Unit of competency details

Descriptor 

This unit describes the skills and knowledge required by workers to apply and manage use of basic oral health products and provide assistance to clients in the use of those products for oral health care as identified in an individualised oral health care plan and where approved within their designated role

Application 

This unit is intended to address specialised skills and knowledge appropriate for a limited range of health and community services workers whose work roles specifically include the application of identified oral health products in line with legislative, regulatory and jurisdictional requirements, organisation guidelines and standard precautions and excluding the application of fluoride varnish

The work involves implementation of oral or written individualised oral health care plans that have been prepared by or under advice from an appropriate registered health practitioner and ideally an oral health practitioner

Pre-requisite 

This unit must be assessed after achievement of either:

• HLTIN301C Comply with infection control policies and procedures

or

• CHCOHS312B Follow safety procedures for direct care work

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Prepare for and participate in the application of basic oral health care products 

1.1 Identify and comply with organisation guidelines  relating to each product and its administration

1.2 Identify high risk products  and comply with specific guidelines relating to their administration

1.3 Explain product application process and purpose to client  and/or substitute decision maker  in line with product guidelines, oral health care benefits and any potential risks

1.4 Obtain feedback from client to determine that procedure is understood and obtain consent from client or relevant substitute decision maker to undertake process

1.5 Ensure client is positioned as comfortably as possible according to their individual needs

1.6 Prepare products and equipment as required and ensure that product has not expired by checking the expiry date on product

1.7 Ensure all actions are in line with legislative requirements , organisation guidelines, standard precautions  and within own work role

2. Apply basic oral health care products

2.1 Apply product in safe and effective manner in line with oral health care plan  and product guidelines

2.2 Support client to apply own product where able

2.3 Where assistance is required position self  to suit client or situation

2.4 Use appropriate amount of product and apply as recommended in line with oral health care plan

2.5 Ensure application is undertaken using correct applicator at correct location

2.6 Use recommended alternative techniques or arrangements outlined in the oral health care plan in case of client refusal or inability to comply

3. Support oral health  and oral hygiene of clients with special care needs 

3.1 Support client with special care needs in line with oral health care plan

3.2 Be aware of common oral health problems associated with clients with palliative care needs  and take appropriate action in line with their needs

3.3 Be aware of common oral health problems associated with nil by mouth instructions  and take appropriate action in line with client needs

3.4 Be aware of common difficulties associated with dementia that may result in oral health problems  and take appropriate action in line with client needs

3.5 Be aware of common oral side effects of medication  and take appropriate action in line with client needs

3.6 Ensure identified preventive measures  are implemented in line with oral health care plan

4. Complete reporting and documentation according to organisation policies and procedures

4.1 Document and report processes undertaken and any concerns arising during oral health practices

4.2 Maintain and file documentation

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge :

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

These include knowledge of:

• Awareness of the National Oral Health Plan and other relevant state, territory and national government policy and programs
• Basic anatomy and physiology underpinning oral health and hygiene
• Benefits and risks associated with basic oral health products
• Common equipment and aids utilised in the application of oral hygiene products e.g. mouth props
• Factors that impact on oral health, including:

• abuse
• access to services
• accumulation of plaque and calculus
• alcohol, licit and illicit drugs and substances, and over the counter and herbal treatments
• alcohol misuse
• bacteria in dental plaque
• client education
• correct infant feeding practices
• diet and nutrition, including fluids
• fluoride
• general health and wellbeing
• immunosuppressant conditions
• medical history
• oral piercings
• psychological issues, such as fear of being seen without dentures or persisting with ill fitting dentures for satisfaction of others
• salivary function
• smoking
• social and cultural determinants of health
• susceptible tooth surfaces
• transmission of bacteria particularly from parent to child
• trauma, such as from seizures

• Healthy eating recommendations as identified in the National Health and Medical Research Council's (NHMRC) Australian Dietary Guidelines
• Impact of certain health conditions and related treatments on oral health e.g. immunosuppressant conditions, HIV, chemotherapy and radiation
• Individualised oral health care support plans, including terminology
• Occupational health and safety (OHS) issues and procedures, including those related to manual handling and infection control

continued ...

