A Mixed-Methods Study of the Challenges of Nurses in a Sri Lankan National Hospital in the Provision of Clinical Oral Hygiene Care

Background: There are multiple challenges associated with the provision of quality oral hygiene care by nurses. This study aimed to identify the challenges experienced by nurses in the provision of oral hygiene care at the National Hospital, Kandy, Sri Lanka. Methods: This mixed-method study was conducted among nurses at the National Hospital, Kandy, Sri Lanka, in medical, surgical and intensive care units. Self-administered questionnaires and an interviewer-administered question guide were used to collect quantitative and qualitative data from 228 and 30 participants, respectively. The collected data were analyzed using the SPSS version 26.0 software (quantitative analysis) and Braun and Clarke’s thematic analysis framework (qualitative analysis). Results: Over threequarters (77.61%) of the participants experienced difficulties in providing oral hygiene care for their patients. The majority (62.18%, n = 97) of them reported that patients’ behaviors and difficulties in movements (physical disability) were the most common challenges they had experienced, while a lack of standardized guidelines, insufficient access to oral hygiene equipment and materials, inadequate supervisory support, overwhelming workloads, staffing shortages, time limitations, and difficulties in securing consistent patient cooperation were lesser challenges. A significant association was found between the participant’s clinical departments and their perception of associated challenges concerning oral hygiene care provision (p = 0.018). There were no significant associations between the educational level (p = 0.720), work experience (p = 0.739), or gender (p = 0.734) of the participants and their perception of challenges associated with performing oral hygiene care. Conclusions: The nurses faced patient-, healthcare professional-, and hospital administration-related challenges, which restricted them from providing effective oral hygiene care. In-service training, awareness programs, standardized protocols, and oral hygiene care instruments and materials to promote the oral health of patients are recommended.