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Identify Oral Care portal captures records of your dental treatment every time you walk into a clinic.
Dental cavities and poor oral hygiene being a mass problem, irrespective of social status, we conduct oral awareness sessions and drives in gamified form at corporate houses. Identify Oral Care aims at creating an eco system to promote oral health among individuals & families. Identify Oral Care also runs Muskaan Community with an intent to create awareness about importance of maintaining good oral health. Understanding the need of awareness and quality dental care, the company has empaneled the dental clinics after performing intense quality checks. AbstractAim To evaluate care home (N) staff knowledge of oral care provision for dependent older people in comparison to guidelines from NHS Quality Improvement Scotland (NHSQIS). IntroductionThe 'elderly support ratio' can be defined as the total number of working age citizens within a population divided by the number of people at pensionable age.
MethodsInitial assessment of attitudes to and knowledge of oral care provisionThirty-three care homes (N) within the Greater Glasgow & Clyde region were randomly selected by an internet search engine. Responsibility of healthcare givers in delivering oral careNurses recruited to this study were differentiated from carers and defined as individuals registered with The Nursing and Midwifery Council. Training in oral health measuresOf those surveyed, 57% (n = 16) of managers and 49% (n = 39) of nurses stated they had been trained in delivering oral care.
Potential barriers to oral care trainingThe most common barriers to care home (N) managers not receiving appropriate training in oral care provision were the lack of availability for this in the home in which they worked (85%, n = 11) or that oral care had not been covered in their university or college course (15%, n = 2) (Fig.
Group statistics performed on collected data did not reveal any statistically significant differences between nursing or manager groups for responses regarding attitudes, knowledge, competence or confidence in oral care procedures. Knowledge of oral healthcare provisionPrior to OHE training, the overall score for staff knowledge of oral care procedures was a mean of 42%. DiscussionNot only is good oral health important for quality of life, but it is also associated with general health. ConclusionThis investigation has identified that there continues to be inadequate training of staff within care homes (N) in the provision of appropriate oral care to the elderly population utilising such facilities.
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As per World Health Organization (WHO) reports, nearly 95% of adults in India suffer from oral disease and close to 70% of school going children have dental caries or some other oral problems.
The community runs various health awareness programs in educational institutions, government organizations, corporates and social gatherings. Through this panel of clinics, the patients are offered quality treatment at subsidized rates. A letter was posted to these homes (Appendix 1) inviting staff to participate in this pilot study. Initial assessment of attitudes towards and knowledge of oral care provisionOf the 33 care homes (N) invited to take part in the study, 28 participated in data gathering.
When asked which members of the care home (N) team, excluding nursing personnel, were primarily responsible for providing oral care (Fig. The majority of managers indicated they had received their training in the form of undergraduate lectures (38%, n = 9). As such, a manager with a poor knowledge or attitude towards oral care was likely to have nurses with a similarly poor knowledge and attitude within their team.B.
Poor oral care is a widely recognised problem and if left unattended, may have wider health implications.
There was poor dissemination of the NHSQIS best practice statement Working with dependent older people to achieve good oral health, and a lack of knowledge towards the content of this document. Through these activities we make attempts to educate people on importance of good oral health. A 'knowledge check-list' founded upon daily oral care guidelines from the NHSQIS best practice statement (BPS) served as a template for knowledge assessment.
The letter introduced the project and established arrangements for administering an interview schedule with three members of nursing care staff and the manager of each home.
Other forms of training included undergraduate practical lessons (25%, n = 6) or from a dentist (13%, n = 3, Fig. Sub-group assessment following OHE interventionFollowing data collection from all study participants, sub-group data analysis was undertaken on eight care homes (N) comprising 24 staff. These include predisposition to conditions such as staphylococcal mucositis13 or aspiration pneumonia.14, 15 Such adverse ailments are most commonly observed in debilitated patients, for example elderly residents in care homes.
Of importance, this study has demonstrated the positive impact that an oral health educator has upon staff attitudes towards, and knowledge of, effective oral care procedures. An OHE undertook small group discussions related to the BPS in a sub-group of original participants and a second round of data was collected.Results The majority of surveyed staff (n = 86, 79%) agreed that residents required assistance with oral care and placed oral care (n = 85, 78%) in a moderate to high priority.
Such features include being involved in decisions about their individual care requirements and being assisted by people who have received appropriate training.2 In Scotland, the Health Care Commission governs training requirements for care home staff and dictates the appropriate ratio of trained to untrained staff for the service.


To ensure that a valid data comparison could be made between participating staff, only registered nurses, as opposed to carers from a broad variety of occupations, were invited to participate. Non-participating homes advised that they were too busy to be involved.Requirements for the provision of oral careWhen asked to express level of agreement with the statement 'All residents in your care desire assistance with oral hygiene procedures', where 1 represents strongly agree, and 7 represents strongly disagree (Fig. Other most frequent responses for oral care provision included the dentist (19%, n = 34) and the resident (17%, n = 30).
