Are we Meeting Oral Health Needs of Nursing Home Populations?

Background: Insufficient oral care for nursing home residents is a widely recognised problem. Objectives: To elucidate nursing home compliance with NHS Quality Improvement Scotland's recent Best Practise Statement (BPS) ‘Working with Dependent Older People to achieve Good Oral Health'. Methods: An introductory letter was posted to all nursing homes in South Glasgow (n =8) detailing arrangements for a structured telephone interview with two members of nursing care staff and home manager. A ‘knowledge check-list' based on the daily oral care protocol from the BPS served as template for knowledge assessment. Subsequently, an Oral Health Educator (OHE) undertook small group discussions with nursing staff and home manager according to the BPS. Thereafter, a second round of data was collected using the same questionnaire with identical staff. Pre- and post-education attitudes, training and knowledge were analysed. Results: Participation of nursing home staff was high (100%). Following OHE involvement, only one nurse failed to complete the telephone questionnaire (n =23). Statistically significant differences were identified in prioritisation given to oral care (p =0.009), perceived competence (p =0.005) and confidence (p =0.004) in giving advice between pre- and post-OHE involvement. Following OHE intervention, overall compliance with ‘Knowledge Check Points for Nursing Home Staff' increased by 45%. Particular increases were observed in care of: oral mucosa (58%); a dry mouth (48%); and resident's natural dentition (45%). Further data has been collected from Greater Glasgow. Conclusion: Oral care of our ageing population requires substantial improvement. Involvement of Oral Health Educators may be an effective method of achieving this in nursing homes.