Introduction:
Ageing population of Australia is a serious problem and health services to be provided to the population require serious attention. Old age patients develop complex health conditions because of their age and lack of access to financial resources. Several factors affect health conditions faced by old age patients. Among different health issues, oral hygiene is an important health concern for patients. Nurses have to get knowledge so that they can effectively provide care to old age patients. It is essential to educate aged care nurses so that they can have knowledge to provide oral hygiene to old age patients. Old patients are vulnerable because they have high chances of developing dental problems. Australian Institute of Health and Welfare has highlighted that most of old age patients in residential age care facilities do not get regular dental checkup (Kullberg et al., 2010). It is also a fact that old age patients are increasing in number. There are 45 percent of patients in age care over 85 years of age.
Australia has one of the most advanced healthcare systems and it sets tough standards on the food and life quality. Positive aspect of high level of healthcare and food quality is that life expectancy in Australia has increased. As a result, ageing population has increased in Australia, and it is continuously increasing. Ageing is a natural phenomenon, and it is impossible to stop. Oral hygiene and health as well as dental care get severer with increase in age. An ageing population develops complications with oral health because it is a natural process of weakening teeth (Parsons, 2013). An ageing population may develop other complications with their oral health as well. In this context, the role of nurses offering an ageing population dental care gets more important.
Education enriches a person with new knowledge and expertise. A professional person also needs education even when he is performing in a professional setting. Nurses are such professionals that they may enrich their knowledge because of education. They may have attained knowledge during studies but the role as aged care nurse requires them to attain more knowledge. Therefore, this project has conducted research to offer education opportunities to nurses so that they can have enhanced knowledge of oral hygiene for ageing population (Wang et al., 2015). Literature on ageing population and oral hygiene may offer valuable insights into the phenomenon and need for care for this vulnerable segment. The following section has background and literature on the topic so that research evidence may set the foundation of the research.
Background and Literature Review:
The research background and literature have focused on the education of nurses for oral hygiene and its impact on their knowledge. There is also focus on elderly people and the importance of oral hygiene and health for them.
Oral health is associated with older people as the World Health organization recognizes them as target population for oral health as well. Non-communicable disease interventions also have older people as target population and these interventions affect oral health of older people (Potempa et al., 208). In this case, oral health is associated with the overall health of older people. It is also worth mentioning that modifiable risk factors for non-communicable diseases and oral health diseases are the same. On the other hand, an ageing person has natural causes of oral health loss including caries, difficulty in chewing, tooth loss, oral cancer, discomfort, reduced salivation, and gingival overgrowth (Weening-Verbree et al., 2013).
Older people have difficulties and risks associated with circumstances at older homes where they face challenges with their oral and overall health. More use of prescribed medications also causes risks for poor oral health. The decline in independence leads to poor and declining quality of life for them. There are reports and research evidence that at least one medication prescribed for older people has the likelihood of affecting oral health negatively. They also experience a decline in their appetite (Pilgrim et al., 2015). The most common negative impact of these medications is dry mouth because of reduced salivary flow (Coker et al., 2013). There are disparities as well for older people with different socioeconomic levels. Disadvantaged older people are more vulnerable than older people with high socioeconomic status are.
Education and knowledge have important roles to play for nurses taking care of older people. It is the responsibility of nursing staff to provide adequate health services to elderly patients. Nurses have to ensure that health complications of elderly people remain there. Older people have a higher level of health issues and concerns, and nursing staff has to be equipped and learned to come up with their requirements (Lindqvist et al., 2013). Medication, safety and diagnosing a reason of disease are two important issues for any patient. Older patients may present challenges or difficulties in diagnosing diseases. It is because they might have deteriorating health and one disease may cause symptoms of another disease. In this context, nursing staff has to get adequate knowledge to deal with diseases and symptoms faced by elderly patients (Wang et al., 2015).
