Related Experiment Video

Updated: Jul 16, 2025

Oral Health Assessment by Lay Personnel for Older Adults

Oral Health Assessment by Lay Personnel for Older Adults

Published on: February 2, 2020

Implementation of a nursing oral health care protocol in a university teaching hospital: A cluster-randomized

Laura Schafthuizen¹, Lotte Spruit-Bentvelzen¹, Monique van Dijk¹

¹Department of Internal Medicine, Section Nursing Science, Erasmus University Medical Centre, Rotterdam, the Netherlands.

International Journal of Dental Hygiene

|September 18, 2023

Abstract

Introduction:

Providing oral care is an essential part of basic nursing care but receives little priority in daily practice, with a risk of adverse events. Also, nurses report many barriers to adequate provision of oral care, such as time restraints, insufficient materials, fear of causing pain, lack of knowledge and a negative attitude towards providing oral care.

Methods:

We performed a cluster-randomized, stepped-wedge study to explore the effect of the the implementation of a new nursing evidence-based oral care protocol on nurses' knowledge, attitude and protocol adherence. The study population included both nursing students, graduated nurses and patients in selected wards. The implementation strategy included oral and written information, instruction videos and reminders. Nurses' knowledge and attitude towards oral care were assessed at baseline and after the implementation of the protocol with a validated 47-item questionnaire with a score range of 0-100. Secondarily, nurses' protocol adherence to teeth brushing, measured in Activities of Daily Living (ADL) dependent patients, was evaluated. The Standards for Reporting Implementation Studies (StaRI) Statement was used.

Results:

At baseline, the questionnaire was completed by 226 nurses; after implementation by 283. Knowledge had significantly improved from 68.8 to 72.3. Nurses' attitude improved not significantly. Protocol adherence was assessed in 73 ADL-dependent patients at baseline, in 51 after implementation. Adherence to teeth brushing significantly decreased in patients with permanent teeth. Also, adherence to both teeth brushing and usage of soap decreased in patients with (partial) dentures.

Conclusion:

Nurses' knowledge and attitude of oral care increased somewhat after the implementation of a new nursing evidence-based protocol. After implementation, there was an unexplained decreased adherence to oral care in ADL-dependent patients.

Keywords:

fundamental care implementation nursing oral care oral health

More Related Videos

Oral Biofilm Sampling for Microbiome Analysis in Healthy Children

Oral Biofilm Sampling for Microbiome Analysis in Healthy Children

Published on: December 31, 2017

Use of a High-throughput In Vitro Microfluidic System to Develop Oral Multi-species Biofilms

Use of a High-throughput In Vitro Microfluidic System to Develop Oral Multi-species Biofilms

Published on: December 1, 2014

Related Concept Videos

Nursing Implementation

Nursing Implementation

Implementation is the execution of the nursing care plan developed during the planning phase.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.

Study Designs in Epidemiology

Study Designs in Epidemiology

Epidemiological study designs are fundamental tools for investigating the distribution, determinants, and control of health conditions in populations. They help researchers understand the relationships between exposures and outcomes, and they broadly fall into two categories: "observational" and "experimental" studies.
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...

Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation

Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation

Planning for learning involves the development of a teaching plan. Teaching plans are similar to nursing care plans—both follow the steps of the nursing process. Planning in the teaching process involves setting goals and outcomes. Here, goals identify what a patient needs to achieve to understand a healthcare topic better, whereas the outcomes are the action to be performed by the patient to achieve the goal within a timeframe. For example, if the goal is to educate the patient about...

Cluster Sampling Method

Cluster Sampling Method

Appropriate sampling methods ensure that samples are drawn without bias and accurately represent the population. Because measuring the entire population in a study is not practical, researchers use samples to represent the population of interest.
To choose a cluster sample, divide the population into clusters (groups) and then randomly select some of the clusters. All the members from these clusters are in the cluster sample. For example, if you randomly sample four departments from your...

Role of Communication in the Nursing Process II: Planning and Implementation

Role of Communication in the Nursing Process II: Planning and Implementation

Several factors are considered while creating a patient's care plan. Motivation is a factor in improving communication, and patients often require encouragement to try different approaches involving significant change. It is essential to involve the patient and family in decisions about the plan of care to determine whether the suggested methods are acceptable. Consider meeting critical comfort and safety needs before introducing new communication methods and techniques. Allow adequate time...

Assessment of the Mouth

Assessment of the Mouth

A thorough mouth assessment, including inspection and palpation of the lips, gums, tongue, tonsils, uvula, and pharynx, is crucial in detecting potential health issues. Diseases ranging from oral cancer to systemic conditions like diabetes could be identified early through careful oral examination. This article provides a detailed guide on conducting a comprehensive mouth assessment.
Mouth Inspection
The inspection begins with visually examining the mouth for symmetry, color, and size.

Articles linked to this work by shared authors, journal, and citation graph.

Dynamic Pressure Ulcer Risk Predictions for Hospitalized Patients: Development and Validation of a Machine Learning Model With Nurses.

Journal of clinical nursing·2026

Clinical Application of a Neonatal Delirium Screening Tool: A Feasibility Study.

Acta paediatrica (Oslo, Norway : 1992)·2026

A nursing care model with a skill mix in the intensive care unit: a qualitative study of ICU nurses' and care assistants' experiences.

BMC nursing·2026

Patient perspectives on hospital's environmental sustainability policy, a cross-sectional survey in the Netherlands.

Health policy (Amsterdam, Netherlands)·2026

What are barriers and facilitators for implementation of music interventions for minor surgical procedures in general practice in the Netherlands? A qualitative study.

BMJ open·2026

A multidisciplinary active lifestyle aftercare programme for individuals with acquired brain injury (ABI-MOTION): protocol of a practice-based implementation study.

BMJ open·2026

See all related articles