Authors (including presenting author) :
Lee WM, Mo YTF, Cheng PS, Chan HYY, Leung CCA, Wong YW, Chan HYJ, Li KY
Affiliation :
Palliative Care Ward, Department of Rehabilitation and Extended Care, TWGHs Wong Tai Sin Hospital
Introduction :
Supporting staff are valuable asset in clinical setting. They play an important role in direct patient care which echo the HA’s core value of “People-centred Care”. As to patient oral care, especially cancer patients, which is crucial and can have physical, psychological and social impact (Davies, 2013; Nakajima, 2017). Being such, the quality of oral care is a very important component for palliative care patients; and a workgroup was formed to develop training program for supporting staff and monitor the quality of oral care performance.
Objectives :
(1) To arouse staff awareness on the importance of oral care; (2) To improve staff skills and competence on oral care; (3) To reinforce People-centered Care when delivering oral care to patient; (4) To highlight the importance of identifying and reporting oral problems; and (5) To consolidate staff knowledge by real case and audit.
Methodology :
An audit form “Care of the Mouth” by CND, KWH was modified with nursing standard to identify the performance of oral care. Two out of eleven items in the audit form were classified as critical criteria. All supporting staff in the palliative care ward were included in a pre and post-test design audit before and after the training.
Result & Outcome :
8 supporting staff participated in the pre-training audit conducted from 28 November to 28 December 2017. There were 12.5% participants forgot to lubricate patient’s lips after oral care and not sure when to perform oral care. All participants performed all critical criteria correctly. After oral care training, post-training audit was conducted from 5 to 22 April 2018. All participants were able to perform a good quality oral care, with all audit items performed correctly. Furthermore, according to the new joined supporting staff, they were acquainted with the knowledge on oral thrush and bleeding in mouth when performing oral care. They appreciated nursing staff for refreshing their awareness and knowledge on oral care. They could refer to hard copy notes anytime if needed. Nurses could easily identify real case for return demonstration and/or case discussion. According to the feedback of staff after the training, their awareness of quality oral care and skill were improved, especially with real case demonstration. It is not just an enhancement or refresher program, but a way to provide an environment for effective communication and performance feedback between nurses and supporting staff. High quality care in palliative care is crucial for patients to maintain their comfort, as well as dignity. For oral care training and auditing, it will be proposed to be included in the new supporting staff training curriculum.