This research was funded by the John A. Hartford Foundation Building Academic Geriatric Nursing Capacity Scholars Program.
Oral Care Provided by Certified Nursing Assistants in Nursing Homes
Article first published online: 2 DEC 2005
Journal of the American Geriatrics Society
Volume 54, Issue 1, pages 138–143, January 2006
How to Cite
Coleman, P. and Watson, N. M. (2006), Oral Care Provided by Certified Nursing Assistants in Nursing Homes. Journal of the American Geriatrics Society, 54: 138–143. doi: 10.1111/j.1532-5415.2005.00565.x
- Issue published online: 2 DEC 2005
- Article first published online: 2 DEC 2005
- oral health care;
- nursing homes;
- certified nursing assistants
The purpose of this study was to describe the actual daily oral care provided by certified nursing assistants (CNAs) for dentate elderly nursing home (NH) residents who required assistance with oral care. The study was conducted in five nonrandomly selected NHs in upstate New York using real-time observations of CNAs providing morning care to residents, retrospective chart review, and CNA screening interviews. Oral care standards developed and validated by a panel of 10 experts (dentists, dental hygienists, registered nurses) to be appropriate for dentate NH residents were used to evaluate the oral care provided by 47 primary dayshift CNAs to a convenience sample of 67 residents. CNAs were blinded to the study's specific focus on oral care. Adherence to individual standards was low, ranging from a high of 16% to a low of 0%. Teeth were brushed and mouths rinsed with water in 16% of resident observations. One resident had her tongue brushed.
Standards never met were brushing teeth at least 2 minutes, flossing, oral assessment, rinsing with mouthwash, and wearing clean gloves during oral care. Most residents (63%) who received oral care assistance were resistive to CNA approaches. For most observations, oral care supplies were not evident. Actual oral care provided to residents contrasts sharply with CNAs' self-reported practices in the literature and suggests that NH residents who need assistance receive inadequate oral health care.