Implementation of oral health recommendations into two residential aged care facilities in a regional Australian city

Fallon, Tony; Buikstra, Elizabeth; Cameron, Michelle; Hegney, Desley; MacKenzie, Debra; March, Judith; Moloney, Clint; Pitt, Jacinta

doi:10.1111/j.1479-6988.2006.00040.x

Cited by 16 publications

(49 citation statements)

References 30 publications

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“…However, studies on the effectiveness of such strategies are limited [43]. Professional factors and individual characteristics identified in our scoping review including lack of dementia-specific knowledge, resistance to change, held attitudes, staff engagement and competence also appear to play a role in the implementation of dementia care practices [32, 44–48]. This indicates that future implementation efforts would benefit from a preparation stage to identify potential barriers and facilitators, and subsequently plan for multifaceted strategies that address the different levels informed by the needs and desires of relevant stakeholders in a constantly changing environment of care provision.…”

Section: Discussionmentioning

confidence: 99%

Dissemination and implementation research in dementia care: a systematic scoping review and evidence map

et al. 2017

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BackgroundThe need to better understand implementing evidence-informed dementia care has been recognised in multiple priority-setting partnerships. The aim of this scoping review was to give an overview of the state of the evidence on implementation and dissemination of dementia care, and create a systematic evidence map.MethodsWe sought studies that addressed dissemination and implementation strategies or described barriers and facilitators to implementation across dementia stages and care settings. Twelve databases were searched from inception to October 2015 followed by forward citation and grey literature searches. Quantitative studies with a comparative research design and qualitative studies with recognised methods of data collection were included. Titles, abstracts and full texts were screened independently by two reviewers with discrepancies resolved by a third where necessary. Data extraction was performed by one reviewer and checked by a second. Strategies were mapped according to the ERIC compilation.ResultsEighty-eight studies were included (30 quantitative, 34 qualitative and 24 mixed-methods studies). Approximately 60% of studies reported implementation strategies to improve practice: training and education of professionals (94%), promotion of stakeholder interrelationships (69%) and evaluative strategies (46%) were common; financial strategies were rare (15%). Nearly 70% of studies reported barriers or facilitators of care practices primarily within residential care settings. Organisational factors, including time constraints and increased workload, were recurrent barriers, whereas leadership and managerial support were often reported to promote implementation. Less is known about implementation activities in primary care and hospital settings, or the views and experiences of people with dementia and their family caregivers.ConclusionThis scoping review and mapping of the evidence reveals a paucity of robust evidence to inform the successful dissemination and implementation of evidence-based dementia care. Further exploration of the most appropriate methods to evaluate and report initiatives to bring about change and of the effectiveness of implementation strategies is necessary if we are to make changes in practice that improve dementia care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-017-0528-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Dissemination and implementation research in dementia care: a systematic scoping review and evidence map

et al. 2017

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“…Conversely, studies have also reported no improvements (Reed et al, 2006), especially long term. Interestingly, Fallon et al (2006) found the implementation of various teaching formats with a strong emphasis on practical skills was more effective in improving oral health knowledge absorption. However, these findings raise intriguing questions regarding a lack of historical requests for oral health education by the participants, given their apparent self-reporting of a deficit in knowledge and skills.…”

Section: Discussionmentioning

confidence: 99%

Promotion of oral health by community nurses

Garry

Boran²

2017

Br J Community Nurs

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Aim: To explore the enablers and barriers perceived by community nurses in the promotion of oral health in an Adult Community Trust Directorate.Background: Oral healthcare promotion in community care settings is being neglected. England and Wales have witnessed marked improvements in periodontal disease; however, no improvements have been seen in older people.Method: A qualitative methodology was employed, where eight nurses from Band 5 to 7 were interviewed using a semi-structured approach. The data was analysed thematically.Findings: Data analysis was organised into four themes: Professional self-concept and the development of knowledge, skills and attitudes necessary in the promotion of oral health; the impact an organisation has on the promotion of oral health and an exploration of the enablers and barriers identified by the community nurses while delivering care; the relationships between the nurse and patient and the potential impact on oral health promotion; the concept of self-regard in relation to the promotion of oral health and its overall impact.A commitment to improving oral health and requests for additional educational input was apparent. Organisational enablers and barriers were identified, alongside the crucial role a positive self-regard for oral healthcare may play in the promotion of oral health. Conclusion:Nurses need relevant education, organisational support, adequate resources and support from a multi-disciplinary team to deliver optimal oral health promotion.

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“…Although the National Oral Health Plan 2004-2013 (National Advisory Committee on Oral Health 2004) and subsequent educational strategies (Fallon et al 2006;Chalmers et al 2009) recognised the critical roles that could be played by HCPs in providing oral health care in RACFs, our review indicated a series of policy/protocol, educational, attitudinal, geographic/ environmental, health, access/equity, research and resource barriers that limit effective communication and collaboration between HCPs (Table 1).…”

Section: Oral Care Provision Barriersmentioning

confidence: 96%

Oral health care in residential aged care services: barriers to engaging health-care providers

Hearn

Slack‐Smith

2015

Aust. J. Prim. Health

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The oral health of older people living in residential aged care facilities has been widely recognised as inadequate. The aim of this paper is to identify barriers to effective engagement of health-care providers in oral care in residential aged care facilities. A literature review was conducted using MEDline, CINAHL, Web of Science, Academic Search Complete and PsychInfo between 2000 and 2013, with a grey literature search of government and non-government organisation policy papers, conference proceedings and theses. Keywords included: dental/oral care, residential aged care, health-care providers, barriers, constraints, and limitations. A thematic framework was used to synthesise the literature according to a series of oral health-care provision barriers, health-care provider barriers, and cross-sector collaborative barriers. A range of system, service and practitioner level barriers were identified that could impede effective communication/collaboration between different health-care providers, residents and carers regarding oral care, and these were further impeded by internal barriers at each level. Findings indicated several areas for investigation and consideration regarding policy and practice improvements. While further research is required, some key areas should be addressed if oral health care in residential aged care services is to be improved.

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Implementation of oral health recommendations into two residential aged care facilities in a regional Australian city

Cited by 16 publications

References 30 publications

Dissemination and implementation research in dementia care: a systematic scoping review and evidence map

Dissemination and implementation research in dementia care: a systematic scoping review and evidence map

Promotion of oral health by community nurses

Oral health care in residential aged care services: barriers to engaging health-care providers

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