Oral Care in Long-Term Care

Oral care (OC) in long-term care (LTC) was a quality improvement project implemented in one LTC facility in rural Pennsylvania. The purpose was to implement an evidence-based (EB) protocol for delivery of routine OC to residents. Objectives included: (1) assessment of nursing staff knowledge, current practices, beliefs, and attitude regarding OC prior to and eight weeks after protocol implementation, (2) protocol implementation, (3) protocol adherence, and (4) perceptions of barriers and facilitators to implementation. Registered nurses, licensed practical nurses, and certified nursing assistants received a 90-minute educational intervention on protocol implementation and threat reduction strategies for resident care resistant behaviors. Matched OC pre- and post-tests were analyzed for staff OC knowledge, beliefs, attitude, and self-reports of OC product use. Adherence was measured with an audit process and checklist. Staff OC knowledge and beliefs increased while attitude remained unchanged. Toothpaste and mouthwash were the most reported OC products regardless of resident dentition. Higher protocol adherence was noted compared to adherence levels reported by Coleman and Watson (2006). Threat reduction strategies were effective 80% of the time with care resistant behaviors. Barriers included care resistant behaviors with fears of causing harm to the resident while facilitators included the OC champion and huddling sessions. Providing OC education and implementation of an EB OC protocol and audit process with existing LTC staff has the potential to increase staff OC knowledge and beliefs, along with protocol adherence. Long-term implications for LTC facilities may include decreased infections and increased person-centered care techniques used by current staff.



Work Title Oral Care in Long-Term Care
Penn State
  1. DNP Project
License All rights reserved
Work Type Project
  1. Lori Lauver, PhD, RN, CPN, CNE
  2. Kimberly Van Haitsma, PhD
  3. Kelly Wolgast, DNP, RN, FACHE, FAAN
  4. Andrea Sillner, PhD, GCNS-BC, RN
Publication Date 4/17/2018
  1. Oral Care in Long-Term Care: A Quality Improvement Project
  1. English
DOI doi:10.18113/S1N059
Deposited April 17, 2018




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  • Added Creator BETH ANN WHITE
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