The following assessment scale was used: a score of 22 (the highest possiblescore) shows that the participant
practice of endotracheal and oral care matched the standards set by the Scott & Vollman (2011) variable,
representing “recommended ETT and oral care practice”. Two ofthe original 24 scale items were not applicable
to our patients because none of them were nasally intubated. Every 24 items on the schedule was weighted with
0 and 1 (zero=not done and 1=done). This was elaborated by computing the summation of the maximum
possible scores for each observation, which was established as being 22. The number 22 therefore represented
perfect adherence to recommended ETT and oral care (Scott & Vollman, 2011) and CDC recommendations
(CDC, 2004). The higher the intensive care nurse scored based on the observation check list, the closer the
participants matched the recommended practices. Likewise, the lower the intensive care nurse scored, least
expected adherence to recommended practices. This score represented the “quality of treatment”. For the
purposes of the data analysis, the score was divided into four parts: practices prior to oral care, during and after
the oral care procedure as well as patients’ monitoring and care.