Implementation of oral health recommendations into two residential aged care facilities in a regional Australian city

Fallon, Tony and Buikstra, Elizabeth and Cameron, Michelle and Hegney, Desley and Mackenzie, Debra and March, Judith and Moloney, Clint and Pitt, Jacinta (2006) Implementation of oral health recommendations into two residential aged care facilities in a regional Australian city. International Journal of Evidence-Based Health Care, 4 (3). pp. 162-179. ISSN 1479-6988

Abstract

Background: Residents of aged care facilities usually have a large number of oral health problems. Residents who suffer from dementia are at particular risk. A systematic review of the best available evidence with regard to maintaining the oral health of older people with dementia in residential aged care facilities provided a number of recommendations. Objectives: The aim of the implementation project was to introduce evidence-based oral hygiene practices for patients with dementia in two publicly funded residential aged care facilities and monitor for changes in nursing awareness, knowledge, documentation and practice to improve patient outcomes and ensure appropriate accreditation standards were met. An additional aim was to identify barriers and strategies to overcome barriers to implementation of evidence-based recommendations. Methods: Two facilities, a 40-bed facility and a 71-bed facility in the health service district of the regional Australian city of Toowoomba, provided the setting. A quality improvement approach was taken, using a number of strategies from the National Health and Medical Research Council guidelines for implementation studies. The implementation involved a number of stages, including project development, interactive oral health education, oral audits of residents, changes to oral hygiene practice via care plans and critical reflection. Results The multidisciplinary approach to improving oral healthcare appeared to improve knowledge and awareness and move oral health practices in facilities closer to best practice. Specialised training in oral health was provided to a Clinical Nurse Consultant. Regular oral audits were introduced and facility staff were trained in the use of the oral audit tool. Care plans at one facility were of better quality and more comprehensive than before the intervention. Comments made during critical reflection suggested improvements in the oral health of residents, increased use of oral swabs and saliva substitutes, improved care of dentures and mention of the use of mouth props in resident care plans. There was also some evidence that changes brought about by the implementation are sustainable. Conclusion: The majority of recommendations provided in the systematic review of oral healthcare for dementia patients were applicable to the applied context. The importance of day-to-day leaders was highlighted by the apparently varied outcomes across target facilities. The quality improvement approach would appear to have considerable advantages when applied to improving practice in residential aged care.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Deposited in accordance with the copyright policy of the publisher. The definitive version is available at www.blackwell-synergy.
Depositing User: epEditor USQ
Faculty / Department / School: Historic - Faculty of Sciences - Department of Nursing
Date Deposited: 25 Mar 2008 00:31
Last Modified: 02 Jul 2013 22:35
Uncontrolled Keywords: oral health; residential aged care facilities
Fields of Research (FOR2008): 11 Medical and Health Sciences > 1105 Dentistry > 110599 Dentistry not elsewhere classified
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111702 Aged Health Care
11 Medical and Health Sciences > 1110 Nursing > 111001 Aged Care Nursing
Socio-Economic Objective (SEO2008): C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920402 Dental Health
Identification Number or DOI: doi: 10.1111/j.1479-6988.2006.00040.x
URI: http://eprints.usq.edu.au/id/eprint/1025

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