Preparation and Supervision of Oral Care (Nursing)

00:00 Now let's take a look at the skill of oral care with a bedridden client, kind of like some of those clients we talked about earlier. Now, let's take a look at some things we're going to need like a towel or cloth would be great to have around, an emesis basin for your patient to spit in to, mouthwash, toothbrush, toothpaste, and water. Now before we get started, we're going to perform with our hand hygiene and put on our gloves. Now as always, we want to explain the procedure to our client and make sure they've got privacy. Now any time we start working, we want to raise the bed to the appropriate height for us for working level and also for the patient. Now here's where assessing the oropharyngeal cavity is really important so we want to take a look in there and see if there are any ulcers, maybe any bleeding, any maybe poor dental things that we note in there. So we really want to take a look. Kind of like I talked about earlier, "Is there some hard mucus in there? Is there excess phlegm?" We want to take a moment to assess this. Now, if your patient can do this, we want to encourage them to perform their own oral care. So any time your patient, we can encourage independence it's really best. So we're talking about oral care for a bedridden client. So typically this is something they can do on their own. They may just not be able to get up and down to the bathroom like me or you could. Now, when we're talking about oral care because we're placing something in the oral cavity, place them in a high Fowler's position. Put the overbed table in front of them so that way they've got a table to work on. And then place their water, their toothbrush, their toothpaste, and the emesis basin so they can spit into that if they need to. Now it's always a good idea to mix your mouthwash and your water in a cup. As you know, sometimes that mouthwash can be really strong so mixing that a little bit is a great idea for your patient. Now, if available, put up a mirror for your patient and most of the times there is going to be a mirror in the bedside table for you. So allow your patient to place a mirror and perform their oral care for themselves. Now, don't forget to drape a towel for them so that will help keep their gown clean, and have the client brush their own teeth and gums while observing their technique.

02:24 So we're really here just for assistance and making sure they get in the back of their mouth, their tongue, and thoroughly cleaned their teeth. And after they've done so, have the client rinse their mouth with that water and mouthwash solution and spit that into the emesis basin. After we've completed thorough oral care, we want to make sure we reassess the oropharyngeal cavity for cleanliness. We need to make sure we've got any excess mucus or gunk out of the patient's mouth. Now we want to make sure we return the bed to the lowest position for safety and then make sure we position the client back to a comfortable position.

03:02 And now, we've used all that toothbrush and those emesis basins, we want to make sure we clean these and rinse these for the next use. Now we can remove our gloves, perform our hand hygiene, and then document our procedure. Hi guys, I'm here with my client and I just want to quickly show you how we would assist them in providing oral care for the bedridden client. So again, I've got my client here and one thing to know is he is in a high Fowler's position. So again, any time you're putting anything down someone's mouth, the higher up they are, the least risk of aspiration you have. So again, if they can tolerate it a high Fowler's position is great or a 90-degree. So again, when you're supervising this, you want to promote as much independence as possible. So as much as the patient can do, please allow and help them accordingly. So just to get ready, again my patient's in position, I've got something over the patient's chest so we don't dirty up their gown and I've got their equipment ready. So it's always good to have an emesis basin just so once they brush their teeth they can spit that out here. I've got a cup to mix mouthwash and also water just to dilute it a little bit. I've also got my toothbrush, a washcloth, and the toothpaste as well. So before we get started, even though the patient may be doing this themselves, it's a great idea to assess the oropharyngeal cavity for cleanliness. So I like to take my penlight for example and just have my patient do an ahhhh for me. So I'm going to take a look at their oral cavity now. So once we've done this and the patient's in position, if they can do it we can apply the toothpaste for them if they can't by themselves.

04:49 We're going to also set them up. Now the nice thing is most tray tables are going to have a mirror. So if that's the case, please make sure that's up for your patient. So again, just supervise, make sure they do a thorough job of cleaning their teeth, assist them with any of the supplies they need, and make sure you reassess the oral cavity before you go.