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Research highlights gaps in oral hygiene practice in aged care


Nursing and care staff should undertake regular oral health and hygiene care training based on the Better Oral Health in Residential Care program, a University of Tasmania study has recommended.

University of Tasmania researchers undertook a qualitative study on aged care staff’s experiences of the Better Oral Health in Residential Care (BOHRC) training program, which was rolled out nationally in 2010.

The BOHRC program delivered 400 workshops nationally to almost 5,000 registered nurses from 2,800 facilities.

The program aimed to train two registered nurses from each aged care facility who would then deliver the program to care workers in their respective facilities as part of a train-the-trainer model.

The study, which involved 13 RNs, five enrolled nurses and two care workers, found that eight of the 20 nursing and care staff they interviewed from 13 residential aged care facilities in Tasmania had attended the BOHRC training while the remaining participants were unaware of the program.

One facility had implemented the train-the-trainer model while two participants said the Oral Health Assessment Tool, a resource used in the BOHRC to identify whether a resident required a dental referral, was implemented in their facility.

Dr Ha Hoang

Lead research and University of Tasmania postdoctoral research fellow in oral health Dr Ha Hoang said the effectiveness of the BOHRC training is unknown.

“There have been no evaluations or reports published on the longer-term impact of this training or whether the goals achieved by the program in the short-term have been sustained overtime,” Dr Hoang told AAA.

“It’s possible the program was not sustained because there was too much reliance on the train-the-trainer model with the involvement of staff,” she said.

The study indicates that those who participated in the BOHRC found it useful, however its goals for ongoing training in facilities haven’t been sustained, she said.

Oral hygiene training is included in initial education courses for both personal care workers and nurses, however ongoing training is not mandated, Dr Hoang said.

She said the research found that regular direct care staff need to be provided training and updates on oral hygiene care at their residential aged care facilities on a regular basis.

The study recommends staff undergo oral hygiene training at least every 12 months using content from the BOHRC.

“Providing ongoing oral health education and training for aged care workers is recommended to improve oral hygiene and care for residents so staff can provide oral hygiene to residents, identify oral diseases and refer them for dental treatment if needed,” Dr Hoang said.

Like in the BOHRC rollout, Dr Hoang suggested all aged care facilities appoint an “oral health champion” to support other staff to improve oral hygiene among residents.

“The oral health champion in each facility can be the go-to-person for all staff in terms of oral health questions and information,” she said.

Reaching out to oral health practitioners to educate staff and ensuring there are regular oral hygiene assessments in place are among the other ways providers can improve residents’ oral hygiene and quality of life, she said.

The study was published online in Contemporary Nurse in July.

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2 Responses to Research highlights gaps in oral hygiene practice in aged care

  1. Liz Wilson August 10, 2018 at 11:13 am #

    I have been the impetus for change in several RACF I have worked in over the previous 4 years. Several points of note are made:
    1. The staff turnover and expediency with which appropriately trained care staff are employed is exponential.
    2. The problem lies withi the demand for limited services within an RACF which are often run on as little funding as possible.
    3. Whilst in WA we have Oral health programs to treat residents, the DAA refuses to permit dental Hygienists to practice independently in this state. Having a DH attend each month would certainly go a long way in prevention of health issues through treatment and management of oral hygiene practices. Education of staff can then be mandatory.

    I ran an Oral Health Program for Carers at one RACF with some success, however resources at the time were limited to a program from SA at that time.

    Poor oral hygeine practices has a significant impact upon the older adults general health , notwithstanding the potential for the development of pneumonia and other health issues as a result of this.
    Having a dental health assessment program is like a bandaid approach when the real issue is education of the care staff providing care for this dempgraphic.

  2. Michelle Sletten August 10, 2018 at 2:02 pm #

    Well said Liz Wilson. I am a care worker and I totally agree that oral health is so important. I also believe that we can do it a whole lot better. It would be great to have an Oral Health Program with regular oral training for staff at Facilities and make it mandatory as as good as the online learning is, face to face is always better. I am so thankful to my trainer of my course for teaching me how important oral health is in all the health sectors. Hopefully one day we can all do oral health care better.

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