Are the barriers to good oral hygiene in nursing homes within the nurses or the patients?

Authors


Tiril Willumsen, Dental Health Services’ Competence Centre for Eastern Norway (TKØ), Hammersborg torg 3, 0179 Oslo, Norway.
E-mail: tiril@odont.uio.no

Abstract

doi: 10.1111/j.1741-2358.2011.00554.x
Are the barriers to good oral hygiene in nursing homes within the nurses or the patients?

Objective:  To explore nursing home patients’ oral hygiene and their nurses’ assessments of barriers to improvement.

Background:  In nursing homes, nurses are responsible for patients’ oral hygiene.

Materials and methods:  This study assessed the oral hygiene of 358 patients in 11 Norwegian nursing homes. 494 nurses in the same nursing homes participated in a questionnaire study.

Results:  More than 40% of patients had unacceptable oral hygiene. ‘More than 10 teeth’ gave OR = 2, 1 (p = 0.013) and ‘resist being helped’ OR = 2.5 (p = 0.018) for unacceptable oral hygiene. Eighty percent of the nurses believed knowledge of oral health was important, and 9.1% often considered taking care of patients’ teeth unpleasant. Half of the nurses reported lack of time to give regular oral care, and 97% experienced resistant behaviour in patients. Resistant behaviour often left oral care undone. Twenty-one percent of the nurses had considered making legal decisions about use of force or restraints to overcome resistance to teeth cleaning.

Conclusion:  Oral hygiene in the nursing homes needed to be improved. Resistant behaviour is a major barrier. To overcome this barrier nurses’ education, organisational strategies to provide more time for oral care, and coping with resistant behaviour in patients are important factors.

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