Changing the Culture of Mouth Care: Mouth Care Without a Battle
Changing the Culture of Mouth Care: Mouth Care Without a Battle
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DOI：
10.1093/geront/gnt145
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发表时间：
2014-02-01
期刊：
影响因子：
5.7
通讯作者：
Barrick, Ann Louise
中科院分区：
文献类型：
--
作者：
Zimmerman, Sheryl;Sloane, Philip D.;Barrick, Ann Louise
研究目的：文化变革旨在以符合个人偏好的方式从根本上改善护理服务。然而，很少有关于文化变革的研究关注日常护理的质量，尽管全系统的努力对于确保以人为本的护理的有效性、采用性和可持续性非常重要，以满足日常需求。本文描述了一种新的文化变革实践，即“无需战斗的口腔护理”。对口腔护理的关注基于以人为本的口腔卫生支持与生活质量之间的重要联系。设计和方法：“无需战斗的口腔护理”是一种以人为本的方法，为有认知和身体障碍的人提供优质的口腔护理。它是由临床研究人员跨学科团队根据文献综述、专家咨询、现有项目的环境扫描以及疗养院测试而开发的。以“沐浴不战”的成功为基础，“口腔护理不战”根据改变的护理实践和结果进行了评估，开发成培训计划，并打包为数字视频光盘 (DVD) 和网站进行传播。结果：“无需战斗的口腔护理”的开发和评估表明对建立文化变革证据基础所需领域的关注，最终授权和支持员工提供护理以实现高质量的结果。启示：如本文所述，通过关注惠及所有居民的护理流程和结果、实施文化变革的能力以及实施成本，有利于为文化变革建立证据基础。
Purpose of the Study: Culture change aims to fundamentally improve care provision in a manner consistent with individual preferences. However, few studies of culture change have focused on the quality of daily care, despite the fact that system-wide efforts are important to assure the effectiveness, adoption, and sustainability of person-centered care to meet daily needs. This paper describes a new culture change practice, Mouth Care Without a Battle. The focus on mouth care is predicated on the important association between person-centered support for oral hygiene and quality of life. Design and Methods: Mouth Care Without a Battle is a person-centered approach to quality mouth care for persons with cognitive and physical impairment. It was developed by an interdisciplinary team of clinician researchers based on literature review, consultation with experts, environmental scan of existing programs, and testing in nursing homes. Building from the success of Bathing Without a Battle, Mouth Care Without a Battle was evaluated in terms of changed care practices and outcomes, developed into a training program, and packaged for dissemination as a digital video disk (DVD) and website. Results: The development and evaluation of Mouth Care Without a Battle demonstrate attention to the areas necessary to establish the evidence-base for culture change, to ultimately empower and support staff to provide care to achieve quality outcomes. Implications: As illustrated in this paper, it is beneficial to build the evidence base for culture change by attending to care processes and outcomes benefiting all residents, ability to implement culture change, and costs of implementation.