18MOUTH CARE: DO WE CARE? A ONE-DAY NATIONAL FLASH AUDIT OF MOUTH CARE PRACTICE IN HOSPITALISED OLDER ADULTS

Abstract

Introduction: Poor oral health is linked to an increase in hospital-acquired infections, longer hospital stays and increased healthcare costs. Plaque and gum disease accumulates during short hospital admissions and most hospitals have no policies for routine oral care practices. Older people are at increased risk of developing medical, physical or cognitive problems that necessitate increased dependence to maintain adequate oral health. Oral care is neglected by nursing staff and is given a low priority compared to other tasks. A recent single-site audit demonstrated only 15% of notes had a documented mouth care assessment. The state of oral health care in hospitals across the UK is relatively unknown. The aim of this study was to assess the: feasibility of conducting a one-day national flash audit using GeMRC (Geriatric Medicine Research Collaborative) network state of mouth care in hospitalised older adults across the UK Method: An audit pro-forma was created and distributed through the GeMRC network. All hospitals nationwide were invited to participate. The national flash-audit day was set as Monday 27th November. Results: Results were received from 15 hospitals nationwide, including 4 separate deaneries. 287 patients were reviewed. 64% of patients had dementia. 46% wore an upper and 34% a lower denture. 61% required assistance with ADLs and 28% were completely dependent. More than half (56%) never had a mouth care assessment during their admission and 27% had no access to a toothbrush/toothpaste. On clinical assessment 34% had damaged lips (5 severe), 42% had a dry/damaged tongue (34 severe), 47% had damaged teeth (3 severe), 16% had damaged gums (4 severe) and 24% had damaged cheeks (2 severe). Conclusions: Using the GeMRC network was an effective way to conduct a national audit and the “one-day” approach was a novel and practical. Learning points included: allowing sufficient time for registration and using clear data collection instructions. Results showed that mouth care is being neglected across UK hospitals. Over 1/3 of individuals had oral health problems, which given the lack of assessments performed, could lead to an increase in hospital acquired infections, distress and costs. The future aim is for the GeMRC network to generate ideas of how to improve mouth care across the UK.