As a nurse in a skilled nursing facility, oral hygiene care is very important, but the importance significantly increases when our patients are functionally dependent or cognitively impaired. These patients are unable to perform this task and depend on nurses to provide daily care. Nurses need to pay close attention for potential problems. They will need to perform assessments, develop oral care plans, and identify preventions and strategies to eliminate any potential problems. Poor oral health has been linked to serious systemic illnesses including diabetes mellitus, stroke, hypertension, myocardial infarction and aspiration pneumonia (Dyck et al., 2012). Patients who suffer from a lack of oral care can have a dramatic impact to their lives emotionally, mentally, physically as well as socially. With persistent and effective daily assessment and care from nurses, we can get help to get this problem under control.
Assessment and prevention are key nursing steps in eliminating potential problems. There are many tools that will assist nurses assessing patient’s oral health, included are Minimum Data Set and Resident Assessment protocols. These tools will help with determining the need for consultation and referral. Oral Health Assessment Tool (OHAT) is another tool that will help nurses develop a care plan individualized to patient’s needs. This paper will investigate an oral hygiene care guideline by comparing recommendations in the guideline to current nursing research. The aspects of the guideline that will be evaluated focuses on risk factors, assessment, development of oral care plan and prevention and strategies.
Guideline: Oral Hygiene Care for Functionally Dependent and Cognitively Impaired Older Adults.
There are not many guidelines for oral hygiene care for the cognitively impaired or functionally dependent older adult. The guideline selected for review is published in the National Guideline Clearing House by Johnson VB, Chalmers J., University of Iowa College of Nursing, John A. Hartford Foundation Center of Geriatric Nursing Excellence. There are three main parts to the guideline: risk factors, assessment, and prevention. The focus of this evaluation is on identifying risk factors, assessment and interventions, and prevention. In brief, the guideline is outlined as follows, and can be read in its entirety on the National Guideline Clearing House website:
Interventions and Practices Considered
1. Identification of risk factors that can increase oral health problems
2. Baseline oral health assessment
3. Current oral health assessment
4. Development of an oral hygiene plan
5. Implementation of oral health care practices for preventing oral disease.
Virginia Henderson is famous for her definition of nursing, “The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death)...