Oral care is an important element of care for older people in care homes as oral health is often poor and can deteriorate rapidly causing pain discomfort and impacting on nutrition and quality of life. With growing numbers of older people this is an area of increasing demand. This aim of the review was to assess article the literature on the effect of providing oral healthcare education to care home nurses on their oral healthcare knowledge and attitude and their oral hygiene care skills.
The databases Medline, Web of Science, Cochrane library, Embase and CINHAL were searched from 1990-2011. Only articles with regard to care home residents of 65 years and older were eligible. Study selection and grading of evidence and data extraction was carried out independently by two reviewers.
- 14 studies were initially selected, with 7 being summarised qualitatively. 3 were randomised controlled trials, 2 describing different elements of the same study. Of the remaining studies 2 were cross-sectional, 1 quasi-experimental and the final one longitudinal
- The studies revealed some scientific evidence and indications that an oral healthcare education programme for care home nurses may improve the nurses’ oral healthcare knowledge and attitude. Any effect of oral healthcare education to care home nurses’ oral hygiene care skills could not be determined.
The authors concluded
Oral healthcare education may have a positive effect on care home nurses’ oral health- care knowledge and attitude and on care home residents’ oral hygiene. Scientific evidence for the potential association between oral healthcare education of care home nurses and improvement in their oral hygiene care skills could not be found.
Comment
This review could only find a limited amount of poor quality evidence on which to address this question. The searches for the review were limited to just a twenty year period which may have been an appropriate times scale given the increase in interest in the care of older people. Since the date of the last search for this review at least one small randomised controlled trial has been carried out (Dental Elf- Oct 9th 2012). Inconsistency in training is one issue raised by the authors in the discussion as a potential factor and readers might find the training support pack for this group of patients developed by NHS Scotland (Caring for Smiles) of interest.
Links
de Lugt-Lustig KH, Vanobbergen JN, van der Putten GJ, De Visschere LM, Schols JM, de Baat C. Effect of oral healthcare education on knowledge, attitude and skills of care home nurses: a systematic literature review. Community Dent Oral Epidemiol. 2013 Jul 30. doi: 10.1111/cdoe.12063. [Epub ahead of print] PubMed PMID: 23895301.
The issue with Caring for Smiles has been getting care home workers to attend training. Not unusual for OHE to attend a care home which has 30-40 members of staff to see only a couple of members of staff released for training. we are competing for a limited resource, staff time, when there are already a number of demands for statuary training.
The FAI of Mrs McGaw spiked interest briefly but has returned to its usual level.
Interesting to attend care home managers meeting when they all pay lip service to staff attending training when you have direct experience of how many staff actually attend.
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