Oral care training in the basic education of care professionals

Virtual reality-based simulation learning on geriatric oral health care for nursing students: a pilot study

BACKGROUND

There is a great need for training and education in the nursing curriculum to improve nurses' knowledge and skills to provide oral health care.

METHODS

A pilot study was conducted to evaluate the use of a virtual reality (VR)-based Oral Health Care Learning System to train geriatric oral health care among nursing students. Fifty undergraduate nursing students were randomly assigned to experimental (n = 25) and control (n = 25) groups. The experimental group received the VR-based simulation training on geriatric oral health care and the training was implemented twice at two weeks apart from March to November 2021. The control group did not receive the training intervention. Knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adults were assessed at the beginning, second, and fourth weeks. Generalized estimating equations were used to analyze the effectiveness of the VR-based simulation training.

RESULTS

After the first round of training, students in the experimental group had significantly greater improvements in knowledge and self-efficacy of geriatric oral health care than in the control group. After the second round of training, students in the experimental group had significantly greater improvements in knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adult than in the control group.

CONCLUSIONS

The VR-based simulation training was effective to improve undergraduate nursing students' knowledge, attitudes and self-efficacy of geriatric oral health as well as the intention to assist oral health care for older adults. The VR-based simulation learning system is an effective tool to provide practice experiences to build confidence and skills and to bridge the gap of understudied geriatric oral health content in entry-level nursing curricula.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT05248542; registration date 21/02/2022).

Toothbrushing compliance tracking in a nursing home setting using telemonitoring-enabled powered toothbrushes

Introduction Nursing home residents with cognitive and physical disabilities often depend on assistance from caregivers to perform personal hygiene tasks including toothbrushing. Only a minority receives the care needed and toothbrushing compliance levels are not registered.Aims To describe toothbrushing compliance levels in a nursing home setting and investigate the relevance and practicality of using telemonitoring-enabled powered toothbrushes for automated compliance tracking. Furthermore, to investigate changes in plaque and bleeding scores.Materials and methods Nursing home residents were provided with powered toothbrushes and telemonitoring gateways. Toothbrushing frequency and duration were automatically recorded by the telemonitoring gateways, and an email report was sent once a week to the nursing home manager. Plaque index and bleeding index were assessed by dentists at baseline, at the end of the intervention and at three months post-intervention.Results Data from 20 participants for 100 days (3,920 measurements) were collected and used to evaluate toothbrushing compliance. A minority of toothbrushings (5%) were in compliance with the two-minute toothbrushing duration recommendation, while around 30% achieved the one-minute toothbrushing minimum duration recommendation. Around 25% of participants would get only one toothbrushing per day, while 40% would get none. Both plaque and bleeding scores improved significantly during the project, but all progress was lost three months after the project's end.Conclusions It is relevant and practical to monitor toothbrushing compliance in the nursing home setting using telemonitoring-enabled powered toothbrushes. Despite finding limited compliance levels, a significant improvement in the plaque and bleeding index was found after the intervention, which was lost again three months after the telemonitoring gateways had been removed.

Evaluation of an Oral Hygiene Education Program for Staff Providing Long-Term Care Services: A Mixed Methods Study

Background: Oral hygiene is often neglected in clients receiving long-term care, suggesting that long-term care workers require formal oral hygiene education. Thus, the aim of this study was to investigate the effects of oral hygiene education on long-term care workers. Methods: This study utilized a mixed methods design. Eighty long-term care workers were recruited for participation in the oral hygiene education program, which employed three teaching methods: narration with multimedia presentation, demonstration, and teach-back. The effect of the education program on the participants’ level of oral hygiene knowledge, attitudes, and skills was measured using a structured questionnaire that was administered both pre- and post-delivery of the education program. Three months later, all participants submitted a self-report of their oral hygiene skills, and six participants completed a telephone interview. Quantitative data were analyzed using paired t-tests, and qualitative data were manually analyzed and coded. Results: Scores of oral hygiene knowledge (p < 0.001), attitudes (p = 0.001), and oral cleaning daily frequency for clients (p < 0.001), were significantly higher three months after undertaking the educational program. Conclusions: This preliminary study suggests that oral hygiene education may be effective in improving oral hygiene knowledge, attitudes, and skills among long-term care staff.

