Introduction Mouth care is essential to provide comfort for the dying patient. Good oral care (assessment, planning and delivery) is underpinned by healthcare professionals' (HCPs) knowledge and utilisation of appropriate tools and care plans. A multi-phase study was commenced within a 16 bed inpatient unit to ascertain factors impeding nursing practice, which staff had felt to be suboptimal.

Method In phase 1, qualitative data were collected from 42 HCPs in a survey comprising 14 open questions and thematic analysis applied. The survey asked HCPs' knowledge, current practice and ideas on improving oral care. Following this an assessment tool, care plan and a purposefully designed product guide were introduced. In phase 2, a second survey reanalysed HCPs' knowledge acquired after implementation of the tools. The Royal Marsden Manual (2008) was used as a point of reference during both phases.

Findings Phase 1 found that 95% of respondents understood the aims of good mouth care, factors leading to poor oral health (reduced oral intake (75%), poor oral hygiene (65%) and medication (45%)) and actions to be taken if problems were suspected (70%). However procedural knowledge of oral assessment was poor and use of assessment tool/s deficient. 90% of respondents failed to identify half the recommended equipment for assembling an oral care tray. Following introduction of the tools, phase 2 survey showed HCPs' knowledge had increased, and patients had benefitted.

Conclusion Although collectively some responses in phase 1 appeared good, on an individual basis findings showed HCPs' knowledge was suboptimal. Phase 2 showed that the introduction of the assessment tool, care plan and product guide, had increased HCPs' knowledge and confidence. Consequently patients routinely experienced higher quality care, now evidenced in the revised documentation.