1. What evidence are you proposing to translate into practice?
Daily oral care improves general health and quality of life in geriatric population.
A. Justify that this evidence is “ready for translation.”
Many older adults are able to retain their natural teeth for a longer duration than before. Older adults often walk a fine line between independent and dependent state. When the balance shifts and they become more dependent oral health is significantly affected. Old age, systemic disease, mental health, disability and limited insurance make oral care even more challenging.
It is proven that poor oral hygiene can worsen the impact of systemic diseases. Maintaining good oral hygiene prevents decay, periodontal disease, infection and pain. It also reduced the risk for aspiration pneumonia and fungal infections. It prevents malnourishment and improves general health and quality of life.
B. Identify a single, key behavior change target for your translational activity.
CNA’s work closely with older adults and help them with ADL’s. They are involved in providing direct oral care to the dependent older adults. Training and educating CNA’s
- To deliver daily oral care using effective brushing techniques
- To appropriately use available dental care products
- To identify gross changes in oral cavity
Will improve oral hygiene and quality of life of the dependent older adults.
2. Conduct a “gap analysis” of your target behavior. Look to diverse sources for “best guess” estimates if specific measures are not available.
A. What is the quality (performance) gap?
It is well known that CNA’s are hard pressed on time and have to balance patient care and turnover all the time. They do not have sufficient time to use oral care devices and products appropriately.
B. What is the outcome gap?
In this study we expect that training CNA’s will improve their knowledge and confidence to provide oral care but we are not assessing the patients to notice the actual change in CNA practices.
3. Is there evidence that changing performance will improve health (clinical outcomes)?
There is a strong evidence suggesting that training auxiliary staff improves oral health outcomes and quality of life in older adults. Studies have shown that daily oral care keeps the opportunistic microorganisms under control hence reducing cavity formation, periodontal disease, and systemic and fungal infections.
References:
1. Ageing, dementia and oral health. Foltyn P1.
2.Oral health of older people admitted to hospital for needs assessment. Ling GY, Love RM, MacFadyen EE, Thomson WM.
3.Oral health status among long-term hospitalized adults: a cross sectional study Leon Bilder,1 Nirit Yavnai,2 and Avi Zini3
4. Oral Hygiene Reduces the Mortality from Aspiration Pneumonia in Frail Elders F. Müller1,*
5. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review José Antonio Gil-Montoya,1 Ana Lucia Ferreira de Mello,2 Rocío Barrios,3 Miguel Angel Gonzalez-Moles,4 and Manuel Bravo3
6. The integration of oral health care into day-to-day care in nursing homes: a qualitative study. De Visschere L1, de Baat C, De Meyer L, van der Putten GJ, Peeters B, Söderfelt B, Vanobbergen J.
7. Effect of oral healthcare education on knowledge, attitude and skills of care home nurses: a systematic literature review. de Lugt-Lustig KH1, Vanobbergen JN, van der Putten GJ, De Visschere LM, Schols JM, de Baat C.
8. Oral health-related quality of life among institutionalized patients after dental rehabilitation. Ilhan B1, Cal E, Dündar N, Güneri P, Dağhan S.