Effectiveness of Oral Care Intervention and Safe Swallowing Education on Post‐Extubation Dysphagia in <scp>ICU</scp> Patients: A Nurse‐Led Quasi‐Experimental Study

BACKGROUND: Post-extubation dysphagia (PED) negatively impacts respiratory and gastrointestinal function in post-extubation patients. Structured interventions-such as routine oral care, swallowing assessments and safe swallowing exercises initiated immediately after extubation-have received limited investigation regarding their effectiveness. AIM: To examine the impact of oral care intervention and safe swallowing education on PED among patients following endotracheal tube removal. STUDY DESIGN: A quasi-experimental design was employed. Four ICUs in a teaching hospital served as the study settings. Participants were consecutively recruited and randomly divided between study and control groups. Two interventions were implemented: oral care and safe swallowing education. For data collection, two instruments were used: a demographic data questionnaire and the Modified Standardised Swallow Assessment (MSSA). The study was conducted over 10 months and included three main stages: assessment, implementation and evaluation. Descriptive (e.g., mean, frequency, percentage) and inferential statistics (e.g., chi-squared, Pearson's r tests) were used for data analysis. RESULTS: A total of 50 adult patients (study group [n = 25]; control group [n = 25]) participated in this study. The control group showed a modest improvement in MSSA scores from baseline (x̄=1.96, SD = 1.35) to day 5 (x̄=8.32, SD = 2.95). Study group demonstrated a significant increase in MSSA scores from baseline (x̄=2.60, SD = 2.85) to day 5 (x̄=13.0, SD = 4.08; F = 145.446, p < 0.001). Regarding MSSA satisfaction, control group scores declined on day 5, changes across phases were significant (F = 41.90, p < 0.001). The study group showed rapid improvement by day 5 (F = 75.00, p < 0.001). Previous medical history and MSSA in the study group had statistically significant associations on days 3 (F = 0.639, p = 0.031) and 5 (F = 0.676, p = 0.004). Significant connection between smoking behaviours and MSSA in the control group on day 3 (F = 2.531, p = 0.034), whereas it was on days 2 (F = 1.422, p = 0.043), 3 (F = 6.100, p = 0.022) and 4 (F = 9.558, p = 0.044) in the study group. On days 4 (F = 2.210, p = 0.014) and 5 (F = 0.325, p = 0.028), there was significant association between the MSSA and the oxygen treatment equipment in the control group, whereas for study, it was on days 2 (F = 0.091, p = 0.047) and 4 (F = 0.432, p = 0.003). CONCLUSIONS: The combined implementation of oral care and safe swallowing education for ICU patients and their caregivers was shown to be highly effective in reducing the incidence of PED in ICU settings. RELEVANCE TO CLINICAL PRACTICE: ICU nurses and other allied healthcare workers working with patients with swallowing difficulty or PED may use this practical intervention to improve swallowing strength, facilitating early recovery, preventing respiratory complications and improving nutritional intake.