This best practice guideline aims to assist nurses working in diverse practice settings provide evidence-based oral health care to adults with special needs. Within the scope of this guideline, those with special needs may include older adults, those who are medically compromised, intellectually challenged, physically challenged, and/or have severe and persistent mental illness. Many may be frail or dependent upon caregivers to help with their activities of daily living. These adults may live in the community or may be in institutions. It should be noted that children have special assessment needs related to developmental stages that are beyond the scope of this guideline.
The guideline will focus on specific vulnerable populations over the age of 18 years (those who need assistance to meet their oral hygiene needs) and will address:
- assessment of oral health (incorporating screening);
- assessment of current oral hygiene practices; and
- interventions (incorporating care plan development).
The goal of this document is to provide nurses with recommendations, based on the best available evidence, to support the provision of oral hygiene care to adults with special needs.
The clinical questions to be addressed by the guideline include:
- What are the risk factors associated with poor oral hygiene?
- What are the current attitudes and beliefs of nurses providing oral hygiene care?
- What are the optimal oral hygiene interventions for oral health in vulnerable populations?
This guideline contains recommendations for Registered Nurses (RNs) and Registered Practical Nurses (RPNs) on best nursing practices in the area of vulnerable adults requiring assistance with their oral hygiene care. It is intended for nurses who are not necessarily experts in this area of practice who work in a variety of practice settings across the continuum of care. It is acknowledged that the individual competencies of nurses varies between nurses and across categories of nursing professionals, and are based on knowledge, skills, attitudes, critical analysis and decision-making that are enhanced over time by experience and education. It is expected that individual nurses will perform only those aspects of oral hygiene interventions for which they have received appropriate education and experience, and that they will seek appropriate consultation in instances where the client’s care needs surpass their ability to act independently