nursing interventions for oral care

Overuse of Xylocaine 2% Viscous has the potential to decrease a patient’s gag reflex if swallowed. Oral hygiene assessment and oral care are important nursing interventions after a stroke. 1.1.2 . Edinburgh: Churchill Livingstone. Excessive use of tobacco 8. Studies have shown that LLLT may: All patients undergoing a HSCT or patients receiving high doses of chemotherapy agents such as COPADM should be referred by the treating team to the Dentistry department for LLLT prior to commencing chemotherapy. More t… Fawzy suggested that psychosocial interventions provide an overall positive effect on quality of life, although some interventions have failed to achieve the desired results. The impaired oral mucous membrane is a disruption of the soft tissue of oral cavity and or lips. The skills needed by a nurse working in aged care are extremely diverse, but probably the most important attributes are being a good listener and having true empathy for older people and their families and carers. ORAL CARE REFERENCES FREER 09/01 1.Jones C. (1998) The importance of oral hygiene in nutritional support. The nurse care coordinator assessed and monitored the usual care patients, providing education on oral care to patients and/or their family members; coordinated with the interprofessional team on the management of pain, dysphagia, and other health care needs; and completed nursing documentation. Avoid petroleum based lubricants such as vaseline that can increase dryness of the tissues, preferably use water, lanolin or aloe based products. Nurses’ mean rating of oral care priority was 53.9 on a 100-point scale. As a result, the child receiving chemotherapy may experience pain, dysphagia, alteration in nutritional status, and risk of infection. Nurses report frequent oral care interventions, but few are documented. There are many reasons why patients’ oral hygiene may be poor, including: Some medications such as anticholinergic drugs and oxygen therapy can cause a dry mouth or an unpleasant taste in the mouth (Major, 2005). So that was the nursing intervention highlight reel. Artificial saliva can be used to alleviate a dry mouth (Dougherty and Lister, 2008). Lalla, R.V., Bowen, J., Barasch, A., Elting, L., Epstein, J., Keefe, D.M., McGuire, D.B., Migliorati, C.,  Nicolatou-Galitis, O., Peterson, D. E., Raber-Durlacher, J.E., Sonis, S.T., Elad, S. (2014) MASCC/ISOO Clinical Practice Guidelines for the Management of Mucositis Secondary to Cancer Therapy. Ask the child to swallow or observe the swallowing process. Other patients should also be referred  Once outcomes have been developed and agreed, nursing interventions that facilitate their achievement are planned and implemented. It is important to provide the equipment to do this. The plan should also include which tools and products are to be used to maintain good oral health care. Decreased platelets 9. This shift in trend appears to result from changes in adult smoking prevalence, where the proportion of men who smoke has decreased and the proportion of young females who smoke has increased. Use tissues to dry around the mouth; Apply moisturiser to the patient’s lips if required. Evidence-based practice supports the excellence in service that nurses are committed to delivering in our day-to-day practice. Oral Care Working Group, ANZCHOG Nursing Sub Group, November 2015, Retrieved 27/07/2018, Great Ormond Street Hospital for Children, (2017) Version 4, Clinical Guidelines : Mouth Care, Retrieved 27/07/2018, Kumar, N., Brooke, A., Burke, M., John, R., O'Donnell, A. Evidence-Based Approach for Oral Care If the nursing care is based on evidence, some important facts like improvement of care … Nursing Standard. Lack of knowledge regard… Economic factors 6. To monitor progress of oral care/treatments. The Shared Oral Care intervention supports an individual and multidisciplinary assessment of nursing home residents’ ability to self‐care concerning oral care. @article{Wrdh2009NursingSU, title={Nursing staff's understanding of oral health care for patients with cancer diagnoses: an intervention study. Methods. Reasons to refer to a dental hygienist include excessive plaque, ill-fitting dentures, multiple ulcers. Exeter: Reflect Press. Consult the, Systemic analgesics (as examples paracetamol or opioids) may be required, and should be administered according to the degree of pain (as stated by the child), the presence of drooling, and/or difficulty in swallowing, talking, eating or opening the mouth. care plan frequently. We undertook a systematic review to describe clinical assessment tools which identify patients at risk of insufficient oral fluid intake and the impact of simple interventions to promote drinking, in hospital and care home settings. (Renton, 2007). 23, pp. Nursing care plan interventions describe specific actions taken by long term care staff member’s to achieve the stated goal, and are based on standards of clinical practice. 