Self-report of oral health services provided by nurses'aides in nursing homes

The purpose of this investigation was to identify the oral healthcare role of nurses' aides in nursing homes. Nurses' aides were asked to report what preventive and referral oral health services they provided, factors that encourage and discourage performance of these services, and their perceived knowledge of oral hygiene care procedures.

A random sample of 40% (n = 14) of nursing home facilities in southeastern Virginia was selected. A 14-item questionnaire was administered to 121 nurses' aides employed at 11 of these nursing home facilities during April, May, and June of 1991. Frequency and percentages were analyzed for discrete, nominally, and ordinally scaled data.

Eleven of the 14 nursing homes selected agreed to participate, representing 32% of the nursing homes in the southeastern region of Virginia. Ninety-eight out of 121 questionnaires were completed and analyzed. Nurses' aides in nursing home facilities typically reported providing preventive oral health services such as mouthrinsing (71%), toothbrushing (63%), and denture cleaning procedures (37%) for nursing home residents. The majority of nurses' aides indicated that patient cooperativeness was a major factor that encouraged (71%) or discouraged (88%) the performance of oral health services. Aides typically reported suspicious and abnormal findings detected in residents' mouths to the nurse in charge of the shift (97 5). The majority of nurses' aides rated their knowledge of mouthrinses for residents with teeth (99%), denture cleaning (99%), toothbrushing (97%), fluoride mouthrinses for residences with teeth (90%), mouth checks for residents with teeth (91%), and flossing (61%) as adequate or excellent. However, a large percentage of nurses' aides rated their knowledge of saliva substitutes (45%) and flossing (39%) as poor.

This study indicated that nurses' aides generally provide daily oral hygiene services to nursing home residents. Thus, the role of the dental hygienist should be to outline specific educational and curricular guidelines and conduct training programs for nurses' aides and to develop instructional materials to be used in nursing homes. Future dental hygiene graduates must be prepared to meet the needs of oral hygiene education for nurses' aides.