Implementation of a hospital oral care protocol and recording of oral mucositis in children receiving cancer treatment
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This retrospective/prospective study was carried out to implement a standardized hospital oral care protocol and record the incidence of oral mucositis for inpatients with childhood cancer.
The implementation process included stages of collaboration, consultation, education, and evaluation. The retrospective part of the study documented the existing hospital oral care protocol and audited medical records of all pediatric patients diagnosed with cancer over a 12-month period. The frequency of recorded oral mucositis and the rate of referral to the pediatric dentistry department were assessed. Following evaluation of the retrospective study, the literature was searched to create a new hospital oral care protocol. Referral to the dental department was standardized and frequent in-service presentations were given to staff. The oral mucositis scale was recorded daily for all inpatients, and compliance rates were assessed.
Fifty-nine patients’ medical records were audited during the retrospective study. Oral mucositis prevalence was clearly documented at 34%, while an additional 20% lacked a definitive diagnosis. During the prospective study, 38 patients were followed and had a verified incidence of oral mucositis of 33%. The rate of compliance of implementing the oral mucositis scale improved from 41% during the first 4 months to 87% during last 3 months. Referral rates to the dental department increased from 53% during the retrospective study to 100% during the prospective study.
Mutual understanding and collaboration between the oncology and dental departments in hospitals is crucial for standardizing patient care and for improving oral care standards.
KeywordsOral care protocol Oral mucositis Childhood cancer Implementation Children Hospital
- 2.Australian Institute of Health and Welfare (AIHW) (2009) A picture of Australia’a children. [PHE 112]. CanberraGoogle Scholar
- 9.Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein EB (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025PubMedCrossRefGoogle Scholar
- 18.Davis ED, Harwood K, Midgett L, Mabrey M, Lien LF (2005) Implementation of a new intravenous insulin method on intermediate-care units in hospitalized patients. Diabetes Educ 31(818–21):823Google Scholar
- 21.van Niekerk, A.C., Venter, D.J., & Boschmans, S.A. (2012) Implementation of intravenous to oral antibiotic switch therapy guidelines in the general medical wards of a tertiary-level hospital in South Africa. J Antimicrob. Chemother 67, 756–762Google Scholar
- 22.(2006) The use of fluorides in Australia: guidelines. Aust. Dent. J 51, 195–199Google Scholar
- 27.World Health Organization (WHO) (1979) Handbook for reporting results of cancer treatment. WHO, GenevaGoogle Scholar
- 32.American Academy of Pediatric Dentistry (AAPD) (2008) Guideline on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation. American Academy of Pediatric Dentistry (AAPD)Google Scholar