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Better Oral Health in Long Term Care

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October 22, 2018

Published in: Healthcare
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Better Oral Health in Long Term Care

  1. 1. Saskatchewan oral health Coalition Fall 2018 Updates and 12month Evaluation Report Better Oral Health in Long Term Care
  2. 2. Teaching and implementing BOH program into another few new LTC homes & Oral Care Kits being put together for all the residents  Rosthern  Middle lake
  3. 3. Traveled to LaRonge to introduce the BOH program to their LTC HOME as well I trained the LaRonge Oral Health team for training the trainer!
  4. 4. Better Oral Health in Long Term Care Class Room settings for the Continuing car aide courses  Sherbrooke’s own CCA’s course Sherbrooke’sCCA students are placed at Sherbrooke and Central haven homes  Saskatoon Business College Urban and Rural classes Continuing Care Aide’s Courses
  5. 5. Better Oral Health in Long Term Care “ALL ABOUT ME” Oral Health section added to “ALL ABOUT ME “ Document found in the LTC resident’s charts
  6. 6. Better Oral Health in Long Term Care NEW BOH in LTC Review and Quiz added to the Annual Review Fair “ARF” There is a this link for you to clink on to find the BOH quiz on the LTC Annual Review fair. • You just have to log in and the BOH in LTC come out for you to look at what SCC has put together for the staff • This is how you would get there, if you started on the info-net page for our Saskatoon Area • On the left hand side under Featured links /Clink on the E- learning /LTC/BOH in LTC • https://learning.saskatoonhealthregion.ca/course/view.php?id=387 Annual Review Fair for staff in LTC
  7. 7. Better Oral Health in Long Term Care Surveys are completed each year by resident’s and families There has never been a question about Daily Oral Care  When they choose to fill out a survey their identity will not be known.  Results provided back to the home so improvement plans can be developed. Oral health Question we have asked to be added to the questionnaire for 2020-2021 Question: I am offered and I receive the assistance I need to ensure my daily oral care is provided each and every day The Annual LTC Resident’s Survey
  8. 8. Better Oral Health in Long Term Care “Did you know?” Articles for Seniors health and Continuing care
  9. 9. Better Oral Health in Long Term Care Huddle Talks Oral Care – Responsive Behavior Care givers are reluctant to provide oral care because of many reasons: ❑Not enough time ❑Not the right dental supplies ❑Fear of being bitten ❑Challenging behaviors ❑Lack of confidence that oral care is being done properly Your Home does have the right dental supplies, please make sure you know where they are stored Oral Health & Responsive Behavior Strategies: • Use your Gentle Persuasive Approach and Purposeful Interaction skills • Timing of daily oral care may have to be adjusted to achieve daily care some times 2 care givers are needed • Develop ways to improve access to the resident’s mouth: overcoming the fear of being touched, modeling, hand over hand, distraction, and/or alternative provider • Be mindful of your body language – ensure it’s approachable. • Establish effective verbal and non-verbal communication • Treat your residents the way you would want to be treated. It’s not acceptable to skip mouth care just because the resident does not request it. • Take the time to figure out what is bothering the resident Oral health is as important as skin integrity in protecting the body against infection. When this defense barrier is broken because of poor oral health, the bacteria in dental plaque can enter airways and the bloodstream causing:  Pneumonia, Heart attack, Stroke, Lowered immunity, Poor diabetic control Huddle Talk #4 For more information please contact: Kerrie Krieg CDA – 306-655-431 Kerrie.krieg@saskhealthauthority.ca Oral Care – Dentures Did you know? • Many oral health problems can occur in residents who wear dentures if Oral Care is not done. Oral Care needs to be a priority! • If dentures are not removed, allowing for the tissues to rest, infections such as thrush, or denture sore mouth can develop. Recommended Daily Denture Care: • Brush dentures with a denture brush morning and night • using a mild soap (suitable to use hand washing soap provided by the LTC home, Do Not Use regular Toothpaste as it will scratch the dentures) • Rinse dentures well under running water after cleaning them. • Brush gums and tongue with a soft toothbrush morning and night to stimulate the oral tissues. Cleaning dentures is not sufficient: both the dentures and the person’s mouth must be cleaned. • Best practice is to take dentures out of the mouth overnight, clean and soak in cold water. If resident does not like their dentures out over night, encourage them remove dentures for few hours during the day to rest their oral tissues. • Disinfect dentures once a week with a disinfectant tablet (ie: Poly dent). Paying careful attention to the kind of tablet, as partial dentures with clasps need a different kind of disinfectant tablet. • Offer and encourage the resident to drink water after meals, medications, other drinks and snacks to keep the mouth clean. • Chart and report any unusual findings in a resident’s mouth or the denture to the RN, RPN, or LPN on shift. Huddle Talk #2 Questions? Contact Kerrie Krieg, LTC Oral Health Coordinator for SHA. (306) 655-4317
  10. 10. Better Oral Health in Long Term Care RUH -Heart and stroke and brain injury department
  11. 11. Better Oral Health in Long Term Care Pizza was served and they did come !!! • During the staff’s Lunch and Learn sessions in the Heart & Stoke and Brain injury Department at RUH • I was able to provide teaching on the Importance of oral health. And introduce to the staff the new dental care products available to them. Lunch and Learn teaching sessions
