Oral Health Documentation in a Pediatric Cancer Unit at a Children’s HospitalÂ

Abstract

Purpose: Patients hospitalized for cancer and blood disorders have an elevated risk of infection due to immunosuppression during treatment. Damaged oral mucosa can be a direct entry for bacteria and fungus, leading to bloodstream and systemic infections. Oral care documentation measures are essential to understanding and improving oral hygiene practices among these high-risk patients. This quality improvement project aimed to increase oral care documentation among patients hospitalized in the Cancer and Blood Disorders Center (CBDC) to support infection prevention efforts. Methods: An interdisciplinary group of healthcare providers developed and implemented interventions to improve oral care documentation. The dental team developed educational materials for families and certified nursing assistants (CNAs) to improve knowledge and behavior around oral care documentation. The documentation rate for the pre and post intervention groups was analyzed. Results: Forty-seven CNAs (87%) completed the post-education oral care questionnaire. Among them, 33 CNAs (70%) reported using the 3-2-1 poster and encouraging families to use hygiene reminder tools. Fifteen CNAs (32%) indicated they chart oral care twice per shift. Post-intervention data showed a statistically significant improvement in oral care documentation (P = .042); however, overall documentation remained low, with a median rate of 4.3%. Conclusions: Improving oral care documentation requires sustained, systemic changes and long-term interdisciplinary collaboration. While targeted interventions showed some improvement, consistent effort is needed to achieve meaningful and lasting outcomes.