Introducing Standardized Assessment and Management of Oral Cares in a Rehabilitation Unit: Patient Outcomes and Experiences.

PURPOSE: The aim of this study was to improve patient oral hygiene outcomes in a rehabilitation unit by implementing a nursing education package and oral hygiene assessment tool. DESIGN: A case-control design with 50 rehabilitation patients was performed. METHODS: Nursing staff received education and training in applying the Modified Oral Health Assessment Tool. Clinician assessment of patient oral hygiene occurred on admission and at days 5-7. Each patient reported their perceptions of oral hygiene and comfort prior to hospitalization, while in the hospital, and after transfer to the rehabilitation unit. FINDINGS: Oral hygiene rating scores improved significantly from admission to the rehabilitation unit to days 5-7 (p = .00). The mean score of patient perceived cleanliness improved from hospital admission to admission to the rehabilitation unit. CONCLUSION: Oral hygiene was improved following admission to a rehabilitation unit with a consistent and individualized approach to oral hygiene. CLINICAL RELEVANCE: The introduction of a consistent and individualized approach to oral hygiene demonstrates positive patient outcomes and high patient acceptance.

External validation of the Rapid Assessment Prioritisation and Referral Tool for multidisciplinary teams in medical assessment and planning units.

OBJECTIVE: The Rapid Assessment Prioritisation and Referral Tool (RAPaRT) was developed for identifying appropriate referrals to allied members of the multidisciplinary team in hospital medical assessment and planning units (MAPUs). This study examined the performance of the RAPaRT for identifying appropriate referrals as well as predicting requirement for admission to hospital and length of stay. METHODS: A prospective cohort study was conducted. The RAPaRT, inclusive of seven mandatory items, was completed by nurses for 195 patients presenting to a hospital ED and assessed in a MAPU external to the instrument development site. Members of the multidisciplinary team (dietetics, occupational therapy, physiotherapy, social work and speech pathology) assessed participants to determine whether a referral to their profession was warranted and this was compared to RAPaRT responses. RESULTS: All health professionals reviewed n = 175/195 (90%) participants, with n = 117/195 (60%) considered appropriate for referral to an allied health professional. At least one positive response to the RAPaRT items was recorded for n = 123 (63%) participants. Patterns of sensitivity and specificity for each item, and the instrument as a whole were consistent with the development study. The RAPaRT also predicted which patients required admission to an acute hospital ward (odds ratio = 1.22; 95% CI 1.01, 1.47) and their length of stay in hospital (coefficient = 0.18; 95% CI 0.14, 0.22). CONCLUSION: Findings supported the external validation of the RAPaRT. In addition, this investigation made a novel contribution in demonstrating that positive RAPaRT responses were associated with requirement for admission to an acute hospital ward and length of stay.