Can Nurses' Training and Documentation Audit Improve the Oral Care Practice among Patients Receiving Cancer Treatment? Results from the Pretest-Post-Pest Study

BACKGROUND: Oral complications arising out of radiation therapy and chemotherapy significantly affect the oral health status of patients leading to severe distress. Poor oral health can impair nutritional intake and patient recovery. Trained nurses lack knowledge of oral care of patients receiving cancer treatment. PURPOSE: The study is aimed at training the nurses and conducting a documentation audit to assess the effect of the training on their clinical practice.  Methods: A quantitative research approach was adopted using one group pretest-post-test design to train 72 nurses on oral care of cancer patients working in radiation oncology wards of a tertiary care setting in the southern part of India. After the training program, 80 head and neck cancer patient records were audited to monitor the implementation of oral care. RESULTS: After completing the training program, the knowledge score increased to 13.54 with a mean difference of 4.15 at a p-value <0.001, which indicates that the training was effective, resulting in a gain in knowledge scores. Nurses reported usage of evidence-based intervention, and patient education materials helped them in the clinical practice and a few barriers to oral care practice were identified while implementing the oral care i.e increased frequency of oral care, increased documentation, and time issues. There was poor adherence to the implementation of oral care for cancer patients after the training program, as monitored by a documentation audit. CONCLUSION: Capacity building of the nurses in providing effective oral care of cancer patients will help in improving the standards of cancer nursing practice. An implementation audit of the records would help check adherence to the new oral care practice. A hospital-instituted protocol can result in the effective implementation of the practice change rather than a researcher-introduced protocol.