Education is very necessary for the knowledge of nurses to provide oral hygiene to elderly patients. In one of such education programs, different activities increase the level of knowledge of nursing staff. They get hands-on training to learn the technique of electric toothbrush. They were given environment where they were divided into small discussion groups (Reigle & Holm, 2016). The education program also had theoretical lectures to deepen the knowledge and concepts for nursing practices. This program brought favorable and effective results for nurses in terms of improvements in their practice and expertise. Results of the education program were very promising and beneficial for oral hygiene and oral health (Reigle & Holm, 2016). There is evidence that their perception and knowledge experienced a change because of it. They got new and adequate knowledge as well as improved perceptions for better oral health for them. Research confirmed that oral or dental hygiene education programs served as an initial step towards developing a model for oral health of elderly people. The model is effective and there is support from qualitative and quantitative studies for its effectiveness (Kullberg et al., 2010). The education program for dental or oral hygiene was repeated in another setting and it again proved improvement in oral hygiene of elderly people. Despite this improvement, the study cautions that perceptions and attitudes toward oral hygiene and dental care are worth addressed (Kullberg et al., 2010). It indicates a research gap that oral healthcare and dental hygiene need research and more insight into it needs to be explored and investigated.
There is a difference in oral hygiene and dental health among elders living with families and administered at healthcare institutions. Elders in institutions need a higher level of dental care and they get limited services for their oral health. It highlights the importance of educating dental or oral caregivers that they should get expertise and excellence (Parsons, 2013). An education program would help them improve their knowledge and perceptions for the service and it would change the situation practically. Studies have noted that elderly living in institutions find many barriers on the way to getting oral hygiene and dental care. These barriers include high cost, restrictions on their movement, lack of awareness and knowledge among caregivers, and fear among elderly that caregivers might not have appropriate knowledge (Lago et al., 2017). In context of these barriers, caregivers can contribute to the betterment of health of elderly only if they have education and knowledge.
Study Significance:
The study has significance as it has taken the perspective in healthcare, which needs primary research. Nurses may have completed their education and hold enough knowledge to exercise their practices. However, research evidence has identified a gap in their education and knowledge regarding oral are and hygiene. Institutionalized elderly has concerns regarding their oral health, which is a point of concern. The project has taken this perspective where education programs for nurses would enrich them with more and enhanced knowledge (Lago et al., 2017). The project is divided into two parts. The first part has taken results to know the education and knowledge regarding oral hygiene among nurses and the second part has interpreted the impact of education and change in knowledge of nurses about oral hygiene.
Aims:
The aim of the project is to change the situation in practice. Nurses have limited or lack knowledge about oral hygiene. This project has provided them with an education so that their knowledge about the issue gets improvement. Elderly patients, especially in health institutions, fear a lack of knowledge among nurses about oral hygiene. It is aim of the project to remove this fear by providing improved knowledge through education to nursing staff.
Objectives:
- To offer an education program for knowledge improvements to nurses about oral hygiene
- To increase their level of knowledge about oral hygiene
- To evaluate and note the impact of educational programs on the level of knowledge possessed by nurses
- To compare the difference between level of knowledge in pretest and post test results about knowledge
- To offer recommendations for better oral hygiene and dental healthcare to elderly
- To improve the health conditions of elderly those are vulnerable of oral diseases
Methodology:
Project Setting:
The project has been conducted in residential age care where 35 nurses work. It is 100-bed unit, and the Nursing home offers daily care to older people. The methodology of the project relies on the selection of samples and convenient sampling methods has been employed.
Project Design:
The nature of the project is to find the impact of education on knowledge of nursing staff. For this purpose, pretest and posttest project design is appropriate to service objectives of the project. The questionnaire developed for the study has been distributed to all nurses in the study sample present in the nursing home. In the pretest stage, results of pretest have been taken. Results of pretest have helped existing knowledge of nursing staff about oral hygiene. Then, education has been provided to nursing staff through different methods including posters, videos, and pamphlets. These methods contain how to provide oral care hygiene to the elderly in the care facility.