  12. 12. Better Oral Health in Long Term Care RUH Stroke and Brain injury department
  13. 13. Better Oral Health in Long Term Care Oral Health In The Hospital Setting Replacement for toothpaste when needed : Perivex is an alcohol free antibacterial non- foaming gel Mouth cleaning gel Replaces Toothpaste for those with an aspiration risk or if they have trouble with rinsing and spitting Helps lubricate the mouth Water based - lubricant for the lips. Used for brushing the tongue
  14. 14. Oral Health In The Hospital Setting *Regular toothbrush  Soft Bristles  Small brush head  Wide handle has a soft rubber on the grip  Handle can be used as a mouth prop used as a bite rest for the patient.
  15. 15. Oral Health In The Hospital Setting *Interproximal tufted end tooth brush  Soft Bristles  Very small brush head  Handle can be used as a mouth prop used as a bite rest for the patient
  16. 16. Oral Health In The Hospital Setting To clean all 3 sides of the teeth at once by straddling the teeth Collis Curve toothbrush  Brush head is specifically designed with curved bristles  Available in 3 sizes
  17. 17. Better Oral Health in Long Term Care New Oral care product provided in all three Saskatoon hospitals
  18. 18. BOH 12 month Evaluation Report Better Oral Health in Long Term Care
  19. 19. Better Oral Health in Long Term Care BOH 12 month Evaluation Report LTC home Total number of residents Total number of neighbourhoods 3 Neighbourhoods assessed Total number of residents at (initial assessment) Total number of residents at follow up assessment (6 months) Total number of residents at follow up assessment (12 months) Sherbrooke Community Centre 263 7  Kinsmen Village (Houses 1 to 7)  Veteran's Village (Houses 8 to 11)  4th Floor 148 115 93 Sunnyside Adventist Care Centre 104 3  Diefenbaker  Prairie land  Riverview 104 62 51 Total 252 177 144
  20. 20. Better Oral Health in Long Term Care BOH 12 month Evaluation Report LTC Home Number of Staff Trained Sherbrooke Community Centre 39  1 Leadership Manager of Learning and Growth/ Training and development  7 Neighbourhood Team Mangers  9 Registered Nurses  22 Continuing Care Aides Sunnyside Adventist Care Centre 10  1 Director of care  1 Leadership Director of Education and Safety  1 Resident Care Coordinator  2 Registered Nurses  5 Continuing Care Aides Total 49
  21. 21. Better Oral Health in Long Term Care BOH 12 month Evaluation Report 12.90% 4.30% 6.45% 76.34% Either upper or lower complete denture Complete Denture in one arch and partial denture in the other arch Only partial denture No denture Proportion of Dentate Residents Using Dentures
  22. 22. Better Oral Health in Long Term Care BOH 12 month Evaluation Report Proportion of Residents with OHAT Scores for Lips BOH in LTC program had a significant impact on OHAT scores for Lips (p-value <0.001). There were 54.99% more residents with healthy lips in 12 month follow-up compared to the initial assessment.
  23. 23. Better Oral Health in Long Term Care BOH 12 month Evaluation Report Initial assessment Follow-up (12 months) Healthy 56.25% 79.86% Changes 43.75% 20.14% Unhealthy 0% 0% 0% 20% 40% 60% 80% 100% Proportion of Residents with OHAT Scores for Tongue BOH in LTC program had a significant impact on OHAT scores for Tongue (p-value <0.001). There were 41.97% more residents with healthy tongue in 12 month follow-up compared to the initial assessment.
  24. 24. Better Oral Health in Long Term Care BOH 12 month Evaluation Report Proportion of Residents with OHAT Scores for Gums BOH in LTC program had a significant impact on OHAT scores for Gums (p-value <0.001). There were 34.18% more residents with healthy gums in 12 month follow-up compared to the initial assessment.
  25. 25. Better Oral Health in Long Term Care BOH 12 month Evaluation Report Proportion of Residents with OHAT Scores for Natural Teeth BOH in LTC program had a significant impact on OHAT scores for Teeth (p-value= 0.0003). There were 70.56% more residents with healthy teeth in 12 month follow-up compared to the initial assessment.
  26. 26. Better Oral Health in Long Term Care BOH 12 month Evaluation Report Initial assessment Follow-up (12 months) Healthy 40.28% 67.36% Changes 52.78% 31.94% Unhealthy 6.94% 0.69% 0% 20% 40% 60% 80% 100% Proportion of Residents with OHAT Scores for Oral Cleanliness BOH in LTC program had a significant impact on OHAT scores for Oral Cleanliness (p-value <0.001). There were 67.23% more residents with healthy oral hygiene in 12 month follow-up compared to the initial assessment.
  27. 27. Better Oral Health in Long Term Care Healthy residents Proportion of healthy residents (OHAT measures) at Initial observation, 6 &12 month follow-up assessments The 2 areas that dropped back in %’s at the 12 month were oral cleanliness and Gums and oral tissues
  28. 28. How are the results on the 12 month evaluation possible? Better Oral Health in Long Term Care
  29. 29. Better Oral Health in Long Term Care Oral health Presence in the home Filthy mouths when arriving for their dental appointments
  30. 30. Better Oral Health in Long Term Care Oral health Presence in the home Checking dental care kits and finding this: Having Care Aides clean the dental care kits Or this
  31. 31. Better Oral Health in Long Term Care Teaching Care Aide how to place a NEW Partial denture
  32. 32. Assisting a Care Aide with placement of the electric toothbrush to make sure the bristles are into the gum line
  33. 33. Better Oral Health in Long Term Care Assisting with figuring out techniques that will work 2 brush technique. One to prop the mouth open the other to brush
  34. 34. Better Oral Health in Long Term Care Moisturizing the mouth and lips with Perivex
  35. 35. Better Oral Health in Long Term Care Showing the care aide how to do Hand Over Hand
  36. 36. Better Oral Health in Long Term Care For more information, visit saskhealthauthority.ca.

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