Oral hygiene of patients with cancer in an acute oncology ward: a best practice project

Background Good oral hygiene is achieved through a conscientious routine of healthy oral hygiene practices. Oral hygiene can be regarded as one of the most fundamental nursing interventions, particularly in meeting the basic needs for personal hygiene of patients. Without a good pre-existing oral condition that is free from gum infection and oral infections, many of the activities of daily living, such as eating, communicating and swallowing, would be difficult. However, a previous descriptive study has found that the majority of hospitalised patients did not have a satisfactory standard of oral hygiene, and in most of those cases, oral hygiene is a much neglected component in both nursing and medical care. Aim The aim of this project is to improve the oral hygiene of patients with cancer in an oncology ward by implementing nursing interventions based on best practices. Methods The research team utilised the Joanna Briggs Institute Practical Application of Clinical Evidence System programme to facilitate the collection of pre- and post-audit data. Getting Research into Practice programme was also used to analyse the potential barriers and for designing the final action plan. This project was conducted in three different phases over a 5-month period at a 24-bed oncology ward located in an acute tertiary hospital in Singapore. Results Comparison of the pre-audit and post-audit results shows significant improvements in all four audit criteria. An increase of 50% of the patients reported having their toothbrushes and toothpaste available during their hospitalisation. The compliance rate of patients who performed tooth-brushing twice daily also nearly doubled (42% to 83%). One hundred per cent of the nurses underwent an oral hygiene education programme. Sixty-seven per cent of patients demonstrated proper denture care, a significant improvement from 0% at baseline. Conclusion In conclusion, this project successfully utilised and actualised the best practices of oral hygiene care in patients in our clinical setting. With effective oral hygiene interventions in place, the oral hygiene of patients with cancer could be more effectively maintained and sustained. In addition, the closer relationship forged between the research team and the oncology nurses as a result of the project not only increased the satisfaction and productivity of the oncology nurses, but also motivated them to deliver a higher quality of care to patients, which would contribute to an improvement in patient satisfaction.