Exploring the role of nursing staff in supporting children’s oral hygiene behaviours during their hospital stay and on their return to home

Abstract

Aim: To explore the evidence and the role of nursing staff in providing toothbrushing and mouth care to promote oral hygiene practice for hospitalised children during their hospital stay and after discharge. Methods: This was a nationwide piece of work representing nursing staff in England. It included a systematic review of the literature of any interventions delivered by nursing staff or parents to promote oral hygiene behaviour for children during hospital stay and on discharge from hospital. A qualitative study of 74 nursing staff explored the enablers and barriers for undertaking toothbrushing, mouth care, and advice to children in the hospital based on the COM-B (capability, opportunity, motivation, and behaviour) theoretical model. Results: The systematic review identified a knowledge gap of evidence of interventions promoting oral hygiene behaviours in hospitalised children who were not in the Intensive Care Unit. The qualitative study found several COM-B model domains as barriers to undertaking toothbrushing by the nursing staff. A key barrier was nurses‘ professional role. Nursing staff felt that toothbrushing was a personal care routine that parents should carry out rather than nurses. Conclusion: This thesis identified a lack of evidence of existing interventions and clinical guidelines on nurse-led oral hygiene interventions for hospitalised children. It also provided a deeper understanding of the barriers limiting their involvement, but also identified opportunities for nursing staff to support parents who often take responsibility for their children‘s toothbrushing routines while in hospital, seen by nurses as personal care to inform future interventions.