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ACE Nursing Education

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The following article examines oral care issues common at the end of life. Read this article to learn more about your patients' oral care needs at the end of life. Click on the following link to go to the website, print and read the article. Then, print, answer and submit the following test to your manager or educator.

Lippincott's Nursing Center.com – resources for better care

Oral Complications at the End of Life
Constance Dahlin MSN, APRN, BC, PCM
ANJ July 2004 Vol 104(7):40-47

Post Test
  1. Dysphagia is defined as:
    1. Difficulty speaking
    2. Difficulty swallowing food and fluids
    3. Experiencing gas and bloating after eating
    4. Having pain after eating
  2. Signs of dysphagia include (select all that apply)
    1. Excessive throat clearing
    2. Weight loss
    3. Drooling
    4. Shortness of breath during eating
  3. The use of gastrostomy tubes in persons with advanced dementia will
    1. Prevent pneumonia
    2. Prevent aspiration
    3. Prolong life
    4. Add to the quality of life
    5. None of the above
  4. The patient with dementia or with Parkinson's disease may eat better if (select all that apply)
    1. They are given only liquids with a straw
    2. The television is turned off
    3. They are assisted into a side-lying position
    4. Their dentures are removed

The department of internal medicine is developing evidence based clinical protocols which will be available in EPIC (as order sets) for use when admitting patients with these diagnoses. Their AIM is to standardize care and decrease length of stay and readmission rates.

Currently available protocols are:
  • CAP - Community Acquired Pneumonia Orderset
  • Congestive Heart Failure (CHF)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Diabetic Ketoacidosis Adult, ICU
  • General Medicine Admission
  • Immunodeficiency Flow Panel
  • MICU/CCU Admission Order Set
  • Oral Analgesic Medicaitons
  • Parenteral Opioids
  • Sepsis, Adult ICU
  • 111 - Stroke Alert
  • 112 - Stroke Activation
  • 300086 - Stroke Floor Admission
  • 3000000001 -  Stroke Critical care without tPA
  • 300088 Stroke - Transfer from Critical care to floor
  • 3004002 - Stroke Discharge

All protocols can be found in the EPIC order set section.

» For more information

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The department of Internal Medicine has a large role in the Meaningful Use Initiative. Our participation is key for the success of the initiative. Please visit the meaningful use website for important communication and updates from the Meaningful Use Initiative.

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