AIM AND OBJECTIVES: To explore the enablers, barriers and experiences of implementing an oral care intervention in an acute hospital setting, from the perspective of nurses and patients. BACKGROUND: Hospital-acquired pneumonia is a common healthcare-associated infection. Oral care can reduce the risk of hospital-acquired pneumonia but is often missed due to clinical priorities. DESIGN: Exploratory qualitative study. METHODS: Semi-structured interviews with 18 Registered Nurses and 8 Research Nurses facilitating an oral care intervention, and three patients who acquired pneumonia during admission to an intervention ward. Data were collected June to August 2025 and thematically analysed. RESULTS: Four themes were identified: varied knowledge and capacity to empower practice; education as a catalyst for practice change; competing demands and resistance; and relational and functional support to achieve change. Participants highlighted that successful oral care delivery relied on understanding its connection to hospital-acquired pneumonia. Competing workload demands often resulted in oral care being deprioritised. CONCLUSIONS: Strengthening nurses', patients' and families' understanding of oral care during hospitalisation can improve adherence to oral care practices and enhance patient engagement. RELEVANCE TO CLINICAL PRACTICE: Acute care nurses are central to delivering oral care, yet competing priorities and limited awareness of its relationship to hospital-acquired pneumonia can affect implementation. These findings can inform nursing education and strategies to support patient, family and clinician engagement. PATIENT OR PUBLIC CONTRIBUTIONS: Consumer and clinician feedback informed the development of interview questions. This study forms part of The HAPPEN study, which included consumer and partner input into intervention design, study materials and dissemination activities.
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Dawson et al. (2026) studied this question.
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