Evidence-based practice for preventing oral mucosal pressure injuries in ICU patients with orotracheal intubation

JIANG Xuejuan; SHI Guangling; YU Tianhao; XU Jianzhen; WANG Ping; ZHANG Ge; LIU Juan; MO Xiaojuan

doi:10.12102/j.issn.1009-6493.2025.17.009

Abstract：Objective:To summarize the best evidence for preventing oral mucosal pressure injuries in ICU patients with orotracheal intubation and to evaluate the application effect of a practice protocol developed based on this evidence.Methods:Literature on the prevention of oral mucosal pressure injuries in ICU patients with orotracheal intubation was retrieved from UpToDate,BMJ Best Practice,JBI Evidence-Based Healthcare Center and professional organization websites,with the search period from database inception to May 31,2023.Two researchers trained in evidence-based practice independently evaluated the quality of the literature and extracted data.An evidence-based practice protocol was then developed and implemented in the general ICU of a tertiary hospital for one year to assess its effectiveness.Results:A total of 12 articles were included,and 12 prevention strategies were summarized,covering risk assessment,intubation management,and oral care.After the second round of implementation,high-risk patient identification rate increased from 62.1%to 91.7%.Compliance with endotracheal tube securement standards improved from 60.50%to 100.00%.Compliance with oral care standards rose from 42.70%to 100.00%.Incidence of oral mucosal pressure injuries decreased from 35.2%to 10.0%,with stage 2+injuries dropping from 14.8%to 0.Healthcare staff knowledge scores improved from 12.5±2.3 to 18.6±1.1.Conclusions:The evidence-based prevention strategies could effectively enhance the prevention of oral mucosal pressure injuries in ICU patients with orotracheal intubation.It could improve high-risk patient identification and standardized care,reduce injury incidence,and elevate healthcare staff's knowledge as well.