Impact of various solutions on the oral health status of critically ill patients.

Oral care is a crucial challenge of nursing care in orally intubated patients. Oropharyngeal colonization with microorganisms is probably the first step in the pathogenesis of most bacterial pulmonary infections. This study aimed to investigate the effect of different oral care solutions on the oral health status of critically ill patients. We conducted a quasi-experimental study involving a convenience sample of 60 adult orally intubated patients, distributed equally into three groups: 20 patients received 0.12% chlorhexidine gluconate (CHX) solution as an oral rinse; 20 patients received 0.1% hexetidine (HEX) solution as an oral rinse; and a control group of 20 patients received routine hospital oral care with 0.9% normal saline (NS) solution. Oropharyngeal and tracheal cultures were obtained from patients within 24-48 h of admission, before the administration of topical oral antimicrobial solutions and then repeated on day 4 and day 7 after the oral solutions. The study revealed that CHX has a more powerful effect than HEX and NS in improving the oral mucosa and decreasing colonization of both the oropharynx and trachea. On day 7, the improvements were statistically significant in the CHX group and the HEX group (P = 0.02 and P = 0.03, respectively), but not in the NS group. This research confirms the effect of CHX and HEX in lowering the risk of tracheal and oropharyngeal colonization, and recommends the use of a CHX solution as oral mouth care in critically ill patients.

Effectiveness of Standardized Protocol for Oxygen Therapy on Improving Nurses' Performance and Patients' Health Outcome.

AIMS: assess nurses' knowledge and performance-related safe administration of oxygen (O2) therapy; apply an intervention program for nurses about standardized protocol for oxygen; and evaluate the effectiveness of standardized protocol for oxygen in improving nurses' performance and patients' health outcomes. DESIGN: a quasi-experimental study was used. SETTING: the current study was conducted at three hospitals in Sakaka City with totally different medical aid units (ICUs), CCUs, emergency care departments (ED), medical and surgical wards, pediatric care units (PICUs), neonatal intensive care units (NICUs), pediatric emergency care departments (PED) and pediatric inpatient\outpatient departments. SUBJECTS: a convenience sample of 105 nurses and 105 patients was divided into 55 patients in the control group who received routine care and 50 patients in the study group who received intervention. FINDINGS: 34.3% of studied nurses had poor knowledge pre-intervention compared with 17% post-intervention. Moreover, 33.3% of them had satisfactory knowledge pre-intervention versus 21% post-intervention. Only 5.7% of them had excellent knowledge pre-intervention, compared with 34.4% post-intervention. Concerning the complications of oxygen therapy, only 10.5% did not have complications in the control group versus 62.9% in the study group, 33.3% of the control group had cyanotic lips and fingernails pre-intervention, versus 7.6% in the study group; 10.5% had oxygen toxicity in the control group, versus 7.6% in the study group, with a highly statistically significant difference at p 0.001 for all. CONCLUSION: the current results of this study concluded that there was improvement in nurses' knowledge and practice related to oxygen therapy post-intervention. Moreover, when the standard protocol for safe oxygen therapy was used in a positive way, it led to better health for patients and fewer problems with oxygen therapy.

Exploring the Psychological Stress, Anxiety Factors, and Coping Mechanisms of Critical Care Unit Nurses During the COVID-19 Outbreak in Saudi Arabia.

Background: The spread of coronavirus disease 2019 (COVID-19) throughout the world leads to a series of modifications of several National Health Service organizations, with a potential series of psychological consequences among nurses. Methods: This study was undertaken to assess the psychological stress, anxiety factors, and coping mechanisms of critical care unit nurses during the COVID-19 outbreak. A cross-sectional research design was employed, and the convenience sample consisted of 469 nurses working at several hospitals in Saudi Arabia during the period from July to September 2020. This study used the Generalized Anxiety Disorder, Coping Mechanism, and Nursing Stress scale. Results: Interestingly, more than one-third and one-quarter of the studied nurses had severe and moderate anxiety levels, respectively. In addition, the most anxiety-causing factors included providing care for their infected colleagues and worrying about infecting their families. More than one-quarter and slightly less than half of the studied nurses had high and moderate stress levels, respectively. Furthermore, more than half of the participants had low coping mechanisms and one-quarter had moderate coping mechanisms. In addition, there was a strong positive correlation between anxiety and stress levels, and there was a strong negative correlation between coping mechanisms and stress and anxiety levels. Conclusions: Collectively, this study explored the psychological stress, anxiety factors, and coping mechanisms among critical care unit nurses during the COVID-19 outbreak in Saudi Arabia. Continuous educational programs for nurses on using coping mechanisms should be developed in combination with teaching preventive measures for defining a psychological intervention plan within a mandatory occupational health surveillance program. This study recommends that constructive planning and necessary provision of supportive measures by the legal authorities and policymakers protect nurses and minimize their psychological stress to fulfill high-quality nursing care.