Barriers and strategies in implementation of oral care standards for cancer patients.

Oral complications of cancer therapy include mucositis, oral pain, poor oral intake, infection, bleeding, and difficulty communicating. Use of oral care standards can help manage these problems, but their systematic implementation is relatively rare. The purpose of this paper is to discuss barriers to implementing oral care standards, and to make suggestions for how such standards might be implemented in clinical settings. These purposes are accomplished through a review of relevant literature from various health-care disciplines, and discussion of one institution's implementation of an oral care standard for leukemia and bone marrow/stem cell transplant patients. Key principles underlying this successful institutional effort were recognition of the medical necessity of oral care, collaboration among health-care disciplines, and use of evidence-based practice wherever possible.