IMPLEMENTATION OF ORAL CARE FOR PATIENTS ON MECHANICAL VENTILATION IN THE PEDIATRIC INTENSIVE CARE UNIT (PICU) OF DR. CIPTO MANGUNKUSUMO NATIONAL GENERAL HOSPITAL

Abstract

Background: The Pediatric Intensive Care Unit (PICU) provides intensive care for critically ill pediatric patients. Mechanical ventilation supports respiratory needs but increases the risk of Ventilator-Associated Pneumonia (VAP). Implementing oral care is essential to reduce bacterial colonization and prevent complications. However, oral care practices in PICUs are often inconsistent, lacking clear Standard Operating Procedures (SOPs), and frequently neglect important aspects such as lip moisture.

Objective: This study aims to explore the implementation of oral care for pediatric patients on mechanical ventilation in the PICU.

Methods: The study employed a qualitative design with a phenomenological approach. Data were collected through in-depth interviews with 10 experienced PICU nurses and analyzed using thematic analysis to identify key themes related to oral care implementation.

Results: Oral care was performed routinely during each shift but lacked detailed technical guidance. The absence of SOPs resulted in variations in frequency and timing. Mouth cleanliness evaluation was conducted subjectively without standardized assessment tools. Lip moisture was often overlooked, leading to cases of chapped lips among patients. Nurses highlighted the need for guidelines, structured training, and tools like checklists to improve the consistency and quality of oral care.

Conclusion: Oral care implementation in the PICU faces challenges such as inconsistent practices, the absence of SOPs, and a lack of standardized evaluation systems. Evidence-based guidelines, training, and evaluation tools are needed to enhance the consistency and effectiveness of oral care, thereby reducing VAP risk and improving the quality of life for patients in the PICU.