31/01/2012 - Oral health

#NurChat to discuss "Oral Health" 31/01/2012 Share with a

Every day of our lives we get up in the morning and clean our teeth and we clean them again before we go to bed.  If we experience problems with our teeth we take ourselves off to the dentist and get treatment.  maintaining our own oral hygiene is a very easy thing for us to do, but what about our patients ?

Often at times of illness our mouths are affected and this, in turn can effect our wellbeing. What incidents of poor oral health and good oral health have you experienced, and what impact has it had on the patients overall health ? Mouthcare is a fundemental nursing task but is it being done or is it a forgotten aspect of care? What can we, as nurses, do to ensure our patients have good oral hygiene? What about access to dental treatment for our patients, is it easy to get dental treatment for hospitalised patients, residents of care homes and our community patients ?

Click the picture to downlaod a printable PDF for notice boards

As always there are some links to some background reading below, but please feel free to suggest your own links

How to provide effective oral care - Nursing Times

Current standards of effective oral care provision are unacceptable -Nursing Times

Developing and implementing an oral carepolicy and assessment tool - Nursing Standard

The importance of mouthcare inpreventing infection - Nursing Standard

Summary by Teresa Chinn RN

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Post Chat Summary


View the Nursing Times blog for this post 

This chat was very much a follow on from our “Basic Care” chat focussing on this one aspect of fundamental care – oral hygiene.  The chat kicked off by asking what everyones first thoughts were about oral care.  Participants saw oral care as being an essential and impactful nursing skill. A colleague from the Netherlands stated that their healthcare inspector had announced that specific attention would be paid to oral hygiene over there, brought about by recent research.

It was generally agreed that the simple act of teeth brushing improved patient wellbeing.  Participants’ reported improvements in speech & enjoyment of food in patients with whom they had helped with oral care.

Complications of poor oral hygiene were touched upon – especially in regard to respiratory and cardiac disease. With some interesting links shared

Difficulties in sourcing dental care was discussed and it was mentioned that often dentists cant attend for weeks and in some cases this delays hospital treatment especially in cardiac surgery.

Dentures were discussed –the importance of good fitting dentures and not loosing dentures was seen as important.

NurChat asked if participants found oral assessments useful – answers ranged from yes they are useful solong as they are part of ongoing care others felt that oral care was basic common sense.  This then led to further debate that although it was common sense it still needed to be taught. Quality of oral health learning was then discussed and some had great experiences involving practical experience, some had on the ward training and some had no formal training in oral care. 

The chat ended by discussing the correlation between poor nutrition and oral health and this raised some interesting points – NurChatters wondered if there would be any similarities in those patients with poor oral health and those identified as needing a “Red Tray” at mealtimes and agreed that it would be a valuable piece of research.

Summary by Teresa Chinn RN

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Chat Transcript (Via Storify)

17/01/2012 - PM David Cameron's statement on nursing

#NurChat to discuss "PM's statement on Nursing" 17/01/2012 Share with a  
 
In response to Prime Minister David Cameron's news  regarding regular nursing ward rounds, nurse leadership and reduced bureaucracy we will now be postponing our #NurChat scheduled for Tuesday 17th January 8pm on COPD and instead be discussing this very important development in the future of nursing

Prime Minister David Cameron announced on 5th January the creation of a Nurse Quality Forum to” lead the uptake of good practice and recommend ways of improving care standards” (Nursing Times) Mr Cameron’s action has come after reports such as the Patients Association report and The Mid-Staffordshire Inquiry which identified poor nursing practice.  Mr Cameron advocated nurses making hourly nursing rounds, strong leadership on wards and less bureaucracy to help to raise standards of care. Howard Catton from the RCN stated (in an interview with the BBC) in response to Mr Camerons announcement that we need to ensure that nurses have time and resources to care.

Mr Camerons announcement sounds like a great step forward for nursing – less bureaucracy and more time to care is what many nurses would love to see.  However is this realistic ? Do nurses have time for hourly rounds? Are hourly rounds practical on busy wards? Do ward sisters have the time and resources to show real leadership? Can nurse cut down on red tape and unnecessary paperwork in order to have time to care ?


PM orders regular ward rounds, nurse leadership and reduced bureaucracy - Nursing Times

Nursing standards: PM aims to tackle care problem - BBC

Intentional rounding; it's role in supporting essential care - Nursing Times

Cameron told nursing review 'must look at staffing' - Nursing Times
Adventures in hourly rounding - YouTube

Some of the issues that Mr Cameron has raised have already been advocated in previous chats by NurChatters as best practice and so please feel free to also revisit our chats especially the chat on "Basic" care in nursing

Summary by Teresa Chinn RN

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Post Chat Summary

View our Nursing Times blog for this chat

This chat was very busy and there were several threads going on throughout the chat so the transcript is well worth a read – but here’s a little summary for you:

The chat started by asking how NurChatters felt about the PMs statement in general? Responses were extremely varied, from disappointment that politicians feel the need to dictate nursing practice to it’s a good thing that nurses have more time with their patients.

The chat very quickly moved on to hourly rounding – again opinions were varied, there were comments made that hourly rounding could improve quality of care but concerns were raised about adequate staffing and if there was an evidence base for hourly rounding and cost effectiveness.  It was suggested that some patients would not need hourly rounds while some needed constant supervision and most NurChatters agreed that hourly rounding for all was too prescriptive and not individualised.  Concerns were raised about HCAs delivering a lot of care and would they be allowed to do hourly rounds?  A point was raised that hourly rounding on a ward would take longer than an hour to go around just once.

The Prime Ministers red tape challenge – releasing time to care – was then discussed.  SomeNurChatters felt that a lot of paperwork could be done at the bedside in order to be visable to patients.  Some felt that better use of technology would help. The productive ward programme was also mentioned as a good way to release time to care.

NurChatters then looked at the PM’s Nursing Quality Forum: some felt that a committee was not needed, some felt that change needed to come from strong leaders and some felt that this committee would only repeat what other committees have done.

The debate then turned to leadership, it was asked if the NHS culture empowered good leadership and agreed that each NHS trust was different and this could be down to leadership. It was then suggested that we should all take the lead, and NHS culture was our challenge – many agreed with these thoughts.

Patient led inspections were briefly mentioned and it was generally seen as a bad thing due to infection control and privacy issues.

The chat concluded by asking what were the participants’ thoughts on David Camerons statements, whether they were good or bad for nursing?  Thoughts were varied : some stated that they thought that Mr Cameron was just trying to recognise bedside care, some thought that it was great that it had got us talking others thought that Mr Cameron shouldn’t interfere with nursing tasks and that he parrots the innovations of others.  One Nurchatter stated that it was a shocking day for nurses but we will rise to the challenge!

Summary by Teresa Chinn RN
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Chat Transcript (Via Storify) - Share with a