After this education program, there is a stage of posttest. In this stage, a questionnaire has been formulated and distributed among participant nurses. Results of nurses in posttest would help reveal improvements in knowledge of nurses. Self-administered questionnaire has been used for project design and timeline has indicated steps to be followed.
Population and Sampling:
There are 35 nurses in nursing homes with 100 bed units. It is the study population for this project, but the sample consists of 20 respondents of the study. Principle was set that target population should be 60 percent more than total participants. Keeping this principle, the sample consists of 20 respondents. The questionnaire has been used for data collection methods and data collection has been continued for a two-week period. For abiding by ethical considerations, approval has been taken from the care manager of nursing home for this research project. Only nurses are included in the project, and they are the target population. Improvement in their knowledge has been the objective of the project.
Interventions:
Interventions used for the research include education and training, the use of questions to find the level of knowledge of nurses, visual reminders, and feedback. These interventions help affect the level of knowledge possessed by nurses. Notably posters, pamphlets, and video have been used for these interventions. Interventions have occurred in the period between pretest and posttest.
Data analysis Method
For data analysis, responses of nurses have been assessed and evaluated on the scale. The scale contains options of very poor (0-3 score), satisfactory (4-7), to good (8-10). The score has been taken to evaluate the level of knowledge about oral hygiene among nurses through pretest and posttest results. Pretest and posttest data has been analyzed using different interventions. Each respondent has taken one mark for each correct answer. As a result, the comparison of posttest and pretest has been conducted by comparing these scores. The data collection of both tests has been underway for two weeks and their responses have been analyzed.
The study is using questionnaires which consist of self-structured questions. The questionnaire consists of 12 questions which will show the knowledge of the nurses in terms of oral hygiene. The sample of the questionnaire used for the data collection is attached to the appendix. The study is going to collect pre-test data from the same questionnaire and then also collect data on the knowledge of oral hygiene of the nurses in the post-test phase. The results of both pre test and post test is going to be compared to analyze the scores of the nurses. Each respondent is going to be awarded 1 point and the total score from the 12 questions would show the level of the knowledge of the nurses in terms of the oral hygiene of the patients.
The scale used for the analysis and evaluation of the scores of each of the participant’s knowledge level on oral hygiene is also attached in the Appendix. The results of the scores for the pre-test and the post-test scores are compared to reach a conclusion.
Results & Discussion:
The results of the questionnaire for both Pre-Test and Post-Test are collected and gathered in the excel sheet. The tabulation of the data allows for its better evaluation and identification of the trends and patterns.
Table 1:
| SN | Modified pre-test post-test questionnaire | Pre-test Answers | Post-test Answers | |||||||||
| a. | b | c | d | Total | a. | b | c | d | Total | |||
| 1 | Do You Have any idea about gum diseases | 7 | 13 | 20 | 17 | 3 | 20 | |||||
| 2 | What is dental plaque | 9 | 6 | 1 | 4 | 20 | 18 | 0 | 0 | 2 | 20 | |
| 3 | What is gingivitis | 6 | 5 | 6 | 3 | 20 | 3 | 0 | 17 | 0 | 20 | |
| 4 | What causes gingivitis | 6 | 6 | 4 | 4 | 20 | 16 | 0 | 4 | 0 | 20 | |
| 5 | What is Periodontitis | 3 | 5 | 7 | 5 | 20 | 5 | 0 | 15 | 0 | 20 | |
| 6 | What causes Periodontitis | 5 | 7 | 4 | 4 | 20 | 19 | 1 | 0 | 0 | 20 | |
| 7 | If the patient stops brushing, when does the gingival disease start | 2 | 6 | 7 | 5 | 20 | 20 | 0 | 0 | 0 | 20 | |
| 8 | Hospitalization more than two days without brushing may lead to oral disease | 4 | 7 | 9 | 20 | 18 | 2 | 0 | 20 | |||
| 9 | Do You Have any idea about oral irrigation device | 3 | 17 | 20 | 15 | 5 | 20 | |||||
| 10 | Are You familiar with the Correct Way of tooth brushing | 12 | 8 | 20 | 20 | 0 | 20 | |||||
| 11 | Is the Oral Health Care Measure Part of your education | 4 | 16 | 20 | 10 | 10 | 20 | |||||
| 12 | Are you interested to learn more about oral health | 18 | 2 | 20 | 20 | 0 | 20 | |||||
The Table of the Results shown in Table 1 depicts the number of options selected by the participants for each of the questions for both the pre test and post test scenarios.
