Facilitators and barriers to Oral Care by ICU Healthcare Providers: A qualitative Meta-synthesis

Background: The oral care practices for critically ill patients in clinical settings, both in the domestic and international contexts, are diverse and lack unified standards. Additionally, a systematic management framework has not yet been established, with various influencing factors at play. Methods: A computer-based search in Chinese and English databases (PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wan-fang Database, VIP database, and China Biology Medicine disc) was conducted from the databases' inception to August 1, 2025, to identify qualitative studies on facilitators and barriers to oral care by ICU healthcare providers. Two researchers assessed the literature quality using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (2016), and a synthesis method was used to integrate the results. Results: A total of 10 studies were included, yielding 44 research findings. These findings were categorized into 10 groups and integrated into 2 main results. Facilitating factors include nurses' positive attitudes, patient understanding and cooperation, and effective quality control and feedback mechanisms. In contrast, barrier factors are insufficient human resources, inadequate system support, oral - space and hygiene limitations, lack of education and training, discrepancies between clinical practices and protocols, and lack of specialized oral care tools. Conclusion: The oral care by ICU healthcare workers is affected by various factors. It's crucial to improve their awareness of oral care importance for ICU patients and help them overcome psychological barriers. Also, it's important to enhance human and material resources, strengthen education and training, and establish a comprehensive support system. Moreover, developing oral care plans according to clinical practices can reduce healthcare workers' workload.