الفهرس 
Introduction and aim of the studyOnly 14 pages are availabe for public view
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Abstract
Oral care by expert and professional nurses is important for neonates undergoing mechanical ventilation to prevent infection, maintain patent air way and gas exchange.
Aim of the Study:
This study aimed at assessment of nurses’ performance regarding oral care for neonates undergoing mechanical ventilation.
Research questions:
What are the nurses’ knowledge regarding oral care for neonates’ undergoing mechanical ventilation.
What are the patterns of oral care for neonates under going mechanical ventilation?
What are the nurses’ practices regarding oral care for neonates undergoing mechanical ventilation.
The subject and methods of the current study are discussed under the following four (4) designs:
Technical Design.
Operational Design.
Administrative Design.
Statistical Design.
I. Technical Design:
The technical design included research design, research setting, research subjects and tools for data collection.
A) Research Design:
A descriptive design was utilized in this study.
B) Research Settings:
This study was conducted in the Neonatal Intensive Care Units (NICUs) at Omm El-Masrieen Hospital affilieted to the Egyption Ministry of Health. The NICU is located in the second floor of pediatric department and consists of 3 rooms, each room included 3 mechanical ventilation and 9 incubators, so the total number of 27 incubators this setting selected due to highst admission rate of neonates in NICU.
C) Research Subject:
A convenience sample composed of 60 nurses working in NICU at the previously mentioned setting and all available neonates (60 neonates) in NICU undergoing mechanical ventilation during the study period.
D) Tools of data collection (Appendix IV):
Data were collected through the following study tools:
Tool I: A predesigned Interviewing Questionnaire sheet:
It was designed by the researcher after reviewing the related and recent literature and was written in an Arabic language in the form of open and closed ended questions and multiple choices questions (MCQ) and consisted of the following parts:
Part I:
Characteristics of the studied nurses; namely, age, gender, social status, years of experience, job tittle and level of education.
Characteristics of the studied neonates; namely, gestational age, gender, diagnosis, birth weight, types of delivery, chronological age, medical diagnosis on admission, type of feeding, and type of milk.
Part II:
Nurses’ knowledge regarding oral care for neonates undergoing mechanical ventilation it included 36 questions as the following:
Nurses’ knowledge (36 questions) regarding neonatal MV (7 questions).
Nurses’ knowledge regarding oral care for neonates on MV (18 questions).
Nurses’ knowledge regarding oral infection of neonates on MV (11 questions).
Scoring system:
Scoring system was followed to assess nurses’ knowledge, the nurses’ knowledge was checked with a model key answer as their level of knowledge was categorized into either:
Satisfactory knowledge : > 85% (> 31% Marks)
Unsatisfactory knowledge : < 85% (< 31% Marks)
Tool II: Observational Checklists (Appendix I) :
That were used to assess the nurses’ practices regarding oral care for neonates undergoing MV.
Scoring system
The total number of the procedures was 7 procedures, the nurses practices categorized as:
Competent practices: > 95% (> 103 Marks).
Incompetent practices: < 95% (< 103 Marks)
Total Studied Nurses’ Performance:
The total studied nurses’ performance was calculated by summation of the total knowledge scores (36), and the total nurses’ practices scores (108) that equal scores 144 (100%), then the total studied nurses’ performance was classified into:
Competent performance: If the nurses’ scores was > 95% (> 138 Marks).
Incompetent performance: If nurses’ scores was <95% (< 138 Marks).
Results:
Two thirds (63.4%) of the studied nurses were in age group of 25 < 35 years old with ¯X ± SD (30.75± 5.23) years old.
Three quarters (75%) at them were females, nearly three quarters (71.7%) were married, two fifths (40%) of them their level of education was technical nursing institute.
More than three quarters (76.6%) of the studied nurses there job title is bedside nurse, more than one third (36.7%) of them their years of experience in the NICU was 5<10 years.
More than one third (38.3%) of the studied nurses were attended training course workshops in oral care.
Two fifths (40%) of studied neonates’ gestational age was less than 36 weeks with ¯X ± SD (36.57±5.49) weeks.
Less than two thirds (61.7%) of neonates gender were females, more than one third (35%) of them their weight at birth was <1500 grams with ¯X ± SD± (2056.67±308.50) grams.
Two fifths (41.7%) of neonates their chronological age less than 7 days with ¯X±SD (9.97±1.50), one fifth (23.3%) of neonates their medical diagnosis on admission was IDM.
More than one half (53.3%) of the studied neonates delived by normal vaginal delivery. Two fifths (42%) of them were receiving their feeding through NGT.
More than three fourths (85.7%) of the studied neonates were fed through artificial milk. More than half (55%) of the studied nurses were agreeing for presence of barriers for oral care of neonates on MV. More than two fifths (43.3%) of the studied nurses mentonied that unavailable of resources or equipment was barrier of oral care of neonates on MV.
More than half (58.3 %) of the studied nurses had incorrect knowledge about routine oral care for neonates on MV, about two thirds (61.7%) of them reported incorrect knowledge about skin care around neonates mouth.
Two fifths (40%) of the studied nurses reported used of distilled water in oral care, half (50%) of them were performing oral care for neonates before and after feeding. More than two fifths (45%) of the studied nurses reported three time / day of oral care for neonates. Less than half of them reported putting the neonate on MV for oral care in supine position with head on one side.
Two thirds (66.7%) of the studied nurses had satisfactory knowledge regarding oral care for neonates on mechanical ventilation.
Nearly two thirds (66%) of the studied nurses’ reported that there is relation between oral infection in neonates and presence of ETT. More than one half (56.3%) of them reported that oral suctioning of neonates mouth on MV prevent oral infection.
More than three quarters (80%) of the studied nurses stated that the causative microorganism of oral infection for neonates on MV is fungal. Nearly half (48.0%) of them reported that one of the predisposing factors of neonatal oral infection is invasive procedure as ETT. Slightly more than half (55%) of them said that they stop treatment of neonatal oral infection immediately after disappearance of oral inflammation.
More than half (56.7%) of the studied nurses had satisfactory knowledge regarding oral infection for neonates on mechanical ventilation.
More than half (61.7%) of the studied nurses had satisfactory total level of knowledge regarding oral care for neonates on MV.
Nearly three quarters (71.7%) of the studied nurses showed competent practices regarding oral care for neonates on MV.
More than two thirds (66.7%) of studied nurses were competent in their performance regarding oral care for neonates undergoing MV.
There was highly statistically significant differences between the studied nurses’ total knowledge level and their characteristics (level of education and years of experiences).
There was positive correlation between total score of knowledge and total score of practices.
Conclusion:
Based on the finding of the current study, we can concluded that, nearly two thirds of the studied nurses had satisfactory knowledge, and nearly three fourths of them had competent practices regarding oral care for neonates undergoing mechanical ventilation.
Recommendations:
In the light of the results of the present study, the following recommendations are suggested:-
Continuous evaluation of nurses’ performance regarding oral care for neonates undergoing mechanical ventilation.
Availability of equipment and resources needed for providing oral care for neonates undergoing MV by the nurse in NICUs.
Development of an educational guidelines to promote excellence of nursing care and provide high-quality care regarding oral care for neonates undergoing mechanical ventilation.
Further study should be applied to upgrade quality of oral care provided for neonates undergoing MV.