Table 2:
| Respondent No | Pre-Test Answers | Pre-Test Answers | ||||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | No of Correct Answers | Points Scale | |
| 1 | a | a | c | a | c | c | b | a | a | a | b | a | 9 | Good |
| 2 | b | b | a | c | a | c | c | b | b | a | b | a | 2 | Very Poor |
| 3 | a | a | c | a | c | a | a | a | b | a | b | a | 10 | Good |
| 4 | b | b | b | c | a | d | b | c | b | a | b | a | 2 | Very Poor |
| 5 | a | a | c | a | c | a | d | b | b | a | b | a | 8 | Good |
| 6 | b | b | b | b | a | d | c | c | b | b | b | b | 0 | Very Poor |
| 7 | a | a | c | a | c | a | a | c | a | a | a | a | 11 | Very Good |
| 8 | b | b | a | d | b | b | b | b | b | a | b | a | 2 | Very Poor |
| 9 | b | b | d | d | d | c | d | b | b | b | b | a | 1 | Very Poor |
| 10 | a | a | c | a | b | b | b | c | b | a | b | a | 6 | Satisfactory |
| 11 | b | b | a | d | d | d | c | c | b | b | b | a | 1 | Very Poor |
| 12 | b | d | b | b | b | b | d | b | b | a | a | a | 3 | Very Poor |
| 13 | a | a | a | d | d | c | b | c | b | b | b | b | 2 | Very Poor |
| 14 | b | a | c | a | c | a | c | a | a | a | a | a | 10 | Good |
| 15 | b | d | d | b | d | b | d | b | b | a | b | a | 2 | Very Poor |
| 16 | a | a | a | c | b | d | b | c | b | a | b | a | 4 | Satisfactory |
| 17 | b | d | b | b | d | b | c | c | b | b | b | a | 1 | Very Poor |
| 18 | b | c | d | b | b | b | c | c | b | b | b | a | 1 | Very Poor |
| 19 | b | d | a | c | c | b | d | b | b | b | b | a | 2 | Very Poor |
| 20 | b | a | b | b | c | a | c | a | b | b | a | a | 6 | Satisfactory |
Table 2 of the results show the options selected by each of the participant nurses for each of the Questions in Pre Test Scenario.
