‘Mondzorg, hoe wordt het mogelijk?’/ ‘Oral health care, how will it become possible?’

Abstract – ‘Oral health care, how will it become possible?’ Introduction. Oral health care in nursing homes is insufficient. Guidelines have been made, but it seems unclear how oral health care should be implemented. The aim of this study is to develop an implementation strategy to implement oral health care in nursing homes. The research question is: what should be the focus of an implementation strategy and which elements should this strategy include? Methods. Clients and nursing home staff of one Dutch nursing home were included. The mouth of clients was examined, for instance with the MucosalPlaqueScore. Nursing staff completed a ‘Checklist Oral Health Care’ and a ‘Knowledge Test’, to describe the oral health care and the knowledge of nursing staff. Two focus group interviews were held to investigate what barriers and stimulations staff experience, giving oral health care. Results. The oral health of clients with their own teeth was unacceptable. Sixty percent of the clients seemed to be care dependent of oral health care. Oral health care was not applied enough, however basic utensils were available. Knowledge of nursing home personnel was relatively good. Barriers are related to nursing staff (knowledge/ skills, attitude, personality, habits), but mostly to clients (behaviour, habits) and the organisation (lack of utensils, task distribution and lack of advise). Conclusions. An implementation strategy to implement oral health care should focus on clients with their own teeth. Continuous stimulation of oral health care is needed, through reminders, feedback of colleagues, usage of a toolbox and a focal point. New ways of schooling could improve knowledge through posters, e-learning or the use of intranet. Dental professionals should advise staff about oral health care and observation. Recommendations. The implementation strategies that have been found should be tested in practise and specific interventions could be developed