Infusing oral health care into nursing curriculum: addressing preventive health in aging and disability

Impact of oral health management by nurses and dental professionals on oral health status in inpatients eligible for the Nutrition Support Team: A longitudinal study

OBJECTIVE

As the participation of dental professionals in multidisciplinary care is often limited, instructions on oral health management provided by dental professionals to other professionals are important to achieve transdisciplinary oral health management; however, the effectiveness of such instructions remains unclear. In this longitudinal study, we aimed to determine the impact of oral health management provided by dental professionals and nurses instructed on oral health management by dental professionals on the oral health of inpatients eligible for a Nurition Support Team (NST).

METHODS

The study participants were 117 patients (66 men and 51 women, mean age: 71.9 ± 12.5 years) who received oral health management during the NST intervention period. The participants received oral health management from nurses (Ns group) or dental professionals (D group). The nurses who conducted the oral health management received instructions from dental professionals. Oral health was assessed at the beginning and end of the NST intervention using the Oral Health Assessment Tool (OHAT).

RESULT

The Ns and D groups showed significant improvements in the total OHAT scores at the end of the NST intervention. Both groups showed significant improvements in the OHAT subitems of lip, tongue, gums and tissues, saliva, oral cleanliness and dental pain, while only the D group showed a significant improvement in the denture subitem.

CONCLUSION

Effective oral health management provided by dental professionals or by nurses trained by them improved the oral health status of inpatients eligible for NST at an acute-care hospital.

Health professionals' education related to people with intellectual and developmental disabilities: A scoping review

BACKGROUND

People with intellectual and developmental disabilities are among the most underserved in an inequitable healthcare system.

METHODS

Using Arksey and O'Malley's methodology and a social determinants of health framework, we conducted a scoping review of literature on the state of practice in education of healthcare professionals in the health and healthcare needs of this population.

RESULTS

Searches found 4948 articles, with 182 included in the final review. Themes identified included gaps of not being informed by workforce needs, continued use of the medical model of care, not addressing intersectionality with racial/ethnic and other discriminations, and lack of involvement of the population in developing/evaluating programs and promising trends of development of competency-based interprofessional programs with experiential learning.

CONCLUSION

We provide recommendations for best practices in a concerted effort to educate a healthcare workforce equipped with the knowledge and skills to address the health needs of this population.

Nurses' educational needs in the oral health of inpatients at Yazd Province in Iran: a Delphi study

Background

Oral hygiene is an integral part of general health of a person. Nurses qualified about oral care can play an important role in improving the quality of oral health in hospitalized patients. This study investigated the educational needs of nurses in the field of oral health of hospitalized patients.

Methods

The study used the modified Delphi method in three rounds. Fifty faculty members of the School of Dentistry and Nursing were selected via purposive sampling. The data collection tool was a demographic form and an open-ended questionnaire in the first round and a structured questionnaire in the next rounds. The analysis was performed using both content and descriptive analysis techniques.

Results

The top ten oral health education priorities for nurses were greater than 75% with a consensus level: oral anatomy and physiology, learning the signs and symptoms of common oral diseases, learning of oral medications and administration, learning the drugs that cause damage to the mouth and teeth, training in managing dental emergencies, patient education for tooth brushing and taking care of the mouth, especially in the elderly patient, providing oral and dental care, training for unconscious and fasting patients, undergoing chemotherapy and radiotherapy, and hospitalization in intensive care unit.

Conclusion

The findings of the study emphasized the need for interdisciplinary cooperation between nursing and dental professionals for the development of an oral health curriculum for nurses to promote and improve oral health and prevent dental diseases in hospitalized patients and the community.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-020-00517-8.

The impact of multicomponent programmes on balance and fall reduction in adults with intellectual disabilities: a randomised trial

BACKGROUND

One challenge a modern society faces is this: providing those vulnerable and ageing groups of adults who have intellectual disabilities with appropriate support for improving static and dynamic balance. Balance is a crucial component of physical fitness and, consequently, of fall reduction and prevention. The aim of the present randomised controlled trial was to evaluate the efficacy, after 16 weeks, that three different Special Olympics physical activity programmes had on balance and on fall reduction in adults with intellectual disabilities.

METHOD

A convenience sample of 150 persons with mild and moderate intellectual disabilities was recruited from the accessible Special Olympics Slovenia population of physically inactive adults with intellectual disabilities. The sample was randomised to the experimental group 1 (multicomponent balance-specific exercise programme group with additional workshops on such social gerontology topics as active and healthy ageing; N = 50), the experimental group 2 (multicomponent wellness programme group; N = 50) and a control group (regular Special Olympics athletic training; N = 50).

RESULTS

Significant differences were found between groups in the balance scores throughout the study period and in the ability to decrease fall frequency.

CONCLUSIONS

Balance assessment is a high predictor of frequency of falls, and among adults with intellectual disabilities, it significantly correlates with exercise. The results indicate that a multicomponent balance-specific exercise programme with a significant sociogerontological component on active ageing could be a useful intervention for intellectually disabled adults who have poor balance and who experience frequent falls.

Implementing and evaluating the effectiveness of an oral health module for the bachelor of midwifery program at an Australian university

OBJECTIVE

Although guidelines recommend antenatal care providers such as midwives promote oral health during pregnancy, oral health training is not routinely provided in undergraduate midwifery curricula. The aim of this study was to implement an oral health module into an Australian undergraduate midwifery program, and evaluate its effectiveness in improving the oral health knowledge and confidence of midwifery students.