Table 3:
| Respondent No | Post-Test Answers | Post-Test Answers | ||||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | No of Correct Answers | Points Scale | |
| 1 | a | a | c | a | c | a | a | a | a | a | a | a | 12 | Very Good |
| 2 | a | a | c | a | c | a | a | a | a | a | b | a | 11 | Very Good |
| 3 | a | a | c | a | c | a | a | a | a | a | b | a | 11 | Very Good |
| 4 | a | a | c | a | c | a | a | a | a | a | a | a | 12 | Very Good |
| 5 | a | a | c | c | c | a | a | a | b | a | b | a | 9 | Good |
| 6 | b | d | a | c | a | a | a | b | b | a | a | a | 5 | Satisfactory |
| 7 | a | a | c | a | a | a | a | a | a | a | b | a | 10 | Good |
| 8 | a | a | c | a | c | a | a | a | a | a | a | a | 12 | Very Good |
| 9 | a | a | c | a | a | a | a | a | a | a | b | a | 10 | Good |
| 10 | a | a | c | a | c | a | a | a | b | a | a | a | 11 | Very Good |
| 11 | a | a | c | a | c | a | a | a | a | a | b | a | 11 | Very Good |
| 12 | a | a | c | a | a | a | a | a | b | a | b | a | 9 | Good |
| 13 | a | a | a | c | c | a | a | a | a | a | a | a | 10 | Good |
| 14 | a | a | c | a | c | a | a | a | a | a | b | a | 11 | Very Good |
| 15 | b | a | c | a | a | b | a | a | a | a | a | a | 9 | Good |
| 16 | a | a | c | a | c | a | a | b | b | a | b | a | 9 | Good |
| 17 | a | a | c | a | c | a | a | a | a | a | b | a | 11 | Very Good |
| 18 | b | d | a | c | c | a | a | a | a | a | a | a | 8 | Good |
| 19 | a | a | c | a | c | a | a | a | a | a | a | a | 12 | Very Good |
| 20 | a | a | c | a | c | a | a | a | a | a | a | a | 12 | Very Good |
Table 3 of the results show the options selected by each of the participant nurses for each of the Questions in Post Test Scenario. The number of correct answers counted in the end for each of the respondent which is then compared with each of the respondent scores to show the points earned by each of the individual nurses. This is depicted in the tables below.
Table 4:
Pre-Test Scores:
| Pre-Test Results | ||
| 0 to 3 | Very Poor | 12 |
| 4 to 7 | Satisfactory | 3 |
| 8 to 10 | Good | 4 |
| 11 to 12 | Very Good | 1 |
Post-Test Scores:
| Post-Test Results | ||
| 0 to 3 | Very Poor | 0 |
| 4 to 7 | Satisfactory | 1 |
| 8 to 10 | Good | 8 |
| 11 to 12 | Very Good | 11 |
Other than this, the Mean and Standard Deviation for each of the questions of the Pre Test and the Post Test are also computed. The results are shown in the table below.
| Pre-test Answers | Post-test Answers | ||||||
| No of Correct Ans | No of incorrect ans | Mean_PreTest | STDEV_Pre Test & Post Test | No of Correct Ans | No of incorrect ans | Mean_Post Test | |
| 1 | 7 | 13 | 0.3 | 0.28 | 17 | 3 | 0.70 |
| 2 | 9 | 11 | 0.1 | 0.49 | 18 | 2 | 0.80 |
| 3 | 6 | 14 | 0.4 | 0.21 | 17 | 3 | 0.70 |
| 4 | 6 | 14 | 0.4 | 0.14 | 16 | 4 | 0.60 |
| 5 | 7 | 13 | 0.3 | 0.14 | 15 | 5 | 0.50 |
| 6 | 5 | 15 | 0.5 | 0.28 | 19 | 1 | 0.90 |
| 7 | 2 | 18 | 0.8 | 0.14 | 20 | 0 | 1.00 |
| 8 | 4 | 16 | 0.6 | 0.14 | 18 | 2 | 0.80 |
| 9 | 3 | 17 | 0.7 | 0.14 | 15 | 5 | 0.50 |
| 10 | 12 | 8 | 0.2 | 0.57 | 20 | 0 | 1.00 |
| 11 | 4 | 16 | 0.6 | 0.42 | 10 | 10 | – |
| 12 | 18 | 2 | 0.8 | 0.14 | 20 | 0 | 1.00 |
The comparison of the mean for the pre test and the post test for each of the questions yields the information that the mean has improved with the educational intervention by the researchers. The positive value of the standard deviation depicts the difference in the mean of the pre test and the post test results for each of the questions.
