Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2024


Doctor of Nursing Practice (DNP)

Primary Advisor

Dr. Joyce Knestrick Ph.D., FNP-BC, FAANP, FAAN


Oral Health; Oral Care; Inpatient Oral Care; Outpatient Oral Care; Education; Policy; Advocacy; Nursing


Background: An increasing lack of compliance by Registered Nurses (RN) to perform oral health assessments leads to detrimental health concerns. Despite increase of evidence regarding abnormalities, compliance performing health exams are still compromised. Inpatient medical surgical progressive care unit (MSPCU) are even more compromised due to the patient’s comorbidities. Measures to optimize oral health performed by RNs could decrease oral health detriments.

Objectives: The purpose of this project was to develop, implement, and evaluate a program in order to improve oral care by RNs and identify the abnormalities assessed. The primary aim of this project was to implement an oral screening program at Kaiser Hospital in the MSPCU inpatient population conducted by nurses.

Methods: A quality improvement (QI) project was to evaluate the effectiveness of the oral screening protocol instituted in MSPCU to improve oral cancer screening and education for RNs to provide the screenings. This project followed a pre-post test design, tracking oral care/assessments done by RNs, and trending abnormalities documented for follow-up referrals.

Results: 11 nurses completed the didactic oral screening educational session with a p-value = 0.139, therefore not statistically significant in changes between the pre and post-test. However, data supports that the program did increase nursing knowledge in oral care and screening. 50 nurses participated in completion of daily oral care and screening education. During the month of October 2023, the least amount of oral screening/care were completed whilst in December 2023 was the greatest amount of oral screenings completed. The Pearson Chi- Square was 45.084, df = 20, with a 2-sided significance of .001, therefore monthly comparisons were statistically significant in improvement of oral screenings over time. However, the results of the screenings found no lesions or abnormalities during this period.

Conclusion: Implementation of an oral screening protocol implicated an increased base knowledge of oral care by RNs, increased screening for abnormalities, and produced increased rates of oral care completion by RNs leading to potential improved health outcomes. The hope is for RNs to continue oral screenings on patients’ hospital wide to improve health outcomes.

Open Access




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