Authors (including presenting author) :
Chan HL, Ho SKS, Leung WT
Affiliation :
Department of Medicine & Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals (RTSKH)
Introduction :
Tooth loss is common among older people in Hong Kong. Elderly have less than 20 teeth and that approximately one tenth are edentulous. Most of the older people rely on dental prosthesis (denture) to manage this deficit of tooth loss. Therefore, it is of vital importance to develop practical tips on denture care for patient care betterment especially related to emergency situation.
Objectives :
1. To evaluate nursing staff’s compliance with quality denture care and related oral care for patients.
2. To alert nursing staff on patients who require denture care with the use of signage and proper responses in emergency situation
Methodology :
A new guidelines on “Practical tips on denture care” was developed in the Geriatrics division of RTSKH in March 2021 which aimed to improve the related care for patients, especially to prevent adverse condition caused by the dislodgement of denture during resuscitation Clinical audits were conducted in four geriatric wards in August and December 2021. Patients with denture were checked on the compliance on bedside signage of denture. Nursing staff were observed for proper handling of denture before/ after meal time and for patients with nil by mouth. 3 nurses were selected in each geriatric ward for knowledge assessment on denture care related to admission, discharge, oral hygiene care and emergency situation (Totally 12 nurses).
Result & Outcome :
Outcomes of the audits revealed a continuous improvement in different areas. The average compliance rate of use of bedhead denture signage increased from 40.8% to 71.5% which showed significant improvement in nursing practice. The knowledge test scored of 96.4% and 98.9% in two audits revealed high standard of nursing knowledge in the denture care. It was worth appreciating that nurses had fully adhered to the practice on removal of denture for patients with nil by mouth as compliance rate increased from 83% to 100%. However, there was room for improvement for proper handling denture during meal time. Some improvement observed in the compliance rate of putting on denture before meal and removal denture then stored in the box with water, an increase from 33.3% to 78% & 25% to 50% respectively. We believed the compliance rate would be further improved when nursing staff had more awareness with practical tips on denture care.
Apart from clinical audit, regular training for nurses would be a solid foundation for quality improvement. Although oral hygiene care is basic nursing care, nurses should pay more attention to provide high standard nursing practice to elderlies with denture for quality geriatric service enhancement. Formulation of care plan could be the further direction.