For the computation of the Overall Mean and the Overall standard deviation, the following table shows the details.
| Pre Test _Overall | Post Test _ Overall | |
| Overall Mean | 0.48 | 0.71 |
The comparison of the overall means for the pre test and the post test shows that the number of correct answers by nurses for the 12 questions has improved. This is also visible in the overall positive standard deviation value.
| Overall STDev Pre Test & Post Test | 0.26 |
This value of 0.26 standard deviation shows that the answers of the nurses have improved by 0.26 mean as compared to the pre test results. The P-Scale value is calculated using the Regression analysis of the Excel function which shows a value of 0.00123 showing that there is high positive causal relationship between the education intervention and the knowledge gained by the nurses.
The results for each of the questions in terms of the options selected and the correct answers are shown as follows.
Question 1: Do you have any idea about gum diseases?
The results show that in the Pre-Test session, the nurses answered with more the b option which was that they do not have idea about the gum diseases, however, in the later posttest session, majority of the nurses responded that they have idea about the diseases related to the gums. Only three nurses selected option b in the post test scenario as compared to 13 nurses who had selected it in the pre-test scenario. This shows that at least 10 more nurses perceived that they have gained knowledge from the educational interventions.
Question 2: What is dental plaque?
As depicted in the bar chart above, the question of dental plaque was answered mostly by the option as which is also the correct option. However, 11 nurses did not know or gave the wrong answer about the dental plaque. Contrary to that, in the post test session, the answers were correct for 18 nurses, while 2 still did not know what dental plaque was. This also shows the effect of the educational intervention on the knowledge of the nurses.
Question 3: What is gingivitis?
The third question was about gingivitis, which is a gum disease. The answers show that most of the nurses have been confused about the correct answer as some selected option d, some selected option b while most selected option a and c. The options a and c both are related to gums problems which was kind of correctly guessed by the nurses, however, still, only 6 answers were correct, and 3 selected the option of “no knowledge”. In the post test scenario, the result improved significantly as only three of the nurses selected the wrong option of a while the remaining 17 selected the correct option.
Question 4: What causes gingivitis?
The results for this question shows that the disease of gingivitis was not a term for which the nurses were much aware of. The options of “b” and “a” is the most selected option of which “a” is the correct one; while c and d options are also selected by 10 nurses. The pre test results are very different than the post test results where it shows that around 16 of the nurses gave the correct answers while the 4 nurses chose the wrong options.
Question 5: What is Periodontitis?
The answers for Question 5 also had 4 options while most of the nurses were aware of the term and knew the meaning of the term and the disease in the Pre-Test as well. However, in the post test, this number increased to 15 from 7 as only 5 nurses selected the wrong option of “a”. This also shows the effect of the knowledge gained by educational intervention in a clear manner.
Question 6: What causes Periodontitis?
Question 6 is answered correctly by 5 nurses in the Pre Test scenario while the post test scenario shows that 19 of the nurses gave the correct answers to this question. Only 1 nurse did not answer correctly to this question in the post test phase.
Question 7: If the patient stops brushing, when does the gingival disease starts?
The answers to question 8 about gingival disease and brushing are shown in the above bar graph. The graph depicts the comparison of the results for both the pre test and the post test scenarios. The results show that the correct answer was the least selected option in the pre test phase; however, all 20 of the nurses selected the right answer in the post test phase. This clearly demonstrates the effect of the educational intervention on the knowledge of the nurses in terms of the oral hygiene of their old aged patients.
Question 8: Hospitalization more than two days without brushing may lead to oral disease?
The analysis of the answers and results to question 8 of the questionnaire in both the pre test and the post test phases is shown in the bar graph above. It shows that the correct answer was the least selected answer in the pre test phase. Most of the nurses chose the c option which was “I don’t Know”. The other wrong option which was selected was of b which said “No”. This shows that most of the nurses either did not know if two days without brushing leads to oral diseases or considered that it did not lead to oral diseases. The Post Test phase shows that most of the answers selected by the nurses were correct and only 2 of the nurses selected the wrong answer.
