Abstract
Oral mucositis is a devastating side effect of cancer treatment negatively impacting the pediatric patient. An oral care bundle was not set in place on an inpatient oncology unit at a Midwestern children's hospital. Based on a systematic review, Qutob, et al (2013), determined there is good evidential support for the implementation of an oral care protocol. An oral care bundle was developed and includes: toothbrush, toothpaste, floss, two-minute timer, lip balm, an educational plan for patients and staff and an algorithm for nursing should a patient develop oral mucositis. The bundle was distributed to all oncology patients on every admission. An order set was created to link to education for the nursing staff and for nursing to order chlorhexidine mouthwash based on the algorithm created. The nursing documentation in the electronic medical record (EMR) was developed and included: patient received the bundle and was educated on the bundle including the expectations of oral care and prevention of oral mucositis. A chart review was conducted to determine if education was provided to each patient and if the algorithm was utilized should the patient score a nine or greater on the Oral Assessment Guide scale. The oral care bundle was set in place for two weeks for the purpose of this study. Results demonstrated that the order was placed 36.3% of the time, education and the kit were documented by the nurse 13.6% of the time and the algorithm was not utilized during the implementation phase. The oral care bundle will remain in place on the inpatient pediatric oncology unit to improve the effects of oral mucositis. After further implementation the impact on oral mucositis will be evaluated.