Improving Nursing Oral Care Practice for Community-Dwelling Care-Dependent Older People

Abstract

Aim

Oral care is one of the most neglected nursing practices owing to a lack of training, standard nursing oral care guidelines and low confidence and skills. There is little evidence to inform the development of oral care training and guidelines, which ideally should be done in collaboration with oral health professionals. Further, there is a lack of research, particularly in New Zealand, with nursing staff caring for care-dependent older people, including those ageing in their own homes. This pilot study aimed to determine the impact of oral care training on nursing staff knowledge, attitudes and confidence in supporting community-dwelling older peoples' oral care.

Method

Mixed methods design comprising delivery of an oral healthcare and assessment training intervention by a team comprising nursing and oral health professionals, pre- and post-intervention questionnaires (N = 14) and a post-intervention focus group with community-based nursing staff (N = 5).

Results

Staff knowledge significantly improved (p = 0.046) following interprofessional collaborative training, but attitude and confidence scores did not (p = 0.127), although focus group responses suggested that participants' confidence was heightened. Participants expressed the need to implement oral care practices to benefit clients' health, clarify roles and identify oral care as a core competency. They sought to make individual- and organisational-level practice changes accordingly.

Conclusion

Oral care training based on interprofessional collaboration and education enhances nursing staff knowledge but not their confidence in oral care provision. Ongoing, hands-on practical training for nursing staff in collaboration with oral health professionals has the potential to advance nursing oral-care practice and improve care-dependent older peoples' oral care.

Implication for Practice

Oral care training and education with oral health professionals is effective to enhance nursing staff knowledge and awareness in oral health care. However, transforming knowledge into nursing oral care practice requires hands on practical training and ongoing collaboration with oral health professionals to improve care-dependent older people's oral health care.