Essential knowledge (contd ):

• Oral disease and broad treatment options available
• Oral health issues for identified high risk sub-populations
• Oral side effects of medications, such as metallic taste in the mouth, dry mouth syndrome and ulcers
• Own work role and responsibilities in oral health care
• Personal safety and security risks associated with provision of oral hygiene care support
• Practical use of oral health products
• Principles and practices in undertaking technical skills associated with the application of oral health products
• Principles and practices of confidentiality, privacy, respect and consent
• Processes and strategies to support people with oral hygiene care needs
• Role of carers in relation to oral health care needs of clients
• Saliva and its role in the maintenance of oral health:

• acting as a lubricant
• delivering calcium, phosphate and fluoride to the tooth surface
• protecting teeth by neutralising acid

• Significance of service setting, including specific contexts, such as providing oral hygiene in a client care setting or in a client's private home
• Signs and symptoms of an allergic reaction
• Specialist oral care and support for clients in circumstances, such as those who:

• are aged
• are on nil by mouth instructions
• are receiving palliative care
• are undergoing chemotherapy
• who have enteral feeding, such as via a nasogastric tube or a percutaneous endoscopic gastrostomy (PEG) tube
• have dementia
• have epilepsy
• have intellectual or physical disability
• have loss of tooth through extraction
• have loss of tooth through injury
• have medical or psychiatric conditions
• have post-surgery or trauma needs

• Strategies to minimise personal safety and security risks associated with provision of oral hygiene care support
• Symptoms and signs that suggest a need for further assessment and/or treatment
• The interaction between oral health and general health

Essential skills :

It is critical that the candidate demonstrate the ability to:

• Adhere to own work role and responsibilities in line with organisation policies and procedures
• Apply identified oral health products (excluding fluoride varnish) safely and effectively in line with product guidelines and oral health care benefits
• Communicate effectively with people requiring application of oral health care products
• Identify and respond to risks associated with the application of oral health care products
• Liaise and report appropriately to supervisor and/or health practitioners
• Make informed observations and report appropriately, including the identification of variations to oral health care support requirements
• Obtain and follow relevant information from an individualised care support plan
• Provide physical and psychosocial support to the person when assisting with oral care needs including, meeting personal preferences, wherever appropriate
• Reflect on and improve own level and application of skills and knowledge to achieve desirable outcomes and maintain own capabilities
• Use processes, aids and equipment appropriately in application of products
• Use relevant technology, including information technology, safely and effectively

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

These include the ability to:

• Apply basic problem solving-skills to resolve problems within organisation protocols
• Apply literacy and numeracy skills required to fulfill work role in a safe manner and as specified by the organisation
• Consistently demonstrate interpersonal skills, including empathy, when relating to people from a range of backgrounds and abilities

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this unit of competency :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• This unit is best assessed in the workplace or in a simulated workplace under the normal range of conditions
• Consistency in performance should consider the particular workplace context

Access and equity considerations :

• All workers in health and community services environments should be aware of access, equity and human rights issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular issues facing Aboriginal and/or Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on Aboriginal and/or Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues relating to factors impacting on Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment :

• This unit can be delivered and assessed independently, however holistic assessment practice with other community services units of competency is encouraged
• Resources required for assessment include:

• access to appropriate workplace where assessment can take place
• simulation of realistic workplace setting

Method of assessment :

• In cases where the learner does not have the opportunity to cover all relevant aspects in the work environment, the remainder should be assessed through realistic simulations, projects, previous relevant experience or oral questioning on 'What if?' scenarios
• Assessment of this unit of competency will include observation of processes and procedures, oral and/or written questioning on essential knowledge and skills and consideration of required attitudes
• Consistency of performance should be demonstrated over a range of relevant workplace conditions

Related units :

• This unit may be assessed independently or in conjunction with other units with associated workplace application

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Basic oral health care products include :

• Products specified in the client's individualised oral health care plan, such as:

• alcohol-free mouthwash
• antibacterial products
• lip moisturiser
• non-medically prescribed therapeutic agents and topical analgesic
• remineralisation products
• saliva substitutes/stimulants:

• chewing gum
• gels
• liquids
• lozenges
• sprays

Organisation guidelines may include but are not limited to :