Other barriers included absence from work on training days (4%, n = 2) or being too busy for training (2%, n = 1) (Fig.
Only one nurse failed to complete the telephone interview schedule (n = 23) after OHE intervention.Attitudes to the provision of oral careA number of statistically significant differences were identified between respective cohorts before and after training by the OHE. This evidence may help form a basis for the delivery of future training to care home staff and should be considered when planning induction programmes for new care home staff members and staff training review meetings. However, only 57% of managers and 49% of nurses had received training in oral care provision.
At this stage, there was deliberately no mention of the NHSQIS best practice statement.Interview schedules were administered over the telephone (see Appendix 2) by a researcher. Care home (N) managers also most commonly named carers as having primary responsibility for the oral care provision of residents (43%, n = 28, Fig. Of the nurses surveyed, 29% (n = 19) had received training from undergraduate lectures, 23% (n = 15) from undergraduate practical lessons, 22% (n = 15) in-house and 12% (n = 8) via an oral health educator (Fig. 3D).Potential barriers to providing oral careMost of the enrolled managers (82%, n = 23) and nurses (76%, n = 61) agreed or very much agreed with the statement that lack of resident co-operation was a barrier to providing a suitable standard of oral care. It should be noted that a control group was not implemented, thus ultimate improvement in staff knowledge cannot be attributed to the OHE alone. The Care Commission Scotland is required to regularly inspect and monitor care homes (N) with respect to levels of training and the specified ratio of trained to untrained staff. The NHSQIS BPS has been specifically developed to provide an achievable basis for good practice in oral health measures. Nurses must be registered with their regulatory body, The Nursing and Midwifery Council, and maintain their standards and registration every three years.
This methodology was selected to ensure that good quality responses were obtained whilst overcoming some of the pitfalls of postal questionnaires, particularly poor response rates.
However, follow-up interview schedules were implemented within one month of the OHE visit in order to minimise the number of external factors potentially contributing to changes in staff knowledge.
Care homes (N) invited to participate in this study were required to employ at least one fully-trained and qualified nurse to provide 24 hour on-call cover. Inclusion of the practices described in the 'protocol for daily oral care' in resident care plans and staff training is designed to ensure the provision of a more consistent and cohesive level of care.
Those with responsibility for management of care homes must be registered with the Scottish Social Services Council and comply with specified minimum training requirements.3 Care homes are required to provide new staff with a clearly defined training programme. In order to standardise techniques, the four researchers responsible for data collection received calibrated training on the interview technique prior to their commencement. Similar to the surveyed nurses, 25% (n = 16) of managers considered dentists to be responsible for the oral care of residents and 17% (n = 11) considered the resident responsible for their own oral care. The vast majority of surveyed managers (79%, n = 22) and nurses (85%, n = 67) were unaware of the NHSQIS best practice statement (Fig. In an attempt to ensure a standardised baseline level of education and knowledge across survey participants, only registered nursing staff and registered managers were approached to participate in the study.
Based on the findings of this pilot study, a training programme structured around these guidelines produces a measurable increase in levels of staff knowledge of oral care procedures. To facilitate measurement of various dimensions of attitudes towards oral healthcare provision and levels of staff training, the first two components of the interview schedule were designed using Likert scales.
3E).Knowledge of oral health careWhen compared to the knowledge checklist compiled from the NHSQIS 'protocol for daily oral care', the average overall score for knowledge of oral care procedures was only 30% for managers and for nurses, 37%. The study participation rate was high within both the initial survey group and sub-group population that received training from an OHE. However, the release of this document has bestowed care homes with a target for providing the best and achievable standard of oral care provision for Scotland's elderly population. The third section adopted an open-ended approach whereby staff were invited to volunteer information in response to questions rather than being offered a scaled response. The contributions from Nicola Cross, Laura Colgan and Pamela Yule in data collection are greatly appreciated. Following OHE intervention, staff knowledge in oral care procedures compliant with best practice guidelines increased by 45%.Conclusions Knowledge of oral health provision by those responsible for the care of home residents was deficient.
The statement places emphasis on the principles of patient-centred care that is consistent, cohesive, fair and cost-effective. These questions were formulated to enable a comparison between staff knowledge and NHSQIS BPS.A 'knowledge check-list' constructed around the BPS protocol for daily oral care (Appendix 3) was used as the template for knowledge assessment. Furthermore, 96% of those staff who undertook educational training in oral care procedures given by the OHE were available for the second round of data collection. The interview schedule and 'knowledge check-list' were designed to allow accurate comparisons of pre- and post-education knowledge following training from an oral health educator (OHE). The five care homes (N) who declined to participate cited insufficient time as the underlying issue.


