of the proposal, conduct and results of the study.

Relevance to clinical practice
What does this paper contribute to the wider global clinical community?
• Oral care is an overlooked nursing aspect during hospitalization, despite the fact that insufficient oral care has been proven to increase health-related complications, prolong hospitalization and, in the worst case, increase mortality.
• Barriers to oral care are due to lack of knowledge, skills and competences among healthcare professionals. As a result, oral care is inadequately addressed and become a deficient part of nursing practice.
• Patients are not aware of the health-related significance of oral care, and need help and support to manage oral care during hospital stay, even if they are self-reliant.