Improving mouth care standards within our physical health, mental health & learning disabilities inpatient areas

Sylvia Jellyman and Julie Lerigo

Background

During the delivery of the Care Certificate we identified variations and inconsistencies with the mouth care practice within our inpatient areas, combined with the use of non-standard equipment leading to a lack of assurance about the standards of mouth care practice and the quality of care our patients expect.

PDSA cycles

ü Produced mouth care policy with action cards ü Standardised Mouth care equipment ü Developed admission and weekly mouth care assessments ü Devised and rolled out training ü Created mouth care champion roles ü Developed clinical competency ü Developed electronic patient records oral assessments for both physical health and mental health systems ü Product information sourced from Mouth Care Matters and other NHS Trusts ü Attended MCM training.

• Roll out mouth care to all inpatient areas in progress.

Our SMART aim

To improve the quality of mouth care for our inpatients, reducing variation and using current recommended products across selected sites by 29 September 2023.

Measurement

ü Positive staff feedback about training and products used ü Positive knowledge improvement from questionnaires ü Amended eLearning ü Yellow resource folders for all inpatient areas ü Intranet page created

Lessons learnt

x ü Staff able to recognise an unhealthy mouth ü Weekly audits showed varying levels of compliance and engagement ü Many patients do not have a dentist ü Feedback collated from trialling equipment and implemented ü A3 poster of what equipment to use and when. ü Yellow lanyards for champions ü Both Reg/Non-Reg staff to complete weekly assessment ü Pause, observe, understand

• Dental referral pathway ü Product guide produced

• Removal of pink foam sponges

Next steps

• Continuous encouragement and reminders to ensure staff complete the mouth care admission and weekly assessments to implement and imbed the process so it becomes "the norm"

• Empowering people along our mouth care journey to see parity of esteem

• The importance of networking with other NHS trusts and organisations sharing practices and supporting each other

• To continue the motivational drive by engaging with all inpatient areas especially within mental health enabling the project to fully roll out

• To begin rolling the project out within our community setting

• To review and update the Adult inpatient mouth care policy making it relevant to all areas including community