Future demand for long-term care in the UK: a summary of projections of long-term care finance for older people to 2051. Care home staff are encouraged to work to their full potential, which NHSQIS hope will in turn stimulate learning and promote interdisciplinary team working. One mark was allocated per correct point mentioned from the NHSQIS 'protocol for daily oral care'.
A lack of time was also mentioned as a factor preventing subsequent attendance at training events. The statement is based upon an agreed set of values developed by the Scottish Gerodontology Community of Practice and is due for review in 2008 and every three years thereafter.Since the Regulation of Care (Scotland) Act 2001 was introduced,12 nursing homes and care homes within Scotland are both legally classified as care homes. The total 'score' for each participant was then calculated and averaged for all staff involved and then assigned a percentage.
Nevertheless, a shortage of time was not identified by surveyed care home (N) staff as a factor precluding the delivery of oral care for their home residents.Assessment of surveyed participants' knowledge of oral care provision in comparison to knowledge check points contained within the NHSQIS 'protocol for daily oral care' revealed major deficiencies in current knowledge levels in the delivery of oral care. However, they are sometimes differentiated as care homes (N) and care homes (R), respectively.
Registered nurses on duty at the time of the telephone call were invited to volunteer for interview.Sub-group assessment following OHE interventionFollowing completion of the first round of questionnaires, an OHE undertook small group training sessions with the three members of the nursing staff and a home manager within a subgroup of care homes (N) from the South Glasgow area.
It was therefore not surprising to find that dissemination of the BPS amongst participating staff was very low, with the majority of managers (79%) and nurses (85%) unaware of the document. Training was centred upon providing knowledge of the protocol for daily oral care within the NHSQIS BPS. Other than qualified nurses, carers were generally identified as those predominantly responsible for the delivery of oral care to home residents. Training was provided by the same OHE for all groups and each training session lasted three hours.From this sub-group, a second round of anonymised data was collected within one month of OHE training by the same members of research staff involved in data collection from the original care home (N) group.
However, whether responsibility for oral care should be delegated to 'kitchen staff', as suggested by one staff member, is somewhat debatable.With an aging population retaining more of their dentition, it is concerning to establish that the standard of staff knowledge in care of the natural dentition was sub-optimal. In addition, the attitude, confidence and current training levels of care home (N) staff in the provision of oral healthcare were investigated.
Statistical analysis was performed on collected data using Excel (Microsoft Corporation, USA) and SPSS (SPSS Inc., Chicago, USA). Of those staff surveyed prior to OHE training, only 52% knew how to correctly care for a dry mouth.
Furthermore, knowledge levels of care home (N) managers and nursing staff in oral care measures were assessed and compared to the NHSQIS BPS. Of particular note, 87.9% of care home (N) staff (n = 20) advised that lemon and glycerine should be used to alleviate symptoms of xerostomia. Finally, the study evaluated if staff training from oral health educator (OHE) training had a positive effect upon care home (N) staff knowledge pertaining to the NHSQIS BPS.
Furthermore, the use of fluoride toothpaste, an essential component in the prevention of dental caries, was mentioned by only one member of surveyed staff (4%) prior to OHE involvement.
Following OHE training, recommendation on the use of a fluoride toothpaste rose to 100% (n = 23). Potential use of a powered as opposed to a manual toothbrush for those with poor manual dexterity was mentioned by only two of the surveyed staff (8.7%).
Most fundamental of these is denture identification, which facilitates the distinction of dentures between different wearers. Denture identification marking would also enable the individual's dentures to be chronologically categorised according to the time of construction.
This would be helpful in both primary and secondary care settings, particularly during clinical assessment when considering denture replacement.18 However, care home (N) staff were unaware that this was one of the key guidelines in the NHSQIS BPS. Within the BPS, a section relating to care of the edentulous patient with dentures expressly states that staff should 'ensure that dentures are marked with the person's name (eg "Identure" Denture Marking System, Geri Incorporated)'. Of further concern, this lack of knowledge was evident not only prior to but also subsequent to OHE intervention.Healthcare and management staff involved in this study rated oral care as a high priority. In contrast, their displayed knowledge in the provision of oral care was revealed to be severely deficient. Furthermore, of staff members that had received formal training, education in oral care measures had taken place as many as 40 years previously. A similar lack of emphasis on oral healthcare education during nurse training has been described in countries such as the USA and Sweden.24, 25 In the care home (N) staff subgroup that received OHE-based training, knowledge, attitude and confidence in providing and advising on oral care were significantly improved.
Many staff stated they hoped such training in oral care would become available on a wider and more regular basis. Indeed, a recent study has demonstrated little meaningful clinical improvement in oral health of residents in long-term care facilities following nurse educator training.27 Our research was undertaken as a pilot study and hence only determined the effect of oral health education on a relatively small number of individual staff members. Further research is required to determine the long-term efficacy of oral health education based upon the best practice statement as a public health approach.



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