Effectiveness of a training program for the nursing staff on the oral health of institutionalised aged. Randomised trial

Background: it has been suggested that nursing-staff’ should be educated in maintaining the oral health (OH) of institutionalised elder people. Objective: this work aimed for measuring the effectiveness of a 3-hour oral health training-programme (OHTP) provided to nursing-staff by assessing the residents’ OH gains. Materials and methods: this was a one-year longitudinal-controlled-interventional study evaluated via a nursing-staff’ questionnaire and residents’ oral examinations. Managers of 30 nursing homes in Granada, Spain, were contacted and offered three oral examinations for their residents and an OHTP for the nursing-staff; nine of them consequently agreed to participate for all consenting people. 269 residents were examined at baseline and 12 months. After the baseline examination, the nursing homes were randomised into an intervention or control group; the OHTP was then carried out on the intervention group. Results: the residents’ denture hygiene (p=0.03) and wearing of dentures at night (p=0.003) improved significantly in the intervention group; caries prevalence increased in both groups. Conclusions: the OHTP was effective for improving caregivers’ knowledge and OH care routines, but the improvements were not enough to improve residents’ overall OH.

Oral healthcare education of future nursing personnel and auxiliary nurses

OBJECTIVE

To investigate the oral healthcare training in the education of auxiliary nurses in Norway.

BACKGROUND

Many elderly residents need assistance in every aspect of daily living, including help with oral care. Auxiliary nurses are the professional group who most often provide this help.

MATERIALS AND METHODS

An e-mail administered questionnaire was sent to all 164 high schools in Norway offering basic education for auxiliary nurse.

RESULTS

Of the 114 high schools responding to the survey (69.5% response rate), 83.3% reported mandatory courses, 49.1% offered three or more hours of teaching in oral health care. 89.5% offered both lectures and practical training, 93.9% had training in tooth cleaning, 37.7% lectured about different dental restorations, 50% lectured on ergonomic working positions, 12.3% on the working lights, 16.7% on inspection techniques, 25.4% on interdental brushes and 6.1% on electrical powered toothbrushes. Additionally, 45.6% assessed that their students are prepared for later work with oral health care. More lessons led to better quality of education.

CONCLUSION

Almost all of the high schools had mandatory education in oral care in the auxiliary nurse programme. Increasing the number of lessons may improve the quality of knowledge, but the teaching programmes for a number of topics seem insufficient. There is a need to strengthen the position of oral health in the education of auxiliary nurses. To meet the future challenges in oral health, international or national expert-developed guidelines for oral care training programmes would be useful for the education of auxiliary nurses.

Are the barriers to good oral hygiene in nursing homes within the nurses or the patients?

OBJECTIVE

To explore nursing home patients' oral hygiene and their nurses' assessments of barriers to improvement.

BACKGROUND

In nursing homes, nurses are responsible for patients' oral hygiene.

MATERIALS AND METHODS

This study assessed the oral hygiene of 358 patients in 11 Norwegian nursing homes. 494 nurses in the same nursing homes participated in a questionnaire study.

RESULTS

More than 40% of patients had unacceptable oral hygiene. 'More than 10 teeth' gave OR = 2, 1 (p = 0.013) and 'resist being helped' OR = 2.5 (p = 0.018) for unacceptable oral hygiene. Eighty percent of the nurses believed knowledge of oral health was important, and 9.1% often considered taking care of patients' teeth unpleasant. Half of the nurses reported lack of time to give regular oral care, and 97% experienced resistant behaviour in patients. Resistant behaviour often left oral care undone. Twenty-one percent of the nurses had considered making legal decisions about use of force or restraints to overcome resistance to teeth cleaning.

CONCLUSION

Oral hygiene in the nursing homes needed to be improved. Resistant behaviour is a major barrier. To overcome this barrier nurses' education, organisational strategies to provide more time for oral care, and coping with resistant behaviour in patients are important factors.