Abstract TP33: Raising The Bar On Oral Care In The Stroke Population

Abstract

Objectives: The purpose of this initiative is to increase compliance with basic oral care, especially in those patients who are dependent on others due to stroke. Although oral care seems like an intuitive hygienic practice to support positive patient outcomes, Speech Language Pathologists (SLPs) report low levels of compliance for stroke patients across hospital systems and settings. Poor oral hygiene in dependent, hospitalized patients can lead to serious complications, such as healthcare associated pneumonia (HAP), poor nutritional intake and increased length of hospital stay. Several epidemiological studies have linked poor oral health with cardiovascular disease, poor glycemic control in diabetics and a number of other conditions. Methods: Methodology includes providing education for staff throughout the year, increasing inventory of needed supplies and performing audits. Audits are completed to evaluate compliance for: a) Proper oral care tools (e.g., toothbrush, toothpaste, wall suction unit, suction canister, suction tubing, suction toothbrush kit) present in room b) Patient dependency for oral care c) Patient knowledge that oral care materials are in room d) Daily performance of oral care or teeth/dentures brushing by patient/family or nursing e) Quality of oral care - SLP needed to provide it or lemon glycerin swabs only were used f) Status of oral cavity. Real time feedback was given to nurses immediately after audit, as appropriate. Audit results shared quarterly at the hospital wide stroke committee to provide engagement with leadership. Results: Prior to the institution of an oral care protocol, compliance was measured at less than 50%. Education, training and audits resulted in an average increase of 30% for performing Basic Oral Care when measured in patients from July 2021-March 2022. Conclusions: In conclusion, the audit process serves the function of focusing attention on oral care and measuring compliance; interventions must also include raising awareness, providing training, and obtaining support from both the nursing and hospital leadership. Formalizing oral care workflows and documentation to standardize oral care should further increase the percentage of patients who receive this basic, but salient intervention.