Component Task: Complete Mouth Care

This is the act of cleaning the buccal cavity of seriously ill, unconscious patients’ or those who have difficulty utilizing their upper extremities. This procedure is carried out solely by the nurse.

Aims

·         Prevent plaque, unpleasant taste and odour from the mouth

·         Refresh the patient’s mouth and improve appetite

·         Assess the buccal cavity of the patient

·         Keep the lips and mucosa clean, soft, moist and intact

Requirements

A tray containing the following:

·         Two gallipots (for mouth cleaning lotion and cotton wool or gauze)

·         Two receivers (for used swab and return mouth wash)

·         Mouth cleaning lotion (e.g. normal saline, sodium bicarbonate, weak strength of hydrogen peroxide, mouthwash)

·         Padded Spatula

·         Mouth gag

·         Artery, sponge or dressing forceps

·         Dissecting forceps

·         Bowl for dentures if any

·         Lip balm e.g. glycerine or Vaseline

·         Orange sticks (toothpick)

·         Towel and mackintosh

·         Jaconet cape/adult bib

·         A jug of water

Steps

1.        Establish rapport (Refer to steps)

2.      Explain procedure to patient and provide privacy

3.      Perform hand hygiene

4.      Prepare tray and take to the patient’s bedside

5.      Put patient in a suitable position

6.      Protect patient’s bed linen with mackintosh and towel

7.       Protect patient’s neck area with the jaconet cape/adult bib

8.      Use the mouth jag to secure the mouth and position if available

9.      Assess the patient’s mouth with the aid of a padded spatula for any abnormalities and removes dentures if any

10.    Pour lotion into gallipots

11.      Take swab with forceps, dips into cleansing lotion and squeezes out excess

12.    Clean mouth thoroughly but gently i.e. from inside the cheeks, both sides of gums, tongue and palates changing swabs frequently

13.    Control movement of the tongue with padded spatula

14.    Use orange sticks to clean in between teeth

15.    Clean mouth with water or any diluted mouth wash

16.    Clean lips and apply lip balm e.g. vaseline or glycerin

17.    Assist patient to resume desirable position

18.    Dispose off used items, decontaminate, wash and sterilize instruments

19.    Perform hand hygiene

20.  Document procedure and findings (manual or electronic)

21.    Report to appropriate officer