Knowledge and Associated Factors Influencing Oral Care Provision Among ICU Nurses Caring for Mechanically Ventilated Patients at Tenwek Hospital, Kenya

Background: Oral care is a critical nursing intervention for mechanically ventilated patients in intensive care units because it reduces oral microbial colonization and contributes to the prevention of ventilator-associated pneumonia, a major cause of morbidity, prolonged hospitalization, and increased healthcare costs among critically ill patients. Despite the availability of evidence-based guidelines, gaps in nurses knowledge and inconsistent implementation of oral care practices remain challenges, particularly in low- and middle-income settings. Objective: This study aimed to assess the level of knowledge among intensive care unit nurses regarding oral care for mechanically ventilated patients at Tenwek Hospital, Kenya, determine factors influencing knowledge, and examine the relationship between nurses knowledge and selected demographic and professional characteristics. Methods: An analytical cross-sectional study design was employed. The study was conducted among intensive care unit nurses at Tenwek Hospital. A sample of 38 nurses was selected from a target population of 60 intensive care unit nurses using simple random sampling. Data were collected using a structured self-administered questionnaire assessing socio-demographic characteristics, knowledge of evidence-based oral care practices, awareness of guidelines, and factors influencing knowledge. Data were analyzed using descriptive statistics, chi-square tests, Pearson correlation, and logistic regression, with statistical significance set at probability value less than 0.05. Results: Thirty-five nurses participated, yielding a response rate of 92.1 percent. The findings demonstrated generally high knowledge levels regarding oral care practices for mechanically ventilated patients. Most nurses correctly identified recommended oral care frequency (88.6 percent), oral assessment before care (91.4 percent), suctioning before and after oral care (94.3 percent), and the role of oral care in preventing ventilator-associated pneumonia (97.1 percent). However, knowledge gaps were identified in areas such as toothbrushing practices and documentation of oral care procedures. Training, continuing professional education, availability of guidelines, workload, resources, supervision, and teamwork were identified as important factors influencing knowledge. The findings revealed that professional qualification (probability value equal to 0.02), intensive care unit experience (probability value equal to 0.030) and formal oral care training (probability value equal to 0.021) were significantly associated with nurses knowledge of oral care practices. Conclusion: Intensive care unit nurses at Tenwek Hospital demonstrated adequate knowledge of evidence-based oral care practices for mechanically ventilated patients. However, targeted educational interventions are required to address identified gaps and strengthen standardized oral care delivery. Continuous professional development, consistent use of guidelines, supportive supervision, and adequate resource provision are recommended to enhance patient safety and reduce preventable intensive care unit complications such as ventilator-associated pneumonia. Keywords: Intensive care unit nurses; Oral care; Mechanically ventilated patients; Ventilator-associated pneumonia; Nursing knowledge; Evidence-based practice