| Description |
Background: While term babies can develop oral thrush with no issues, premature infants are at a higher risk for increased susceptibility to more invasive infections. The oral mucosa is home to hundreds of microbial species, including bacteria, fungi, archaea, protozoa, and bacteriophages (Baumgardner, 2019). Candida albicans is an opportunistic pathogen that commonly attaches to oral mucosa and is the most common cause of oral thrush (Vila et al., 2020). Local Problem: A 51-bed NICU that lacks a formal oral thrush guideline for neonates, hindering staff in the prevention and management of oral thrush. Methods: A needs assessment was conducted at a Level IV NICU in Utah to evaluate the feasibility and useability of a NICU oral thrush guideline. Interventions: This scholarly project was initiated by addressing an issue in the NICU related to oral thrush. First, an extensive literature review was conducted to evaluate the current best practices. A survey was created and distributed to stakeholders to assess the feasibility and potential useability of an oral thrush guideline. External benchmarking was conducted to evaluate various practices across Utah and internationally. A retrospective chart review from January 2024 to December 2024 was completed to assess the previous incidences of oral thrush in the NICU. Lastly, a strengths, weaknesses, opportunities, and threats (SWOT) analysis was conducted to examine the feasibility and useability of the oral thrush guidelines. Results: The chart review found that 8.1% of infants admitted to the NICU had thrush and received treatment. Of those infants that had thrush, 21.4% required additional treatment after the initial oral thrush infection. The survey indicated that stakeholders agreed there is a need for an oral thrush guideline. Survey results were collected using REDCap, with the total number of surveys (n=89), which is a 26% return rate of the stakeholders. The majority of the survey was from registered nurses (66.3%). The SWOT analysis highlighted the strengths of professional support and weaknesses of time limitations and increased learning requirements. Conclusion: This needs assessment used literature review, a survey, discussions, and the development of a SWOT analysis to demonstrate the usability and feasibility of an oral thrush guideline. This project would benefit from a continued effort to implement the oral thrush guideline and utilize rapid plan, do, study, act (PDSA) cycles to address discrepancies. |