Question 9: Do you have any idea about oral irrigation device?
This question is answered in the pre test with most of the answers being wrong. The correct answer is the option and most of the nurses showed that they do not have had any idea of the workings of the oral irrigation device. However, after the education intervention, in the post test phase, the answers of most of the nurses were yes, except the 5 nurses who still did not think that they knew about the oral irrigation device.
Question 10: Are you familiar with the Correct Way of tooth brushing?
The answers selected by the nurses are shown in the above bar graph. The results show that most of the respondents selected option a as they perceived themselves to be familiar with the correct way of brushing teeth, however, 8 of the nurses considered that they are not aware of the correct way of brushing teeth. The post test intervention results show that all of the nurses considered that they are aware of the correct way of brushing their teeth.
Question 11: Is the Oral Health Care Measure Part of your education?
The answers to Q 11 are shown in the bar chart above. The results show that most of the respondent nurses perceived that the oral healthcare measure is not part of their education. Only 4 of the nurses considered it as part of their education. In the post test, an interesting trend has been identified. The intervention caused half of the nurses to realize that oral health hygiene is not part of their education, while the other half thought that this is part of their education. This can highlight the fact that the nurses might have considered that they have not learned about it in their education so this is not part of their education, however the other part might be of view that they should have education of oral hygiene as part of their courses. Therefore, there is a possibility that the nurses have misunderstood the question.
Question 12: Are you interested in learning more about oral health?
This was the last question in the questionnaire and the answers to this question are depicted in the bar chart above. 18 of the total 20 nurses had shown interest in learning more about the oral health in the pre test session. In the later session of post test, all 20 of the nurses showed interest in learning more about oral health.
The results of the data analysis as per the questions is shown and discussed above. Now, the results of the questionnaire in terms of their scores are going to be discussed. The data tabulated in Table 2 is analyzed in terms of the total number of correct answers given by each of the 20 respondents. Based on the number of correct answers the score of level of the understanding of the nurses about oral hygiene is selected. The result for the Pre Test Scores for the respondent nurses is shown in Table 4 in the above section. The following pie charts also present the same results in graphical form. The results show 12 of the nurses had very poor knowledge of the oral hygiene and health while 3 of the nurses had satisfactory knowledge and 4 of the nurses had good knowledge and only 1 of the nurses had very good knowledge of the oral hygiene and health.
The Post Test Analysis of the results is as per the Table 4 attached in the prior section. This shows the results of the scores for each of the respondents of the nurses after the educational intervention was delivered. The results show that 11 of the nurses now showed very good knowledge of oral hygiene, 8 of the remaining nurses showed good knowledge of oral hygiene and only 1 nurse showed satisfactory scores in terms of the knowledge of oral hygiene. None of the nurses showed very poor knowledge of oral hygiene after the educational intervention was delivered.
The results clearly depict the level of the effect of the educational intervention about the oral hygiene of the knowledge of the nurses working with the old aged people as the scores of the nurses improved in the post test phase as compared to the pre test phase.
Conclusion:
The project concludes that education has a positive impact on knowledge of nurses about oral hygiene for elders. There is only one participant who scored “very good” in pretest. However, this number increased to 11 participants in posttest. It shows that educating nurses helps increase their knowledge and awareness about oral hygiene. It also shows that oral hygiene is an issue worth of research because there is limited research in this field. Nurses can promote the health and well-being of the elderly through improved knowledge because of education. Oral hygiene is an area which gets a low level of attention from nurses. Education can change the situation effectively.
Recommendations
The project recommends that nurses should pursue their education process in order to increase knowledge level. Care centers should also ensure education programs for nurses so that they can improve the level of knowledge about a disease. The project recommends that nurses should understand and gain knowledge about elder patients because they need a higher level of care. Oral hygiene and dental care are not popular fields among nurses and the project recommends focusing on these medical fields. It is also a recommendation for nurses that the education process should continue in their career so that they can equip themselves with new ways of nursing.
