A reflection by Samantha King, an MCM National Lead on the completion of Training for 30 U.K. Trusts.
Thinking back to December when Almas Ataie (the other MCM National Lead) and I were starting out our organisational phase of the national roll out, we grouped local trusts together and worked out dates that we could offer for training, finishing in June 2018 which seemed so far off. But we made it and boy it went fast!
Our first training was way back in December, we didn’t really know what to expect, we’ve come a long way from that session; content wise was mostly the same but as presenters we have grown. We learnt it was best to stop swapping around who was presenting so often and so Almas took day 1 in the morning, and I delivered the afternoon session; day 2 was the other way around.
Death by PowerPoint is never a good thing, so we included different methods of teaching, Kahoot always went down well, question and answer sections, hands on practical sessions with products and paper work as well as group training activity.
From every trust we trained we have learnt something new, and from then on shared with the other trusts.
One of my favourite quotes was from a lady called Faye who works at St Georges, “Mouth Care is not Sexy, touching all the fancy equipment in ICU is sexy”. Faye is right, we need to make Mouth Care sexy and get it back up to the top of the agenda.
Up and down the country every trust we have visited is faced with the same issues, lack of staff, lack of time, lack of products and lack of support for staff on the wards. We have now trained over 300 staff who can take what they have learnt back to their trust to champion Mouth Care Matters, but what every trust also needs is a designated Mouth Care Matters Trust Lead.
We learnt about the lack of products on the wards, why does mouth care start at home with a toothbrush and toothpaste yet when a patient enters the hospital foam sponges are used instead? So how are staff supposed to confidently clean a patient’s mouth when all they have is a foam sponge? Or toothbrushes which are more suited to cleaning finger nails than teeth. Staff have reported using paraffin in patient’s mouth to soften secretions because they have no access to dry mouth gels which we feel are a godsend to patients suffering from a dry mouth, which in hospital is nearly all!
With the support from a range of different reps and suppliers we were able to show and demonstrate to trust the range of mouth care products and other useful items we have come across which help make mouth care the best it can be. We have created a useful product guide which can be found here.
We were lucky to have a handful of doctors present over our training sessions; but how are doctors supposed to accurately diagnose conditions of the mouth when they have little to no training about oral conditions? This needs to change. Patients have a top to toe assessment when admitted to hospital, but so often the mouth is not included, it should be high on the agenda like pressure ulcers. Pen torches are a must for all mouth care assessments. If everyone had a pen torch and used that every time mouth care was delivered or the mouth assessed I am sure that there would be less problems on our wards, less patients suffering when that doesn’t need to be the case.
We need to change staff’s attitudes about oral hygiene and remind them its more than just a bit of tooth brushing. All levels of staff need to take responsibility in recognising that issues to do with a patient’s oral hygiene will cause unnecessary suffering and by preventing problems from developing, treating early we can ultimately get our patients back to full health sooner and back home where they should be.
Together we are all responsible for the care we give to our patients.
It comes down to compassion and dignity and every patient should feel like they matter, put yourself in the patient’s shoes, would you be happy if your mouth was like that?
There is still so much more that needs to be done to improve mouth care for our patients on the wards, and in the community and this is what makes me sad. We hope we have created enough buzz to get more people talking about why Mouth Care Matters, we understand that it is an ambitious project and change won’t happen overnight but it’s the start!