Implementing an Evidence-Based Oral Health Assessment Tool (OHAT) in a Nursing Home
Nyongesa, Nancy Nekesa
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Literature substantiates that there is a relationship between poor oral health and cardiovascular risk, uncontrolled diabetes, aspiration pneumonia, poor nutritional status, and poor social life for the older adults, especially those residing in nursing homes. Recognizing the impact of poor oral health and putting protocols in place to improve oral health status is a safe and cost effective intervention. This Practice Improvement Project (PIP) introduces and pilots a regular oral health assessment system into the care of residents in the nursing home. Four study questions were posed. These questions were: 1) how does an education intervention on the "Importance of Oral Health" increase nursing staff's knowledge of oral health in the elderly; 2) what impact does the use of Oral Health Assessment Tool (OHAT) have on resident assessment, documentation, and referral; 3) what are nursing staff and nurse practitioners' (NP) views of OHAT in assessing a resident's oral health status; 4) How does the brochure "My Mouth is Part and Parcel of My Health" impact the willingness of families to seek dental services for their loved ones living in the nursing home? This project was conducted in four phases. These phases were; 1) introduction of (OHAT) to nurse practitioners, nurses, and resident assistants and educating family members and nursing staff about the importance of oral health; 2) use OHAT for three months to assess oral health status of residents; 3) chart reviews to answer question two; and 4) survey nursing staff about their perceptions of OHAT. A comparison of pre-test versus post-test indicated improved knowledge (p-value <0.0001). During the three-month implementation, there was noted to be more documentation in residents’ charts in relation to oral health. Nursing staff viewed OHAT as an efficient tool to use. In addition, the NP was willing to prescribe OHAT in the nursing home for nursing staff to use. This project highlights that health care providers are willing to learn ways of improving care for residents in nursing homes. The findings support existing literature that increased knowledge about evidenced-based best practices is a factor in better oral health.