Mouth Care Matters for Everyone
My name is Sarah Haslam. I am a qualified and registered dental nurse, oral health practitioner, EDDN and dental nurse assessor. I am currently working at my NHS Trust as Mouth Care Nurse. My role is involves delivering mouth care training to medical and nursing teams across the Trust.
My role also involves supporting vulnerable patients in regards to their oral health. This can include mouth care advice, sin posting to a dentist or referring to the community dental team.
In January 2017 I teamed up with my Learning Disabilities Liaison Nurse and we discussed piloting a project looking at the mouth care needs for patients with learning disabilities.
There has been a great deal of evidence to support the fact that people who have a LD do not receive equal health care treatment or a good health service. There are significant unmet health needs that often go unrecognised and this may have an impact upon the person’s quality of life.
The Royal College of Nursing (2013) highlighted that this may be due to a poor diet, poor dental hygiene and the lack of accessible oral health promotion. They also recognise that despite these problems they are less likely to visit their dentist.
I am part of a larger group called Mouth Care Matters. Mouth Care Matters (MCM) is a training initiative aimed at improving the oral health of hospitalised adult MCM is not only about training the nursing staff in a hospital, it is also important for other health care professionals involved in the care of hospitalised patients including doctors, speech and language therapists, dieticians, occupational therapists and pharmacists. Through working together a more holistic approach to patient care, including mouth care, can be formed (HEE 2016).
The aims of the project:
- Investigate how many adults with a LD are admitted to DVH and have mouth care issues
- Raise awareness to patient, their family/carers and staff of the impact of mouth care in relation to general health with patients with a LD
- Advise patient and/or their family/ carer of any necessary referrals to specialist resources in the Community, such as Special Needs Dental Service and the Community LD Team
Some of the objectives were
- On identification of a patient with a LD during admission the LD Liaison Nurse will discuss making a referral to MCM Lead Nurse, with the patient and their family/carer
- MCM Lead Nurse to refer to LD Liaison Nurse if aware of admission of patient who may have a LD but is unknown to the LD Nurse
- MCM Lead Nurse, LD Liaison nurse and ward staff will jointly assess the patient on the ward as part of both Mouth Care Matters and LD Awareness training for staff. This will identify whether the patient has any mouth care issues and enhance skills of staff working with patients who have a LD
Evaluation
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Summary
The project highlighted that there was equal input required by patients with LD whether living independently or receiving support from either family or carers. Input provided by MC Lead following assessment included providing mouth care to patients, training staff in how to complete mouth care assessments, giving oral health advice to patient, family and carers, referring to Community Dental Service for ongoing support following discharge.
Guidance was given by both LDLN and MC Lead to family, carers and staff on how to support mouth care needs of patients who did not comply with mouth care due to presentation of behaviours related to not having capacity in understanding the need for mouth care.
This project showed that mouth care is important for everyone and showed the important role of support from carers and families
References:
- Department of Health: Valuing People Now: a new three year strategy for people with learning disabilities (2009)
- Health Education England. Mouth Care Matters: A guide for hospital healthcare professionals (2016)
- Improving Health and Lives Learning Disabilities Observatory: Health inequalities and people with learning disabilities in the UK (2012)
- Sir Jonathon Michael report: Healthcare for All (2008)
- The Oral Health of Adults with Learning Disabilities in Sheffield (2011)
- NICE Guidance 2012 LD and OH
Contact details:
Sarah Haslam RDN and Oral Health Practitioner
Mouth Care Specialist Nurse
Dartford and Gravesham NHS Trust
Darent Valley Hospital
Dartford
Kent
DA2 8DA
Email: s.haslam@nhs.net
Workforce Development for & with People with Intellectual Disabilities 