Article type
Abstract
Background: Oral hygiene is pivotal in palliative care, significantly affecting patient comfort and quality of life. Yet, a gap persists between recommended oral hygiene practices and actual care in hospice settings.
Objectives: This study aimed to bridge this gap by evaluating current procedures, identifying barriers to effective care, and implementing strategies to boost adherence to evidence-based guidelines.
Methods: Employing the Joanna Briggs Institute (JBI) evidence implementation framework, this study was conducted over six months at Changhua Christian Hospital, Taiwan. The study utilized JBI's PACES and GRiP programs for strategy implementation, focusing on 18 nurses and 30 patients across two hospice wards. Baseline and follow-up audits assessed compliance with oral hygiene practices.
Results: The baseline assessment revealed significant variances in compliance with oral hygiene guidelines: while routine care by nurses achieved 100% compliance, natural teeth cleaning was at a mere 10%, with stark deficiencies in denture care—both cleaning after meals and overnight soaking recorded 0% compliance. Additionally, baseline compliance for assessing mouthwash options in patients with swallowing difficulties was notably low at 50%. Post-intervention, compliance soared to 100% for all guidelines, including those that already demonstrated relatively high compliance at baseline, specifically positioning for oral hygiene (83.33%) and the application of water-based gels for lip moisture (80%). The Oral Assessment Guide (OAG) scores, which indicate oral health status, improved from an average daily score of 14.1 pre-intervention to 11.7 in the sustainability phase, signifying enhanced oral hygiene and an improved quality of life for patients.
Conclusions: The study's achievements underscore the profound impact of targeted interventions, transitioning from nonexistent compliance (0%) to full compliance (100%) in critical areas, thus addressing previously overlooked practices in palliative oral care. The attainment of 100% compliance across all guidelines, including the one initially at full compliance, highlights the project's role not just in rectifying gaps but in reinforcing the importance of consistent and comprehensive oral hygiene practices. These results advocate for the importance of evidence-based practices in enhancing patient care quality and suggest that even well-adopted practices can be refined and improved, setting a new standard for oral hygiene care in hospice settings.
Objectives: This study aimed to bridge this gap by evaluating current procedures, identifying barriers to effective care, and implementing strategies to boost adherence to evidence-based guidelines.
Methods: Employing the Joanna Briggs Institute (JBI) evidence implementation framework, this study was conducted over six months at Changhua Christian Hospital, Taiwan. The study utilized JBI's PACES and GRiP programs for strategy implementation, focusing on 18 nurses and 30 patients across two hospice wards. Baseline and follow-up audits assessed compliance with oral hygiene practices.
Results: The baseline assessment revealed significant variances in compliance with oral hygiene guidelines: while routine care by nurses achieved 100% compliance, natural teeth cleaning was at a mere 10%, with stark deficiencies in denture care—both cleaning after meals and overnight soaking recorded 0% compliance. Additionally, baseline compliance for assessing mouthwash options in patients with swallowing difficulties was notably low at 50%. Post-intervention, compliance soared to 100% for all guidelines, including those that already demonstrated relatively high compliance at baseline, specifically positioning for oral hygiene (83.33%) and the application of water-based gels for lip moisture (80%). The Oral Assessment Guide (OAG) scores, which indicate oral health status, improved from an average daily score of 14.1 pre-intervention to 11.7 in the sustainability phase, signifying enhanced oral hygiene and an improved quality of life for patients.
Conclusions: The study's achievements underscore the profound impact of targeted interventions, transitioning from nonexistent compliance (0%) to full compliance (100%) in critical areas, thus addressing previously overlooked practices in palliative oral care. The attainment of 100% compliance across all guidelines, including the one initially at full compliance, highlights the project's role not just in rectifying gaps but in reinforcing the importance of consistent and comprehensive oral hygiene practices. These results advocate for the importance of evidence-based practices in enhancing patient care quality and suggest that even well-adopted practices can be refined and improved, setting a new standard for oral hygiene care in hospice settings.