2. However, when they are unable to do this maintaining patients’ oral hygiene is an essential nursing duty and is considered a fundamental aspect of care (Department of Health, 2010). The patient is unconscious, oral care will be needed more frequently. The priority of oral care. The shared oral care intervention supports an individual and multidisciplinary assessment of nursing home residents’ ability to self‐care concerning oral care. Anaesthetic effect lasts approximately 5-10 minutes. The OAG Assessment tool should be added for all paediatric oncology and HSCT patients under the ENT assessment in the Focused Assessment flowsheet. Nursing Interventions - Assess respiratory rate pattern, lung sounds, lung expansion, signs of tissue hypoxia, cyanosis, pallor; presence of airway secretions; occlusion of oropharynx by epiglottis or tongue; aspiration of vomitus or oral secretions. 29, 19, 44-50. doi: 10.7748/ns.29.19.44.e9383. We promise, you actually will use care plans while providing patient care as a practicing nurse. To identify any new problems (Dougherty and Lister, 2008). Importance of Oral Care in Nursing: Oral care or mouth care is one of the most basic nursing activities. Cryotherapy is most effective in regimens with chemotherapy with a short infusion time and short plasma half-life; patients receiving the chemotherapy melphalan in the HSCT preconditioning phase, or a bolus of 5-fluorouracil chemotherapy may apply ice cubes/ice chips in their mouth for 5 minutes prior the infusion and continuing for a total of 30 – 45 mins if able to be tolerated. Point of Care Resources; Node Name Weight Weight Selector ; Oral care infection prevention and control: Algorithm for Oral Care: Oral Health History — Sample Questions: Risk Factors for Oral Disease and Poor Oral Health: Oral Hygiene Care Plan for Long-Term Care: Sample Oral Health Care Plan: Toothbrushing Techniques: Denture Care ORAL CARE REFERENCES FREER 09/01 1.Jones C. (1998) The importance of oral hygiene in nutritional support. Ensure you set out your duty of care in relation to residents' oral health needs and access to dental treatments. All children diagnosed with cancer or receiving a haemopoietic stem cell transplant should be screened by a paediatric dentist prior to the commencement of treatment. Impaired Oral Mucous Membrane: Disruption of the lips and/or soft tissue of the oral cavity. A history of inadequate oral hygiene or poor nutrition. Oxford: Wiley Blackwell. Head and neck cancer is the 10th most common cancer in the world, and in the United Kingdom, it accounts for 4% of all malignant cancers. The prevalence of malnutrition has been extensively reported, but there is little empirical data on the prevalence of the underlying causes of reduced oral intake and the extent of nursing interventions that address malnutrition. Extreme use of abrasive cleaning agents 9. Not all chemotherapy-induced mucositis can be prevented but, with proper management, the severity and duration of oral complications can be minimised. Nursing interventions and supportive care for the prevention and treatment of oral mucositis associated with cancer treatment. Chemical trauma (e.g., acidic foods, drugs, noxious agents, alcohol) 6. Develop an Oral Health Care Plan. 7, (2), pp. Peer review Because of the transient nature of this population, the development of services is administratively complex and requires a proactive approach to ensure access to continuity of oral health care in hospital and community residence. This may also include excessive production of mucus. RNAO is delighted to provide this key resource to you. Chlorhexidine based gels and mouth rinses have a broad antimicrobial activity, with some antifungal and antiviral properties. This article reviews nursing interventions to increase adherence to oral cancer therapies, such as patient and care-partner education, side-effect and medication management, and safety issues. Research output: Contribution to journal › Review article Cryotherapy may be offered to cooperative children and adolescent patients receiving chemotherapy or HSCT preconditioning with regimens associated with a high incidence of mucositis. Dental caries, oral cancers, and sports-related craniofacial injuries are potentially preventable conditions. Wherever possible, patients should be encouraged and supported to carry out their own oral care. Keeping the mouth and teeth clean will protect a patient’s oral health and allow quicker recovery by preventing infections. It is recommended to use chlorhexidine based gels and mouth rinses that are alcohol free as the presence of alcohol may contribute to mouth dryness, irritation and brown staining to the teeth. The nurse care coordinator assessed and monitored the usual care patients, providing education on oral care to patients and/or their family members; coordinated with the interprofessional team on the management of pain, dysphagia, and other health care needs; and completed nursing documentation. Data sources included peer-reviewed nursing and medical literature, healthcare Web sites, and published monographs. For example, it can: These benefits will all help patients to recover from illness. Nursing interventions. Dentures may be soaked occasionally – use specific soaking solution and follow manufacturer’s instructions. The male/female ratio is less than 2:1, and this gap is closing steadily. Home Care Interventions 1. Here are some factors that may be related to the nursing diagnosis Impaired Dentition: 1. Dietary habits 