The Impact of an Oral Care Protocol on Post Stroke Survivors

Abstract

Post –stroke survivors are at risk for poor oral health as the provision of oral care is not usually a priority. Few research studies have focused on oral care for post -stroke patients in rehabilitation hospitals. Most oral care research has used samples of patients in intensive care settings, oncology patients, and older adults residing in nursing homes. A standardized protocol for the provision of oral care to post-stroke patients was developed that is being tested for its effectiveness by nurses in a rehabilitation hospital. Using the germ theory of disease, this honor thesis focused on the effects of an oral protocol compared to standard oral care on the incidence of nosocomial infections and pneumonia in post-stroke survivors. A prospective randomized design was used where participants were randomly assigned to either the intervention or control group. Data was collected from each participant for a period of ten days. The nine participants in this study were drawn from the larger study. Six of the participants were in the intervention group and 3 were in the control group. The majority of the participants were females (n=6), Caucasians (n=8), and over 60 years of age (n=6). The revised THROAT assessment tool showed an overall improvement in positive oral outcomes (normal to mild) in the intervention group compared with the control group outcomes (mild-moderate). In both groups, the Mann Assessment of Swallowing Ability (MASA) scores had an overall decline in dysphagia and aspiration severity from Day 2 to Day 10. The Functional Oral Intake Scale scores indicated that most participants had minimal or no restrictions with their diet, except for one participant in the intervention group that was tube dependent throughout the study. The results from the oral cultures indicated that none of the participants were positive for S. aureus or MMSA throughout the study. Two were positive for MSSA however converted to negative by the end of the study. None of the participants in either group had any signs and symptoms of pneumonia. These findings are preliminary in determining the effectiveness of the oral protocol intervention in terms of outcomes. No definitive conclusions can be made until the larger study is complete.