Standardizing Oral Care Practice for Oncology Patients: An Evidence-based Practice Project
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Date
2022-05
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Publisher
The Ohio State University
Abstract
Many forms of cancer treatment compromise the host's immune system, increasing individual's
susceptibility to infections. Infection prevention practices are a foundational part of cancer treatment. Oral
care serves as an infection prevention practice by reducing pathogens that cause local and systemic
inflammation and infections such as mucositis, bloodstream infections, and pneumonia. An internal
review conducted at a comprehensive cancer center identified that the oral care practice for non-ventilated
patients varied across the organization. The purpose of this evidence-based practice project was to
improve quality of care by implementing an oral care protocol. The primary objectives of this project
were to reduce variation in the oral care practice and to improve clinical staff's perception of the practice.
The long-term objective is to improve clinical outcomes. An oral care protocol was developed based on a
review of the external literature and implemented on one inpatient unit. Changes in documentation of oral
care practices were evaluated through electronic medical record (EMR) extraction. An anonymous staff
survey was distributed to the registered nurses (RNs) and patient care assistants (PCAs) prior to and 4
weeks following implementation to measure staff's perceptions of the practice using the Implementation
Outcome Measures (Weiner et al., 2017). Central line associated bloodstream infection (CLABSI) rates
and length of stay were trended. The total oral care documentation rate had no change, but rates of oral
rinse, mouth wash and lip lubricant increased. Staffs' perceptions of the feasibility and appropriateness of
the practice improved. A change in clinical outcomes was not demonstrated.
Description
Keywords
evidence-based practice, oral care, infection prevention, nursing care, oncology care