Person-Directed Mouth Care – A QAPI Strategy

May 07, 2014
Laura Beck, The Eden Alternative

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As conversations about QAPI heat up, it becomes exceedingly clear that person-directed practices are a powerful complement to performance improvement.  Person-directed care actually strengthens efforts to improve clinical practice, aligning further with QAPI guidelines.  Take mouth care, for example.  When I first learned about the domino effect of poor mouth care practices, I was floored.  Like so many people, I hadn’t made the connection between poor oral hygiene and the development of life-threatening diseases.

The NY Times shares that approximately one in 10 cases of pneumonia-related deaths in nursing homes could be prevented by improving oral hygiene.  There is also the toll poor mouth care takes on good nutrition and how inflammation in the mouth impacts diabetes and could even lead to heart attacks.

In a University of North Carolina article, UNC School of Social Work Professor Sheryl Zimmerman says, “What people need to understand is that mouth care is not grooming. It’s health care. It’s infection control.” Zimmerman has played a part in a 5 year, $2.5 million study that has brought together researchers from the School of Social Work, Department of Family Medicine, Schools of Public Health and Dentistry and the UNC Center for Infectious Diseases.  The focus of their work has been the impact of better oral hygiene practices on individuals receiving long-term care.

Recognizing that mouth care for individuals living with different physical and cognitive abilities can involve unique challenges, Zimmerman and her colleague Dr. Philip Sloane co-developed “Mouth Care Without a Battle.” By empowering employee and family care partners with person-directed mouth care techniques, everyone wins. Care affirms the individual, since it’s based on each person’s preferences and needs. This results in more relaxed interactions, which support a stronger sense of collaboration between Elder and employee care partners. Set up for success, they work together to achieve the end goal –  excellent mouth care and better overall health.

Like any new change initiative, creating a strategy for improving mouth care practices takes thoughtful attention and planning. Organizations should strive to work smarter, not harder, by creating fully integrated quality improvement approaches that honor quality of life and well-being for all involved.  Instead, the tendency is to think programmatically and compartmentalize quality improvement efforts, which dilute the impact of their divergent strategies and create more work for all.

On Wednesday, May 14th, learn more about integrated quality improvement efforts by checking out “Promoting Mouth Care for Health & Well-Being,” the second event in the Eden Alternative webinar series, Person-Directed Clinical Practice – A QAPI StrategyFeaturing “Mouth Care Without a Battle” co-developer Philip Sloane, MD; Beth Irtz, RN; and Denise Hyde, PharmD, this webinar event highlights the value of person-directed techniques and offers a roadmap for initiating new person-directed mouth care practices via The Eden Alternative’s GROWTH Model.

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