Fighting Infection with a Toothbrush

Posted on May 08, 2018

Patient with Oral Care Bundle

We brush our teeth twice a day, every day with the intention of keeping our mouth healthy. It’s so routine we may hardly notice the habit in our daily schedule.

For kids undergoing cancer treatment, maintaining oral health is so much more than preventing cavities–it can be the difference between staying healthy and fighting off a major infection.

Chemotherapy can be effective in eliminating cancer cells, but it can also cause many side effects. One such effect is inflammation of the mouth, including sores and chapped lips. Areas of broken skin make it easier for bad bacteria to enter the body. This increases the chance of infection.

“The type of bacteria found in and around the mouth can make cancer patients very sick,” explains Debbie Del Favero, D.N.P/E.D., C.P.N., N.E.-B.C., N.E.A.-B.C., senior director of nursing for the Johns Hopkins All Children’s Cancer & Blood Disorders Institute. “If we can prevent that bacteria from reaching the bloodstream, we can keep these kids healthier.”

Leading the charge against these infections are the forward-thinking nurses of the Cancer & Blood Disorders Institute. In cooperation with the Solutions for Patient Safety collaborative, nurses introduced an Oral Care Bundle to patients receiving treatment for cancer.

Every patient family receives standardized education on oral care and the supplies to make it happen. The Oral Care Bundle requires that patients brush their teeth twice a day, use a mouth rinse three times a day and use a lip balm twice a day or as needed. Another component is cryotherapy, which uses cold to help prevent the formation of mouth sores caused by certain types of chemotherapy. Before, during and after receiving the therapy, kids may suck on ice chips, drink ice cold drinks or slushies or eat cold foods like popsicles or ice cream.

Since implementation of the Oral Care Bundle just over a year ago the incidence of these infections within the hematology/oncology unit have fallen more than 50 percent. Though the results so far have been positive, the work is far from over. Data is reviewed and shared with the team on a regular basis to track patient compliance, drill-down on infections that do occur and improve the overall process. Real-time discussions between managers and care team members provide valuable feedback and encourage patient participation.

“This has been an ongoing journey and the initial results are encouraging,” adds Del Favero. “As we continue to work with families on this initiative we hope to see the rate of infection continue to fall.”

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