Oral hygiene is crucial for patients’ health, and a fundamental nursing responsibility Show
This article has been updatedThe evidence in this article is no longer current. Click here to see an updated and expanded articleIntroductionWherever possible, patients should be encouraged and supported to carry out their own oral care. 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). Cleaning patients’ oral cavity is a skill that requires practice. Why might patients have poor oral hygiene?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). Why do patients benefit from a clean mouth?Providing effective mouthcare to patients has a range of benefits. For example, it can:
These benefits will all help patients to recover from illness. What should nurses do?Where necessary nurses should facilitate/prompt patients who are able to carry out oral hygiene for themselves, at appropriate times, such as first thing in the morning and last thing at night, as well as after meals or after vomiting. It is important to provide the equipment to do this. For example, patients who are unable to go to the bathroom should be given water and a bowl. They should also be given privacy to carry out the procedure. Nurses should undertake oral care for patients who cannot maintain a clean mouth for themselves. How often should oral care be carried out?As often as necessary. This will have been identified from the oral assessment tool and could be daily, twice daily, four-hourly, two-hourly or hourly, depending on the patient’s individual circumstances (Dougherty and Lister, 2008) 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. There are a variety of tools, use the one selected by your trust. Procedure for oral assessment
Why should an oral assessment be carried out?
What problems might you find?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). (Renton, 2007) The patient should be referred to a dental hygienist if specialist advice is needed, but in the meantime it is important to proceed with oral care. Reasons to refer to a dental hygienist include excessive plaque, ill-fitting dentures, multiple ulcers. While nurses should educate patients about their oral care needs, in some cases patients would benefit from the special advice that the dental hygienist can provide. The procedure for oral hygiene
Denture care
Dentures may be soaked occasionally – use specific soaking solution and follow manufacturer’s instructions. Always use a dedicated denture container, carefully labelled with the patient’s details. Key points
Department of Health (2010) Essence of Care 2010: Benchmarks for Fundamental Aspects of Care. London: DH. Dougherty L, Lister S (2008) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. Oxford: Wiley Blackwell. Hickson E (2008) Personal hygiene. In: Richardson R (ed) Clinical Skills for Student Nurses. Exeter: Reflect Press. Major C (2005) Meeting hygiene needs In: (2nd Ed) Baillie L (ed) Developing Practical Nursing Skills. London: Hodder Arnold. Nursing and Midwifery Council (2008) The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives. London: NMC. Nursing and Midwifery Council (2005) Guidelines for records and recordkeeping.London: NMC. Renton S (2007) Mouth Care In: Jamieson EM et al (eds) Clinical Nursing Practices. Edinburgh: Churchill Livingstone. When providing oral hygiene to an unconscious patient care must be taken to prevent?Suction may be required to prevent aspiration, and a soft toothbrush or gauze-padded tongue blade may be used to clean the teeth and mouth. Brushing and flossing are essential for preventing plaque and tooth decay, but oral hygiene should be performed at least every four hours, ideally without doing so.
What is the priority when providing oral hygiene to an unconscious patient?The priority is to prevent aspiration. Aspiration of bacteria may lead to lower respiratory tract infection. Therefore, to prevent infection frequent procedures of oral hygiene are performed.
When providing mouth care for unconscious client the nurse aide should?What's the process of oral care for an unconscious patient?. Gather supplies.. Check identification bracelet or name tag.. Introduce self, tell patient what you are going to do, provide privacy.. Wash hands, put on gloves.. Raise bed to comfortable height to perform oral care and raise head of bed 30 degrees.. What intervention should the nurse take when providing oral care for the unconscious client quizlet?Place the unconscious patient in semi-Fowler's position with head to the side or use the Sim's position to help avoid aspiration while performing oral care.
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