Date of Conferral
10-23-2025
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Dr. Jonas Nguh
Abstract
Hospital-acquired pneumonia (HAP) remains the most common hospital-acquired infection in the United States, with nonventilated adult patients particularly at risk. This doctoral project focused on improving oral care practices among night shift nursing staff on a medical-surgical unit to reduce the risk of HAP. The practice gap identified was the inconsistent and inadequate delivery of oral hygiene during night shifts, primarily due to staff knowledge deficits, time constraints, and a lack of standardized procedures. The project was guided by the Johns Hopkins Evidence-Based Practice model and addressed the following question: In adult patients on a medical-surgical unit, will staff education on the importance of evidence-based oral care, compared to usual care without targeted education, improve the quality of oral care, specifically the time spent brushing patients' teeth? A targeted educational intervention was implemented, incorporating a PowerPoint presentation, a fact sheet, a hands-on return demonstration, pre- and post-training knowledge/confidence surveys, and a commitment pledge. 14-night shift staff participated, including registered nurses, licensed practical nurses, and nursing assistants. Descriptive statistics were used to measure knowledge gain, confidence improvement, skill proficiency, and behavioral intent. Results demonstrated an 80.7% increase in knowledge, a 41.4% increase in staff confidence, a 125% improvement in skill proficiency, and 100% pledge completion. Staff acknowledged the role of oral hygiene in pneumonia prevention. Qualitative feedback identified barriers such as time constraints and supply availability, but reflected strong engagement with the intervention. This initiative successfully improved the consistency and quality of oral hygiene delivered during night shifts, emphasizing the importance of including night shift staff in quality improvement efforts. Recommendations include integrating oral care education into onboarding and annual competency training, standardizing documentation, and maintaining readily accessible supplies. The project's implications extend beyond the local site, supporting the scalability of oral care education to reduce preventable harm in nonventilated patients. By prioritizing staff engagement, infection prevention, and health equity, this work fosters enhanced nursing practice, improved patient outcomes, and better organizational quality goals.
Recommended Citation
Mbionwu, Uzoamaka, "Staff Education on Oral Health to Night Shift Staff" (2025). Walden Dissertations and Doctoral Studies. 18517.
https://scholarworks.waldenu.edu/dissertations/18517
