David Casey, Gerard Gavin
DeCare Dental, Dublin, Ireland
Background: This study investigates how an oral care training programme for nurses
and carers in a hospice could help manage end of life oral health symptoms through
appropriate oral hygiene interventions.
Methods: A total of 66 staff were trained onsite in a 3 hour module over 14 weeks. This
included 52 healthcare assistants and 14 specialist nurses. Prior to training a baseline
questionnaire was given to identify oral health knowledge and problems most frequently
encountered by staff. The questionnaire was repeated 6 months following the training
programme. A sample of 30 patient charts was examined pre and post training using an
Oral Health Assessment Tool devised by Chalmers 2002 to report how oral health status
was being recorded and the outcome of any oral health interventions.
Results: The baseline questionnaires from 66 staff highlighted low awareness of oral
health knowledge prior to training. A post training questionnaire demonstrated greatly
improved knowledge about oral health conditions and simple oral health interventions
with 85% of staff showing major improvement in scores immediately after training. An
analysis of 30 patient charts showed that recording was highest for Visible Debris/Food
Plaques at 65%, Xerostomia 24%, Oral Ulceration 8% and Oral Thrush 3%. A re –
examination of patient charts using Chalmer’s Oral Health Assessment Tool after 6
months showed recordings of Visible Debris/Food Plaque had decreased by 61%, and
Xerostoma being actively managed with fewer patient complaints and greater oral comfort
being recorded for these patients.
Conclusions: Preventive aspects of oral health are seldom highlighted as part of
Palliative Care. This study shows that improvements to patient’s oral comfort can be
achieved by an educational intervention aimed at improving oral health knowledge and
skills of all care staff in a hospice setting.
This training programme was approved by the Nursing and Midwifery Board of Ireland.