Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland
Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland
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DOI：
10.1136/bmjopen-2016-014124
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发表时间：
2017-03-01
期刊：
影响因子：
2.9
通讯作者：
Tinanoff, Norman
中科院分区：
文献类型：
--
作者：
Bernstein, Judith;Gebel, Christina;Tinanoff, Norman
目的：探索跨专业合作（IPC）的机会，以改善联邦合格卫生中心（CIMCs）的儿科口腔健康，确定IPC领导的口腔健康预防纳入健康儿童访问的挑战，并提出克服障碍的策略。示例：护士管理人员（NM），执业护士（NP），儿科临床工作人员和管理人员在两个国家的六个CNOHC进行了采访，使用semistructured formature.Design：扎根理论研究。主题包括整合的可行性，感知障碍和战略，将口腔健康纳入儿科初级care.Measurements：定性数据进行编码和分析，使用NVivo 10生成的主题iteratively.Results：护士在不同的角色认识到口腔健康预防的重要性，但不知道的专业准则，将口腔健康纳入儿科遇到。他们重视合作护理，特别是内部沟通，联合倡议和培训，并与牙科学校或社区牙科诊所合作。IPC的障碍包括培训不足，交叉沟通的机会很少，没有在电子健康records.Conclusions图表模板：NM，NP和儿科护理人员都重视IPC，以改善患者的口腔健康，但缺乏口腔健康培训和支持性的图表和转诊系统的限制。在支持下，他们愿意承担责任，将口腔健康预防措施引入到健康儿童的访问中，但需要IPC方法进行培训和系统更改。如果政策和行政支持到位，健康中心环境中的IPC团队可以共同努力，提供口腔健康评估，教育，氟化物保护漆应用和牙科转诊，降低幼儿龋齿的患病率，并增加低收入儿童到牙科之家的机会。
Objectives: To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers.Sample: Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format.Design: Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care.Measurements: Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively.Results: Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records.Conclusions: NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children.