DESIGN

Pre-test post-test study (2015-2017).

SETTING

An undergraduate midwifery program within an Australian university.

PARTICIPANTS

All first-year undergraduate midwifery students enrolled in two core units at the above university (N = 56).

METHODS

Oral health modules were implemented into each of the two core units within the first year of the Bachelor of Midwifery course. Changes in knowledge and confidence were measured using a standardised questionnaire, administered at baseline, immediately following module completion, and at 2 and 3 years following module completion.

RESULTS

44 students participated in the baseline survey (79% response rate), of which 41 completed the first post-module questionnaire, 21 completed the second post-questionnaire, and 24 completed the third post-questionnaire. Knowledge scores significantly increased from baseline (mean 13.12) to follow-up (mean 17.78, p < 0.001), with increases being retained through to the 3-year mark (mean 18.29, p < 0.001). Confidence scores also showed a sustained increase following the module, particularly regarding introducing oral health in the first antenatal appointment (62.1% increase, p < 0.001) and referring pregnant women to a dentist (48.2% increase, p < 0.001). However, the 48.2% increase (p < 0.001) in confidence in conducting a visual mouth check on a pregnant woman following the module was not sustained at subsequent time points, reducing to a 31.5% increase (p = 0.118) by the third year post-module.

CONCLUSIONS

The module is effective in improving and sustaining the knowledge and confidence of midwifery students to promote maternal oral health. Ongoing updates may be required to keep confidence high regarding visual mouth checks.

Evaluating student learning outcomes in oral health knowledge and skills

AIMS AND OBJECTIVES

To evaluate whether a set of oral health resources designed for workforce training was relevant for students undertaking an entry-level nursing or aged care qualification.

BACKGROUND

Oral health is one of the most neglected aspects of nursing care experienced by older people. Despite efforts to improve aged care worker oral health knowledge and skills, one-off training and rapid staff turnover have hindered the success of workplace programmes. Inadequate oral health content in entry-level nursing and aged care qualifications has perpetuated this.

DESIGN

Kirkpatrick's training and evaluation model was used to evaluate the resources developed by a project called Building Better Oral Health Communities. Students used them as prescribed study materials and completed pre- and postintervention questionnaires. Educators were interviewed to obtain their feedback. Quantitative data were analysed using descriptive and inferential statistics. Qualitative data were collated according to relevance to learning, presentation style and interest.

RESULTS

Evaluation showed high levels of student and educator satisfaction. Student learning outcomes demonstrated consistently positive attitudes and significant self-reported improvements in oral health knowledge and skills. Irrespective of course type, students gained similar levels of oral health knowledge and skills following use of the resources.

CONCLUSION

Nurses and care workers must be able to provide consistent standards of oral health care as a fundamental part of caring for patients. Validated as an effective learning and teaching package, it is recommended that these resources be used to strengthen the oral health content of entry-level nursing and aged care qualifications.

RELEVANCE TO CLINICAL PRACTICE

Building the oral health capacity of nurses and care workers is one way of reversing oral health neglect and improving the quality of care provided to older people.

Oral health knowledge and psychological determinants of oral health behavior of nursing students

This survey examined the oral health knowledge and psychological determinants of oral health behavior of 1019 undergraduate and postgraduate nursing students. Overall, most of the students perceived their oral health to be average, and their flossing and dental visiting frequencies were inadequate. Moreover, the students' oral health knowledge was suboptimal, regardless of the type of study, and it was not significantly associated with oral health behavior. Binary logistic regression showed that toothbrushing self-efficacy and the type of study were both significantly associated with toothbrushing behavior. Furthermore, flossing self-efficacy and dental visiting self-efficacy were both significantly associated with flossing and dental visiting behaviors, respectively.

Integrating a primary oral health care approach in the dental curriculum: a Tanzanian experience

This paper is based on a conference presentation made during the inauguration of the Faculty of Dentistry, Kuwait University, as a World Health Organization Collaborating Centre for Primary Oral Health Care (POHC) on November 27-28, 2012. The aim of this paper is to review how the POHC approach has been integrated into the dental curriculum, sharing the Tanzanian experience as a case presentation from a developing country. The burden of oral diseases worldwide is high, and the current oral health workforce is inadequate to meet the challenges. Curative oral health care is very costly and not accessible to the poor and minorities. To tackle the problem, the POHC approach rooted in primary health care that emphasizes equity, community involvement, prevention, appropriate technology and a multi-sectorial approach was developed and has been operating for more than 3 decades now. Execution of a comprehensive POHC requires a trained oral health workforce mix with essential competencies. For this case study, a literature search was done using the search engines subscribed to by the library of Muhimbili University of Health and Allied Sciences, including PubMed, Cochrane, ScienceDirect and Scopus, Wiley-Blackwell Interscience, Sage and the Health InterNetwork Access to Research Initiative (HINARI) that gives access to Scirus and Google Scholar. Challenges are discussed with an emphasis more on addressing the common risk factors and determinants of oral health. Integration of the POHC approach in the dental curriculum for training a competent workforce is crucial in attaining better oral health. Resources are still a major challenge, and the impact of the POHC approach in the curriculum is yet to be evaluated.