Involve Frontline Staff, Patients, and Families
A nurse-led intervention study in Singapore found that
new oral protocols could improve patients’ oral health in
high-dependency units when frontline nurses were engaged
in the process of change (Chan, Lee, Poh, Ling,
& Prabhakaran, 2011). We also engaged at-the-bedside,frontline staff as co-creators of training and in the development
of a new oral care protocol that was user friendly.
The oral care protocol was expanded to include all patients,
not just those on a ventilator in the ICU. The new
protocol included a chart at-a-glance format with pictures
of products, specific procedures, and frequency of
oral care for each type of patient. The new protocol included
provision of oral care for all adult nonventilator
patients four times per day; for patients able to eat, after
each meal and before bedtime; and for patients not
eating or on tube feedings, oral every 6 hr. New patient
and family education materials were developed. Posters
with oral care health information were displayed in the
hospital elevators. Documentation forms were revised to
include easy-to-locate daily oral assessment and oral care.