Care home staff knowledge of oral care compared to best practice: a West of Scotland pilot study.

AIM: To evaluate care home (N) staff knowledge of oral care provision for dependent older people in comparison to guidelines from NHS Quality Improvement Scotland (NHSQIS). This pilot study also aimed to identify barriers to delivering oral care and determine if oral health educator (OHE) training had an effect upon staff knowledge of oral care delivery. SETTING: This cross-sectional analytic investigation was undertaken within the Greater Glasgow & Clyde area between 2005 and 2007. METHODS: From 33 care homes (N), 28 participated in data gathering through an interview schedule involving 109 staff. A 'knowledge check-list' founded upon daily oral care guidelines from the NHSQIS best practice statement (BPS) served as a template for knowledge assessment. An OHE undertook small group discussions related to the BPS in a sub-group of original participants and a second round of data was collected. RESULTS: The majority of surveyed staff (n = 86, 79%) agreed that residents required assistance with oral care and placed oral care (n = 85, 78%) in a moderate to high priority. However, only 57% of managers and 49% of nurses had received training in oral care provision. Most staff (79% of managers, 85% of nurses) were unaware of the NHSQIS BPS. Deficiencies in knowledge were identified in several areas of the BPS. In particular, knowledge in the care of the natural dentition was inadequate. Between pre- and post-OHE training, the research suggests the following areas are liable to change: prioritisation given to oral care (p = 0.01), perceived competence (p <0.0001) and confidence in providing oral care advice (p <0.0001). Following OHE intervention, staff knowledge in oral care procedures compliant with best practice guidelines increased by 45%. CONCLUSIONS: Knowledge of oral health provision by those responsible for the care of home residents was deficient. An OHE training programme structured around the NHSQIS BPS demonstrated a measurable increase in levels of staff knowledge of oral care procedures.