Knowledge of Evidence-Based Oral Care for Mechanically Ventilated Patients and Associated Factors Among Intensive Care Unit Nurses at Tenwek Hospital, Kenya

Background: Oral care is a key nursing intervention for mechanically ventilated patients in intensive care units (ICUs), reducing oral microbial colonisation and preventing ventilator-associated pneumonia (VAP), a leading cause of morbidity, prolonged hospitalisation, and increased healthcare costs. Although evidence-based oral care guidelines are widely available, gaps in nurses’ knowledge and inconsistent adherence persist, particularly in low- and middle-income countries. Moreover, context-specific evidence from Kenya on factors influencing ICU nurses’ knowledge of evidence-based oral care remains limited, hindering the development of targeted educational and institutional interventions. Objective: To assess ICU nurses' knowledge of evidence-based oral care for mechanically ventilated patients and its associated factors at Tenwek Hospital, Kenya. Methods: An analytical cross-sectional study was conducted among 38 randomly selected ICU nurses from a population of 60. Data were collected using a structured self-administered questionnaire assessing socio-demographic characteristics, knowledge of evidence-based oral care, guideline awareness, and factors influencing knowledge. Data were analysed using descriptive statistics, chi-square tests, and Pearson correlation, with statistical significance set at p<0.05. Results: Thirty-five nurses participated, yielding a response rate of 92.1%. The findings demonstrated a generally high level of knowledge regarding oral care practices for mechanically ventilated patients. Most nurses correctly identified recommended oral care frequency (88.6%), oral assessment before care (91.4%), suctioning before and after oral care (94.3%), and the role of oral care in preventing VAP (97.1%). 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 (p=0.02), ICU experience (p=0.030), and formal oral care training (p=0.021) were significantly associated with nurses' knowledge of oral care practices. Conclusion: ICU 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 standardised 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 ICU complications such as VAP.