Children s Nursing Oral Hygiene

Transcription

1 This is an official Northern Trust policy and should not be edited in any way Children s Nursing Oral Hygiene Reference Number: NHSCT/10/367 Target audience: Registered nursing staff within the paediatric nursing service Sources of advice in relation to this document: Peter Johnston, Clinical Educator for Community Paediatrics Brenda McConville, Assistant Director Paediatrics Fiona Brown, Head of Children s Nursing Replaces (if appropriate): Legacy Homefirst Protocol on Oral Hygiene Type of Document: Directorate Specific Approved by: Policy, Standards and Guidelines Committee Date Approved: 18 March 2010 Date Issued by Policy Unit: 21 December 2010 NHSCT Mission Statement To provide for all the quality of services we would expect for our families and ourselves

2 Aim To provide registered nurses within the paediatric nursing service:- With an evidence based framework for theoretical and skills based training when delegating nursing care to non registrants With an evidence based framework when undertaking nursing care during their day to day professional role. Responsibilities Assistant Director The Assistant Director for Children s and Related Services has overall responsibility for monitoring the implementation and operation of this policy. Lead Nurse The Lead Nurse in paediatrics has operational responsibility for monitoring the implementation and operation of this policy. Paediatric Clinical Educator The Paediatric Clinical Educator has responsibility for reviewing and updating the children s nursing protocols in line with evidence based practice. Paediatric Nursing Staff The paediatric nursing staff have responsibility to familiarise themselves with the children s nursing protocols of care and utilise them appropriately within their scope of practice. They will also be expected to support the Paediatric Clinical Educator to review protocols of care. Target Audience Registered nursing staff within the paediatric nursing service. Equality, Human Rights and DDA These protocols are purely clinical/technical in nature and will have no bearing in terms of its likely impact on equality of opportunity or good relations for people within the equality and good relations categories. Alternative formats These protocols can be made available on request on disc, larger font, Braille, audio-cassette and in other minority languages to meet the needs of those who are not fluent in English. Sources of Advice in relation to this document The Policy Author, responsible Assistant Director or Director as detailed on the policy title page should be contacted with regard to any queries on the content of this policy.

3 CHILDREN S NURSING PROTOCOL FOR ORAL HYGIENE Name of child DOB / / Statement: Oral hygiene is an essential part of the care of a child. An inadequate fluid intake and poor nutritional status can be predisposing factors for poor oral health. Dietary requirements should be reviewed regularly by a dietician. The aims of mouth care are to:- Keep the mouth and lips clean, moist and intact to prevent infection. Remove food debris and dental plaque Alleviate pain and discomfort Prevent halitosis and freshen the mouth. Oral complications can manifest as pain, ulcers, infection or bleeding. Stomatitis i.e. inflammation of the oral cavity, may be caused by trauma or infection. Children should be registered with a dentist and attend six monthly for check-ups. Flouride drops/tablets to be used as prescribed by dentist. Equipment: Paper tissues Small headed, soft toothbrush Toothpaste Clean bowl Non woven gauze swabs Mouthwash (if prescribed) Gloves and apron ACTION Teeth brushing Explain to child you are going to brush his teeth. Wash hands with warm soapy water and dry. Put on gloves and apron. Using a small toothbrush and toothpaste (pea size amount only) brush child s teeth, gums and tongue. Brush inner and outer aspects of the teeth with firm individual strokes directed outwards from the gums. RATIONALE To ensure understanding of procedure. To reduce the risk of infection. To remove food and dental plaque. Brushing loosens and removes debris trapped in and between the teeth and gums. This minimises the risk of plaque formation and dental caries.

4 ACTION Inspect mouth for oral complications (including presence of loose teeth). Rinse toothbrush in water and clean the teeth again. Allow water to drain from mouth and clean with tissue. Wash hands with warm soapy water and dry. RATIONALE To facilitate early identification and treatment of problems. Rinsing removes loosened debris and toothpaste and makes the mouth taste fresher. IN THE CHILD WITH A REDUCED OR WITH NO SWALLOW REFLEX STAFF SHOULD POSTION THE CHILD TO ENSURE NO FLUID FLOWS TO THE BACK OF THE CHILD S MOUTH To minimise risk of infection. Record care and report any relevant findings to parents and CCN. Mouth care In the case of a child unable to have his/her teeth brushed mouth care may be used Explain to child you are going to clean their mouth. Wash hands with warm soapy water and dry. Put on gloves and apron. Moisten gauze swab in cooled boiled water / cleaning solution (if prescribed) and squeeze out any excess Using the above swab gently clean child s tongue, Buccal cavity and roof of mouth. Allow water/cleaning solution to drain from mouth and clean with tissue. To ensure all children receive appropriate care To ensure understanding of procedure. To reduce the risk of infection. To reduce risk of accidental inhalation of fluid Care should be taken not to cause the child to gag or otherwise be uncomfortable IN THE CHILD WITH A REDUCED OR WITH NO SWALLOW REFLEX STAFF SHOULD POSTION THE CHILD TO ENSURE NO FLUID FLOWS TO THE BACK OF THE CHILD S MOUTH December 2009 NB: Child should participate in brushing his teeth. This will encourage the correct technique and facilitate independence. Oral hygiene should be carried out 2-3 times daily. If you have any concerns contact the parent or Community Children s Nurse

5 Signature. Position.. Date.. Review date Signature Review date Signature Review date Signature

6 CHILDREN S NURSING COMPETENCY FOR ORAL HYGIENE Name of Child DOB / / Performance Criteria Knowledge The carer will be able to: Discuss named child s need for oral care Discuss potential risks of oral hygiene Discuss potential benefits of oral hygiene Taught Date/Sign Competency Assessment Date/Sign Competency Achieved Performance Criteria Skills The carer will be able to: Demonstrate collection of equipment Demonstrate effective teeth brushing Demonstrate effective mouth care Demonstrate effective recording and report as required Demonstrated Dates Practiced Dates Competency Assessment Date I have received training and consider myself competent in all of the above Name: Signature:. Assessor: Qualifications:. Signature: Date:.