5. Continuous vomiting 4. Oral assessment tools are designed to help nurses carry out a thorough assessment of the oral cavity and develop a care plan tailored to patients’ individual need. Oral care and the promotion of good oral health can reduce the amount of microbial flora, reduce pain and bleeding, prevent infection and the risk of dental complications. The evidence table for the Mouth Care – Oral Care of the paediatric oncology patient and haematopoieitic stem cell transplant patient can be found here. Always use a dedicated denture container, carefully labelled with the patient’s details. A recommended alternative is a toothpaste marketed for use from 6+ years of age (adult strength toothpaste with a mild taste that is suitable for young children)  or, A low fluoride toothpaste (0.11% fluoride) marketed for use below 6 years of age. / Eilers, June. Nursing interventions and supportive care for the prevention and treatment of oral mucositis associated with cancer treatment. Barriers to professional care 3. It can, however, cause irritation and may be unacceptable for some patients, Application of a moisturising cream to the lips is recommended. Nursing Care Plans Diagnosis: Impaired Oral mucous membrane Definition: Disruptions of the lips and soft tissues of the oral cavity Defining Characteristics: Purulent drainage or exudates; gingival recession, pockets deeper than 4 mm; enlarged tonsils beyond what is developmentally appropriate; smooth atrophic, sensitive tongue; geographic tongue; mucosal denudation; presence of … 23, pp. Guideline (CCC): Infection: Prophylaxis and Treatment in Haematopoietic Progenitor Cell Transplantation, Aciclovir is recommended as a prophylactic and treatment measure for herpes simplex virus in patients undergoing haemopoietic stem cell supported therapy, Further information on the prevention and treatment of viral infections in the HSCT patient can be found at, Guideline (CCC): Infection: Prophylaxis and Treatment in Haematopoietic Progenitor Cell Transplantation, A multidisciplinary approach to oral care (nurse, medical officer, dentist, pain management team, procedural pain management team, dietician, pharmacist and others) will assist in providing appropriate supportive care to the paediatric oncology patient, Several therapy and patient specific factors, including the chemotherapy drug, the type of malignancy, age, neutrophil count and level of oral care are important in the pathogenesis of oral mucositis, Parent Information Sheet; Mouthcare – Taking care of your child's TEETH and MOUTH after chemotherapy or a bone marrow transplant. Diminished hormone levels (women) 12. Conclusion. British Journal of Nursing. - if it is anticipated there is a high risk of the development of mucositis OR During the course of the pandemic, a tree has sprouted in the…, South Eastern Health and Social Care Trust, Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. It is important to ensure the client feels comfortable while performing oral assessment and care. Contextual factors, supportive and restraining mechanisms influence the intervention's success. An azole antifungal agent, such as fluconazole, may be prescribed, Prophylaxis for fungal infections will be based on sensitivities of the proven or suspected organism, consideration of medication toxicity and consideration of the patient's clinical status, comorbidities and concomitant medications, Antifungal agents that are not absorbed by the GI tract, such as nystatin, are NO longer recommended for the treatment of oral candida in the immunocompromised patient, Oral anti-fungal agents (intravenous if not tolerated) should be used for the treatment of visible oral candidia. 2.3 Oral health related nursing interventions Oral hygiene is an essential aspect of nursing care and is methodically planned using nursing interventions. Cleft lip or palate 8. For example, patients who are unable to go to the bathroom should be given water and a bowl. 31, No. Immunocompromised 13. Poor oral hygiene can lead to a range of problems including dry, sore lips; ulcers; plaque; dryness; dental caries; tumours; cracks; bleeding, white/yellow deposits of candidiasis (thrush). Evidence suggests that oral health deteriorates while people are in hospital (Terezakis et al, 2011) and it is generally acknowledged that mouth care in hospitals and care homes needs to be improved (Binks et al, 2017). Further information on dental management of the paediatric oncology and the haemopoietic stem cell transplant patient can be found at.  - brush teeth, gums and tongue using  soft toothbrush BD, ¹  Replace toothpaste in the morning with 0.5% chlorhexidine gel if child has dental decay (as verified by a dentist), Mouthcare for paediatric oncology & HSCT patients at risk of oral complications², - allogeneic HSCT (preconditioning to Day =+100), - brush teeth, gums and tongue using soft toothbrush TDS, ² Once the patient is no longer at risk of oral complications, mouthcare should continue as outlined in Level 1. 74-83. Inadequate support for oral care. British Journal of Nursing. These therapeutic nursing interventions help to reduce the effect and heal impaired oral mucous membrane. 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