Congress Abstracts 2006

125

IDENTIFICATION OF AN ORAL ASSESSMENT TOOL AND DEVELOPMENT OF A PATIENT EDUCATION GUIDE TO ORAL MUCOSITIS. Michelle Luke, BSN, RN, OCN^®, Northwestern Memorial Hospital, Chicago, IL.

Oral Mucositis (OM) refers to the inflammation of the mucosa. Incidence of mucositis ranges from 30-40% of patients receiving chemotherapy and increases to 50-80% of those receiving high dose chemotherapy and radiation therapy. Mucositis affects quality of life causing pain, difficulty or inability to eat and/or swallow, infection, decrease or delay in chemotherapy treatment, and in some cases death.

Northwestern Memorial Hospital does not use a standardized Oral Assessment Guide or Tool to assess patients' oral mucosa. Staff nurses were not adequately assessing and educating patients on OM. Adapting an assessment tool into our standard charting regimen would help to identify mucositis in our patients and enable nurses to educate and implement interventions.

Best Practices were identified through review of the literature, which included an Oral Assessment Guide, healthcare education, and patient education. A PowerPoint was created titled "Education Guide to Pathophysiology, Assessment, and Management of Oral Mucositis" to educate staff. Two oral assessment tools were introduced and education was provided to staff on implementation. A trial on the unit by staff nurses of the Oral Assessment Guide (OAG) by June Eilers and the NCI Common Toxicity Criteria Tool were performed. The staff was then given a survey comparing the effectiveness of the two tools. A patient education guide was then created to help increase patient involvement in maintaining proper oral hygiene.

An Evaluation Questionnaire was handed out to staff nurses and a discussion session was held. Data was collected on ease, time, effectiveness, benefits/disadvantages, and improvement of patient outcomes. The majority of staff picked the OAG by J. Eilers due to its ease and effectiveness for a thorough assessment.

Implementing a standard OAG will help to improve patient outcomes. Next steps would include educating all oncology units on properly using the OAG, adapt to online charting system, and continuing to educate staff and patients. The nurses will have the skills to access and implement plans of care and enable patients to take an active role in assessing and maintaining proper oral hygiene. This will help to increase quality of life by helping to decrease pain and better manage infection.