Effect of specific training course for competency in professional oral hygiene care in the intensive care unit: a quasi-experimental study for developing a standardized learning curve

Abstract

Background: The development of evidence-based training standards can help improve the quality of educational programs for novice intensive care unit (ICU) nurses. This study was conducted to assess the application of a training course on competency development of nurses in relation to oral hygiene care in ICU patients and to develop a checklist for evaluating the competence performance. In addition, to achieve a certain level of oral hygiene competence, as well as to assess the relative importance of predicting factors and learning competency patterns in oral hygiene care, we used standard learning curve.

Methods: This quasi-experimental study with time series design was conducted on newly registered ICU nurses of a teaching hospital affiliated with Tehran University of Medical Sciences, Iran, between 2016 and 2018. In the first phase of this study, we designed a checklist to assess nurses' professional competence in oral hygiene care in three stages: before, during, and after care. Then, in the second phase, the level of competence of nurses in repeated times of oral hygiene care was determined based on checklist items and recorded in the learning curve.

Results: The greatest increase of oral hygiene care competency due to repetition was observed in the first and fourth times of repetition in comparison to the subsequent and previous steps. In the linear regression model, demographic variables predicted 12-19% of changes related to skill scores in repetitions.

Conclusion: According to the learning curve, newly registered ICU nurses can reach an acceptable competency after 6 repetitions of oral hygiene care.

Keywords: Intensive care unit; Learning curve; Nursing education; Oral hygiene care.

Fig. 1

Study design for developing and testing a standardized learning curve for professional oral hygiene care competency for nurses

Fig. 2

Box plot for scores for professional oral hygiene care

Fig. 3

Mean score for professional oral hygiene care according to learning curve

Fig. 4

Mean changes in scores in professional oral hygiene care among times of experience

Fig. 5

Poisson model accuracy in predicting the number of times essential for professional oral hygiene care according to the cutoff point of the learning curve

Fig. 6

Distribution of time essential for professional oral hygiene care according to the cut-off point of the learning curve

Fig. 7

Percentile curve for scores for professional oral hygiene care. This graph presents the rate of increasing skill scores of nurses according to the number of practices. The black line indicated the median of scores, the red line indicated the percentile between 3 and 97%, and the green line indicated the percentile from 15 to 85%. The percentile from 3–15 is assumed the weak level, 15–50% is assumed the middle level, 50–85% is assumed a good level, and 85–90% is assumed a well level