PACES in action at St John of God Hospital, Murdoch

$7.95 		PACEsetterS
September 2009 
Volume 6  Number 3
Pages 26 - 27
 
  PDF Version Available!

ABSTRACT
Recently St John of God Hospital Murdoch WA became the first St John of God Hospital to gain endorsement from the Joanna Briggs Institute as an evidence-based hospital. St John of God Murdoch is a 357 bed hospital in the southern suburbs of Perth. In February 2006 the 20 bed, stand-alone Murdoch Community Hospice, as it was previously known, joined St John of God Health Care to become known as St John of God Murdoch Community Hospice. As part of our endorsement and our ongoing commitment to quality improvement and best practice, the Hospice recently undertook a clinical audit using the JBI Practical Application of Clinical Evidence (PACES) tool. The prevention and treatment of oral mucositis in clients with cancer was chosen as a topic, which had the potential to change practice and provide a significant improvement in patient outcomes.Using the three PACES criteria listed in Table 1, Hospice staff led by Tish Morrison Clinical Specialist Nurse Palliative Care, undertook the first audit. Whilst surprised by the poor first audit result, a meeting with key stakeholders found that mouth care was considered well done but that poor documentation and the lack of a formalised mouth care assessment tool were the main contributors to the poor result. Our GRIP (Getting Research Into Practice) action plan identified three key areas for improvement: * Lack of an accepted mouth care assessment tool; * Need for ongoing education; * Need for improved documentation.The first priority was to find a mouth care assessment tool, which used an accepted grading system. St John of God Hospital Subiaco provided a tool which described the four grades of mucositis as defined by the World Health Organisation (WHO). Based on this information, Tish developed a draft Mouth Care Assessment and Care Plan for trial use at the Hospice. She also undertook a significant education campaign for nursing staff to review the audit results, highlight current best practice, identify areas for improvement and

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