Effects of Standardized Protocol Interventions on Nurses’ Knowledge and Practices of Oral Care for Bedridden Patients

Abstract

Background: Oral hygiene is a critical aspect of nursing care for bedridden patients, as poor oral care contributes to bacterial colonization, plaque accumulation, and hospital-acquired infections such as pneumonia. Despite its importance, adherence to standardized oral care practices among nurses remains inconsistent, particularly in intensive care and long-term care settings. Educational interventions guided by standardized protocols may enhance nurses’ knowledge and practices, thereby reduce complications and improve patient outcomes. Objective: To evaluate the effect of standardized oral care protocol interventions on nurses’ knowledge, confidence, and practices in providing oral care for bedridden patients. Methods: A quasi-experimental pre-test/post-test design was conducted at Ali Fatima Hospital, Lahore, with 50 nurses selected through total population sampling. Baseline knowledge and practices were assessed using a validated questionnaire and observational checklist. Participants received structured educational sessions on oral care protocols, followed by reassessment. Data were analyzed using paired-sample t-tests and odds ratios with 95% confidence intervals. Results: Mean knowledge and practice scores improved significantly from 22.28 ± 4.54 pre-intervention to 33.78 ± 3.82 post-intervention (mean difference 11.50, 95% CI: 9.8–13.2, p < 0.001, Cohen’s d = 2.16). Daily oral care performance increased from 58.0% to 74.0%, and standardized protocol use rose from 48.0% to 78.0%. Conclusion: Standardized protocol-based training significantly improved nurses’ knowledge, confidence, and practices in oral care, supporting its integration into nursing education and institutional policy for sustainable patient benefit.