References:
Coker, E., Ploeg, J., Kaasalainen, S. & Fisher, A., 2013. A concept analysis of oral hygiene care in dependent older adults. Journal of advanced nursing, 69(10), pp.2360-71.
Kullberg, E. et al., 2010. Dental hygiene education for nursing staff in a nursing home for older people. Journal of Advanced Nursing, 6(6), pp.1273-79.
Lago, J.D., FAIS, L.M.G., Montandon, A.A.B. & Pinelli, L.A.P., 2017. Educational program in oral health for caregivers on the oral hygiene of dependent elders. Revista de Odontologia da UNESP, 46(5), pp.284-91.
Lindqvist, L., Seleskog, B., Wårdh, I. & Von Bültzingslöwen, I., 2013. Oral care perspectives of professionals in nursing homes for the elderly. International journal of dental hygiene, 11(4), pp.298-305.
Parsons, S., 2013. Collaborative oral health education for caregivers in an assisted-living facility. Journal of Nursing Education and Practice, 3(3), pp.44-51.
Pilgrim, A., Robinson, S., Sayer, A.A. & Roberts, H., 2015. An overview of appetite decline in older people. Nursing older people, 27(5), pp.29-35.
Potempa, K. et al., 208. Strengthening non-communicable disease research capacity in Thailand: leveraging PhD nurses and other health professionals. Pacific Rim international journal of nursing research, 22(3), pp.178-86.
Reigle, J.A. & Holm, K., 2016. Knowledge of oral health of nursing staff caring for disadvantaged older people. Journal of Nursing Education and Practice, 6(1), pp.31-38.
Wang, T.-F., Huang, C.-M., Chou, C. & Yu, S., 2015. Effect of oral health education programs for caregivers on oral hygiene of the elderly: A systemic review and meta-analysis. International journal of nursing studies, 52(6), pp.1090-96.
Weening-Verbree, L. et al., 2013. Oral health care in older people in long term care facilities: a systematic review of implementation strategies. International Journal of Nursing Studies, 50(4), pp.569-82.
Appendix:
Questionnaire:
| Q1 | Do You Have any idea about gum diseases? |
| a. | Yes |
| b. | No |
| Q2 | What is dental plaque |
| a. | Bacteria Adhere to Oral Tissues |
| b. | Calculus |
| c. | Stains |
| d. | I don’t Know |
| Q3 | What is gingivitis |
| a. | Gum disease |
| b. | Burning Sensation |
| c. | Gum Inflammation |
| d. | I don’t Know |
| Q4 | What causes gingivitis |
| a. | Plaque |
| b. | Smoking |
| c. | Teeth Grinding |
| d. | I don’t Know |
| Q5 | What is Periodontitis |
| a. | Pain in the gums |
| b. | Stains |
| c. | Inflammation of Tooth Supporting Structure |
| d. | I don’t Know |
| Q6 | What causes Periodontitis |
| a. | Plaque |
| b. | Dental caries |
| c. | Flurosis |
| d. | I don’t Know |
| Q7 | If the patient stops brushing, when do the gingival disease start? |
| a. | 7 Days |
| b. | 14 Days |
| c. | One Month |
| d. | I don’t Know |
| Q8 | Hospitalization more than two days without brushing may lead to oral disease |
| a. | Yes |
| b. | No |
| c. | I don’t Know |
| Q9 | Do You Have any idea about oral irrigation device? |
| a. | Yes |
| b. | No |
| Q10 | Are You familiar with the Correct Way of tooth brushing? |
| a. | Yes |
| b. | No |
| Q11 | Is the Oral Health Care Measure Part of your education? |
| a. | Yes |
| b. | No |
| Q12 | Are you interested in learning more about oral health? |
| a. | Yes |
| b. | No |
