Barriers and facilitators of oral health care experienced by nursing home staff

Weening-Verbree, Linet; Schuller, Annemarie; Cheung, Sie-Long; Zuidema, Sytse U.; Schans, Cees P. van der; Hobbelen, Hans

doi:10.1016/j.gerinurse.2021.04.012

Cited by 24 publications

(37 citation statements)

References 35 publications

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“…could affect self‐efficacy and attitudes. In Weening‐Verbree's study, the most frequent barriers to providing oral care were lack of support from dental staff, residents with cognitive impairment and lack of education (Weening‐Verbree et al, 2021 ), consistent with results in Göstemeyer's systematic review (Göstemeyer et al, 2019 ). In this study, nurses' self‐efficacy was higher in GCFs established for a shorter time.…”

Section: Discussionsupporting

confidence: 59%

Self‐efficacy and attitudes of nurses providing oral care in geriatric care facilities: A cross‐sectional study in Shanghai

Chen

et al. 2022

Nursing Open

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Oral health is a primary global public health concern, with 46% of the world's population suffering from varying degrees of oral disease (Bernabe et al., 2020). The trend of declining oral function in older people should be especially noted in an ageing society (Lauritano et al., 2019). According to the fourth oral health epidemiological survey report in China in 2017, the number of surviving teeth was 22.5, and the proportion of total edentulousness was 4.5%, periodontal health and oral hygiene were poor among the older persons aged 65-74 years (Yu et al., 2021).Good oral health is a critical factor in healthy ageing, associated with general health, morbidity and mortality in older people (Lauritano et al., 2019). Many studies have reported that oral disease

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Section: Discussionsupporting

confidence: 59%

Self‐efficacy and attitudes of nurses providing oral care in geriatric care facilities: A cross‐sectional study in Shanghai

Chen

et al. 2022

Nursing Open

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“…Consistent with previous studies, providing tools, support, and American Dental Association (ADA) recommended supplies are ways to facilitate the successful implementation of the HAPPEN initiative. [11][12][13] Engaging leadership and providing support to team members is critical to infection prevention efforts 14 and was an important element of the HAPPEN initiative and NV-HAP prevention, leading to better integration into the workflow and access to supplies. Systemwide educational efforts to change provider, staff, and patient and family perceptions, like the highly successful hand washing campaigns of the last decade, were successful in improving buy in and uptake of the HAPPEN intervention.…”

Section: Discussionmentioning

confidence: 99%

A mixed-methods evaluation of the national implementation of the Hospital-Acquired Pneumonia Prevention by Engaging Nurses (HAPPEN) initiative

Stevenson

Munro²,

Klocko³

et al. 2022

Infect. Control Hosp. Epidemiol.

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Objective: To describe healthcare provider, veteran, and organizational barriers to, challenges to, and facilitators of implementation of the oral care Hospital-Acquired Pneumonia Prevention by Engaging Nurses (HAPPEN) initiative to prevent non–ventilator-associated hospital-acquired pneumonia (NV-HAP). Design: Concurrent mixed methods. Qualitative interviews of staff and patients were conducted in addition to a larger survey of VA employees regarding implementation. Setting: Medical surgical or extended care units in 6 high-complexity (01a–c) VA hospitals. Participants: Between January 2020 and February 2021, we interviewed 7 staff and 7 veterans, and we received survey responses from 91 staff. Intervention: Provide education, support, and oral care supplies to prevent NV-HAP. Results: Barriers to HAPPEN implementation and tracking at the pilot sites included maintaining oral care supplies and completion of oral care documentation. Facilitators for HAPPEN implementation included development of supportive formal and informal nurse leaders, staff engagement, and shared beliefs in the importance of care quality and infection prevention. Nurses worked together as a team to provide consistent oral care. Oral care was viewed as an essential infection control practice (not just “a task”) and was considered part of the “culture” and “mission” in caring for veterans. Conclusions: Nurse leaders and direct-care staff were engaged throughout HAPPEN implementation, and most reported feeling supported and well prepared as they walked through the steps. Veterans reported positive experiences and increased knowledge about prevention of pneumonia. Lessons learned included building a community of practice and sharing expertise, which led to the successful replication of the HAPPEN initiative nationwide, improving patient safety and care quality and influencing health policy.

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“…To assess the attitudes and knowledge of home care nurses, a questionnaire ( File S1 ; in Dutch) was developed prior to the start of the OCP; it was based on previous questionnaires and current guidelines for oral care [ 25 , 34 , 35 , 36 ]. The questionnaire included questions about the (educational) background of the home care nurses, their opinion about performing or supporting clients with oral care and oral care materials.…”

Section: Methodsmentioning

confidence: 99%

“…To evaluate the level of implementation, we used the measurement instrument for determinants of interventions (MIDI) of Fleuren et al [ 33 ]. To assess the attitude and knowledge of home care nurses, a questionnaire ( File S1 ) was developed prior to the start of the OCP based on previous questionnaires and current guidelines for oral care [ 25 , 34 , 35 , 36 ]. To assess oral (self) care and the performance of daily oral hygiene, a questionnaire (File S2) was compiled with items that derived from the national guidelines for daily oral hygiene [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of an Oral Care Program to Improve the Oral Health of Home-Dwelling Older People

Weening-Verbree

Schuller

Zuidema

et al. 2022

IJERPH

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The aim of this study was to evaluate the impact of the implementation of an Oral Care Program on home care nurses’ attitudes and knowledge about oral health (care) and the impact on older people’s oral health. A pre–post study, without a control group, was conducted. A preventive Oral Care Program (OCP) was designed, focusing on home care nurses and older people, in collaboration with dental hygienists. Implementation was measured with questionnaires at baseline and after 6 months for home care nurses; for older people, implementation was measured at baseline and after 3 months with the Oral Health Assessment Tool and a questionnaire about oral (self) care between January 2018 and September 2019. Although the study design has limitations, the oral health of older people improved significantly after 3 months and the OCP was most beneficial for people with full dentures. The OCP improved knowledge and attitude of home care nurses. The program fitted well with the daily work routines of home care nurses. Individual-centered care plans for older people, education of home care nurses and the expertise of the dental hygienists have added value in home care nursing. Future implementations should focus on older people with natural teeth.

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Barriers and facilitators of oral health care experienced by nursing home staff

Cited by 24 publications

References 35 publications

Self‐efficacy and attitudes of nurses providing oral care in geriatric care facilities: A cross‐sectional study in Shanghai

Self‐efficacy and attitudes of nurses providing oral care in geriatric care facilities: A cross‐sectional study in Shanghai

A mixed-methods evaluation of the national implementation of the Hospital-Acquired Pneumonia Prevention by Engaging Nurses (HAPPEN) initiative

Evaluation of an Oral Care Program to Improve the Oral Health of Home-Dwelling Older People

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