• M J Dodd, P J Larson, S L Dibble, C Miaskowski, D Greenspan, L MacPhail, W W Hauck, S M Paul, R Ignoffo, and G Shiba.
• University of California, San Francisco School of Nursing, USA.
• Oncol Nurs Forum. 1996 Jul 1; 23 (6): 921-7.

Purpose/ObjectivesTo test the effectiveness of a nurse-initiated systematic oral hygiene teaching program-PRO-SELF: Mouth Aware (PSMA)-in conjunction with two mouthwashes (0.12% chlorhexidine or sterile water) in preventing chemotherapy-induced oral mucositis.DesignRandomized, double-blind, placebo-controlled, clinical trial.Settings23 outpatient clinics and office practices in California.Sample222 patients who were starting a cycle of mucositis-inducing chemotherapy.MethodParticipants were followed over three chemotherapy cycles. All patients were provided the PSMA program. Random assignment to a mouthwash occurred prior to the development of oral mucositis. Researchers used the Oral Assessment Guide to assess the patients oral cavities monthly (with the patients cycles of chemotherapy) and when patients reported any oral changes between cycles.Main Research VariablesType of mouthwash, incidence, days to onset, and severity of chemotherapy-induced oral mucositis.FindingsNo significant differences existed between the two mouthwashes in regard to incidence, days to onset, and severity of mucositis.ConclusionsBecause chlorhexidine (S20 per pint) was no more effective than water, a substantial cost savings can be realized by rinsing with water. Interestingly, the PSMA program appeared to reduce the incidence of mucositis from on a prior estimate of 44% to less than 26%.Implications For Nursing PracticeA nursing prescription of a systematic oral hygiene program using water as a mouth rinse is cost efficient and may be effective in preventing oral mucositis.

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