• Clinical protocols
• Position descriptions
• Workplace policies and procedures, including:

• infection control
• OHS

High risk products may include :

• Pharmacy only products, such as:

• antifungal products
• fluoride gel
• high fluoride toothpaste
• topical anaesthetic

Client refers to those living in the community and /or facilities and may include :

• Children receiving care, including in children's services
• Older persons
• Palliative care clients
• People in care or health facilities
• People with acquired brain injury
• People with dementia
• People with disabilities
• People with mental health issues

Substitute decision maker  (in relation to consent ) must be :

• The person appointed with the right to speak for the client, such as:

• advocate
• carers
• guardians
• health attorneys
• medical power of attorney
• members of family
• other practitioners
• parent of child
• person responsible
• public trustee

Legislative requirements refer to :

• Federal, state or territory legislation that may impact on workers' practices and responsibilities, noting that implementation of the unit of competency must reflect the legislative framework in which a worker operates

Standard precautions refer to infection control and include :

• Washing hands before and after oral care
• Appropriate use of personal protective equipment (PPE):

• gloves
• mask
• eye/facial protection e.g. glasses/face shield
• gown

• Disposal of PPE

Oral health care plan may include :

• A stand-alone individualised oral health care support plan
• Care plan written by an appropriate health practitioner
• Oral hygiene care plan
• Personal care tasks embedded in a wider individualised plan

Position self may include but is not limited to :

• Front position:

• sit client in chair facing you
• if in bed, support their head with pillow
• support client's chin with index finger and thumb without placing pressure on throat
• use thumb holding chin to roll down and hold lower lip for better vision and access
• client mouth to be partly opened to comfortable level

• Stand behind position/head support position:

• stand behind and to the side of client
• rest client's head against side of your body and in the crook of your arm
• support client's chin with your index finger and thumb without placing pressure on throat
• use thumb holding chin to roll down and hold lower lip for better vision and access
• client mouth to be partly opened to comfortable level

Oral health refers to but may not be limited to :

• A person's mouth that has:

• breath without offensive odour
• inflammation and lesion-free soft tissue
• intact and stable teeth without cavities
• moist lips without chapping
• no build up of food, calculus or plaque
• no oral pain
• pink, moist, uncoated tongue
• watery plentiful saliva

• Looking after the whole mouth, including natural and artificial teeth, gums, tongue, lips and inside the cheeks
• Oral health related quality of life factors, such as appearance, social interaction and self-esteem

Special care needs may include but are not limited to :

• Support for clients:

• following loss of tooth through injury
• following loss of tooth through extraction
• post-surgery or trauma
• receiving palliative care
• undergoing chemotherapy
• who are ageing
• who have enteral feeding, such as via a nasogastric tube or a percutaneous endoscopic gastrostomy (PEG) tube
• who have a communication deficit
• who have intellectual or physical disability
• who have medical or psychiatric conditions
• who have nil by mouth instructions
• who have swallowing issues (dysphagia)
• who have dementia

Common oral health problems associated with clients with palliative care needs may include but are not limited to :

• Angular cheilitis
• Candida (thrush)
• Debris
• Dental caries
• Dry mouth and/or lips
• Excessive saliva
• Hairy leukoplakia
• Herpes simplex
• Kaposis sarcomis (HIV patients only)
• Sensitive mouth
• Ulcers, including viral and traumatic

Common oral health problems associated with nil by mouth instructions include but are not limited to :

• affected vocal function
• dry mouth (xerostomia) which can decrease saliva and may result in discomfort
• increased bacteria and decreased protection against bacteria

Common difficulties associated with dementia that may result in oral health problems include but are not limited to :

• Behavioural, such as not eating or drinking water
• Memory difficulties
• Paranoia
• Side effects of medications
• Skill deterioration

Common oral side effects of medication include but are not limited to :

• Dry mouth
• Effects of sugar content
• Excessive saliva
• Metallic taste
• Rash
• Ulcers

Preventive measures include but are not limited to :

• Good hydration
• Oral hygiene as recommended in the oral health care plan, including when unable to wear denture
• Regular observation of oral mucosa