Date completed:___________________________ Variables Resident Resident Resident Resident Resident Resident room # room # room # room # room # room # Oral health care card present Toothpaste present Toothpaste labelled Mouth wash present wash labelled Cup for rinsing the Cup labelled Cup is clean Lip moisturizer Lip moisturizer labelled *Use N/A if not applicable Oral health care card present: ______% Toothpaste present: ______% Toothpaste labelled: ______% (divide number in total column with the number that are present) Mouth wash present: ______% Mouth wash labelled: ______% (divide number in total column with the number that are present) Cup for rinsing present: ______% Cup for rinsing labelled: ______% (divide number in column with the number that are present) Cup for rinsing is clean: ______% (divide number in total column with the number that are present) Lip moisturizer present: ______% Lip moisturizer labelled: ______% (divide number in total column with the number that are present) Oral care practices
Date completed:___________________________ Variables Resident room # Resident room # Resident room # Resident room # Resident room # Resident room # Oral health care card present Toothpaste present Toothpaste labelled Mouth wash present wash labelled Cup for rinsing the Cup labelled Cup is clean Lip moisturizer Lip moisturizer labelled *Use N/A if not applicable Oral health care card present: ______% Toothpaste present: ______% Toothpaste labelled: ______% (divide number in total column with the number that are present) Mouth wash present: ______% Mouth wash labelled: ______% (divide number in total column with the number that are present) Cup for rinsing present: ______% Cup for rinsing labelled: ______% (divide number in column with the number that are present) Cup for rinsing is clean: ______% (divide number in total column with the number that are present) Lip moisturizer present: ______% Lip moisturizer labelled: ______% (divide number in total column with the number that are present) Oral care practices
Oral%20Care%20Auditing%20tool%20v5.docx