The standard protocol might be used to make sure that all nurses are implementing oral care and following the same steps during implementation, however, there are no specific tools provided in the guideline on how to put the recommendation into practice. Therefore, this project will apply the modified Beck Oral Assessment Scale and oral care policy as a useful tool to ensure a higher quality of oral hygiene is implemented(appendix1&2). However, this scale does not assess the ability to swallow or voice quality . According to Holmes and Mountain (1993), it is difficult to assess the tool of validity and reliability because of the mouth condition change unexpectedly, limiting the ability to deliver reproducible results. Oral care policy is clear
