Basic Mouth Care

[adrienurse, LPN]

deleted

[renerian, BSN, RN]

I ask them to show me what they are doing particularly if I seeing a problem. You could take them under your wing and mentor them or give suggestions on how they could do it earlier. Check their charting. If you think that may be a threating thing to do ask them to observe you doing it and they might take it as a you are willing to take the time to show them and get your hands dirty so to speak.

renerian

[Reabock]

I am interested in knowing what sort of techniques and products you/your facility uses for mouth care. Anyone care to elaborate?

[canoehead, BSN, RN]

Make sure the equipment is at the bedside and that it moves every so often telling you it is being used. Inspect the pt's mouth and recommend more frequent mouthcare, or ask them to demo what they have been doing if you are unhappy with the quality of their interventions. Show them "how" and it moves up their priority list because you are paying attention to that part of the pt care.

[Step]

What amazes me is mouth care is more often then not performed on elderly people and everyone forgets about the 23yo from surgery that is on O2 and nil by mouth for 2 days.

My mouth feels grotty after 7 hours sleep, I can imagine what they feel like after 48 hours with wind blowing down there.

[Anagray, BSN]

On my unit there are not that many patients who are unable to care for themselves in that manner, however there was a problem with

some techs not washing the patients in the morning and not offering toothburshes and washcloths to those who can't ambulate and not doing mouth care on those who can't do anything for themselves along with that.

Eventually, there was a meeting with unit supervisor who addressed this issue.

If our techs are not swamped with work, the charge nurse tells all the techs coming on to the shift what needs to be done to re-enforce the task and also writes a small note on the schedule.

(like on evenings, she will tell everyone what room needs oral care)

If the techs are very busy (like having 18-30 patients for 1 person) , the charge nurse discusses with everyone what we can do to help each other.

nurses and housekeeping people will provide help with other tasks, so the tech actually gets to oral care.

A supervisor can also make sure that an aid gets a report from an aid from the previous shift about things like oral care. Some times I will come on my shift

and find out from the patient that she hasn't had a bath during the day and I end up doing it at the last minute.

If i had a report (truthful report!) from the person before me, I could plan my day better,communicate with the nurse and do what had to be done.

On my floor we don't have any fancy mouth care equipment. I am told to get some sponges on the stick ( not sure what the name of it is lol) and some clean water and just clean the mouth with damp sponges, lubricate the lips if they are dry and cracked.

I think it's important to figure out why something isn't done by the aids - are they lazy or do they actually have more work than they can handle. There are times when nurses on are not aware of how many people I am taking care of and this is when communication makes a big difference.

[Pam I Am]

I've been pondering this question myself the past few months. I would think the nurse techs could provide oral care as they make their 7 a.m. rounds taking vital signs.

[ShortFuse_LPN, LPN]

I think the sponges on a stick are called toothettes....

[Step]

sponges on a stick in australia are "Q Tips" or "mouth swabs" :)

[adrienurse, LPN]

I attended a lecture by a dental hygienist last year about institutional mouthcare. I'm interested in knowing if any of you use the attachments that can be attached to suction. Anyway she says that mouthcare using a toothette and mouthwash will hydrate the mouth, and improve the taste for short term, but doesn't cut it as basic mouthcare. I can't even seem to get our heath care aides to use a toothette. I'm not blind, I can tell if someone is not performing mouth care. Yet another pet peeve.

[nakitamoon]

Oral care,,,, in my opinion,,, shouldn't be something the C.N.A.'s or Nurses have to be reminded about,,, it should be performed prn,,, and routinely,,,

Using,,, toothbrush,,, denture cleaner,,, toothettes',,, what ever will get the job done,,,

The suggestions mentioned earlier are good ones,,, if you think improper mouthcare is being given or not being given,,,, ask the staff member to demonstrate,,,, how they do it,,, then teach them the proper way,,,,,

I have used suctioning on one resident,,,,, I wouldn't recommend the c.n.a's do it,,, but the women,,, bed bound,,, would get mucous / phlem that would harden and stick to the roof of her mouth,,,, at the time I only worked baylor on weekends,,,, some Saturdays,,, cleaning her mouth was an hour long procedure,,,, as it was obvious it hadn't been done through the week,,,,

So many nasty things,,,, find places to hide and grow in someones mouth,,, and no matter how well they have been groomed,,,, dressed,,, if mouthcare hasn't been done,,,, soon as the exhale,,,, you know it!!!!!

~~~kitamoon

[nursenoelle]

Originally posted by adrienurse

I attended a lecture by a dental hygienist last year about institutional mouthcare. I'm interested in knowing if any of you use the attachments that can be attached to suction. Anyway she says that mouthcare using a toothette and mouthwash will hydrate the mouth, and improve the taste for short term, but doesn't cut it as basic mouthcare. I can't even seem to get our heath care aides to use a toothette. I'm not blind, I can tell if someone is not performing mouth care. Yet another pet peeve.

Adrienne- at our facitilty, the pt with a gt or ngt have a standing order for suction equip at bedside, with HOB^ 45 and some caution the nurses ( well most anyway) do a good cleaning with a soft toothbrush,BID then toothettes when we are already in there to flush tubes or give meds q2h.

-noelle

p.s. we ended up just doing it ourselves