P-132\u2005Dry mouth in palliative care, how essential oil mouthwash can help

Abstract

Background Dry mouth is extremely common in palliative care affecting 62% of patients (Otukoya & Doshi, 2018). To try and improve this for our patients a quality improvement programme (QIP) using essential oil mouthwash was agreed. Aim To improve dry mouth for palliative patients using an evidence-based essential oil mouthwash, working in collaboration with medical and complementary therapy staff. Method Precautions of using essential oils orally were identified; Patients were assessed for their suitability to use essential oils; All essential oils needed a safety data sheet and mouthwashes were clearly labelled; Observational study was undertaken 2018–2019; Staff trained to select sample group using validated assessment tool for inclusions (Health Education England: mouth care matters programme), exclusions: ulcers, thrush, patient unable to rinse, sensitive to oils, using oxygen; Qualitative and quantitative data was analysed on day 1,4,8,12; The amount and ingredients were standardised, and a doctor stated dosage and frequency on the patient drug chart; Dryness was scored from 1–10 (1 least –10 highest), and to state any comments. Results Introducing the mouthwash has had a positive impact on patient care. 82 patients were referred across the services. Inpatients 49, Day hospice 9, Out patients 24. 83% of the 82 participants continued stating positive comments compared to 17% who had to withdraw from the study. The average dryness score decreased from 7.4 start day 1 to 3.6 day 12. Positive comments stated, ‘Helps remove the metal taste after chemotherapy’; ‘used at night don’t have a dry mouth in morning’; ‘helped after using inhaler’; ‘refreshing better than others I have used’ and ‘if used before meals able to eat without feeling dry’. Conclusion The results from patient feedback were qualitative and quantitative. Due to the volume of patients referred nurses were trained to prepare the mouthwash. Several hospices, care homes and the local hospital have shown an interest in this QIP due to the benefits patients expressed and want to use it for their patients. The positive impact for this change for our patients mean that we will continue to use the essential oil mouthwash.