If we cannot measure it, we cannot improve it: Understanding measurement problems in routine oral/dental assessments in Canadian nursing homes-Part II.
assessment
long-term care
oral health
Journal
Gerodontology
ISSN: 1741-2358
Titre abrégé: Gerodontology
Pays: England
ID NLM: 8215850
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
30
04
2019
revised:
23
01
2020
accepted:
27
01
2020
pubmed:
3
3
2020
medline:
19
5
2020
entrez:
3
3
2020
Statut:
ppublish
Résumé
To evaluate the response process validity of the Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items and the organisational processes for assessing nursing home (NH) residents' oral/dental status. Although care aides provide most direct care to NH residents, including oral care, they are not directly involved in structured care planning activities, including RAI assessments. This most likely affects the accuracy of RAI assessments, as well quality of care. However, we neither know how well regulated and unregulated care staff understand the RAI oral/dental items, nor what processes are used in completing oral/dental assessments. We conducted nine focus groups with 44 care aides, nurses, allied health providers, clinical specialists and managers. We discussed randomly selected RAI oral/dental assessments with focus group participants, including participants' understanding of the items and why the options were selected. Participants also explained the communication and process for completing the RAI. Participants' perceptions of the oral/dental items aligned fairly well with the item definitions. However, responses primarily focused on severe oral/dental problems with obvious physical characteristics (eg black teeth denoting caries). For non-visual oral problems, such as pain, staff relied on resident verbalisation. No formal mechanisms were described for care aides to update nurses on residents' oral health needs. Performance problems of RAI oral/dental items are largely rooted in poor communication between care aides and nurses and not integrating care aides in assessment processes. We need policies that address these problems in order to improve NH residents' poor oral health.
Sections du résumé
OBJECTIVE
OBJECTIVE
To evaluate the response process validity of the Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items and the organisational processes for assessing nursing home (NH) residents' oral/dental status.
BACKGROUND
BACKGROUND
Although care aides provide most direct care to NH residents, including oral care, they are not directly involved in structured care planning activities, including RAI assessments. This most likely affects the accuracy of RAI assessments, as well quality of care. However, we neither know how well regulated and unregulated care staff understand the RAI oral/dental items, nor what processes are used in completing oral/dental assessments.
METHODS
METHODS
We conducted nine focus groups with 44 care aides, nurses, allied health providers, clinical specialists and managers. We discussed randomly selected RAI oral/dental assessments with focus group participants, including participants' understanding of the items and why the options were selected. Participants also explained the communication and process for completing the RAI.
RESULTS
RESULTS
Participants' perceptions of the oral/dental items aligned fairly well with the item definitions. However, responses primarily focused on severe oral/dental problems with obvious physical characteristics (eg black teeth denoting caries). For non-visual oral problems, such as pain, staff relied on resident verbalisation. No formal mechanisms were described for care aides to update nurses on residents' oral health needs.
CONCLUSIONS
CONCLUSIONS
Performance problems of RAI oral/dental items are largely rooted in poor communication between care aides and nurses and not integrating care aides in assessment processes. We need policies that address these problems in order to improve NH residents' poor oral health.
Types de publication
Journal Article
Langues
eng
Pagination
164-176Subventions
Organisme : Alberta Innovates - Health Solutions
ID : File No: 201300543, CA#: 3723
Organisme : University of Alberta
Informations de copyright
© 2020 Gerodontology Association. Published by John Wiley & Sons Ltd.
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