IMPROVING ORAL CARE PROVIDED BY NURSING ASSISTANTS

描述(申请人提供)：这项研究的目的是衡量对注册护士助理(CNA)的教育干预对虚弱和功能依赖的养老院(NH)老年人的口腔护理的影响。这项研究的具体目的是：1)收集和分析有关CNA为虚弱和功能依赖的老年人提供口腔卫生护理的知识、意见和做法的数据；2)制定口腔护理教育计划，以解决为认知障碍的NH居民提供口腔护理的CNA的知识、意见和做法方面的缺陷；以及3)在所有权、地理位置和居民人口统计不同的两个设施中对教育计划进行试点测试。将对2个NHS的所有CNA进行调查，以满足具体目标1。居住在两个NHS的阿尔茨海默病单位的39名NH居民将被招募参加研究。将测量和记录假牙和牙菌斑、功能状态、对护理的抵抗力和认知障碍。来自两个阿尔茨海默病单位的48个CNA样本提供的口腔护理的数量和质量将被测量。CNAS将接受一小时的培训，向认知受损和护理困难的老年人提供口腔护理，然后在他们的日常工作时间接受一小时的一对一有组织的支持，调查员或研究助理将帮助CNAS将他们学到的策略应用于现实生活中的患者护理情况。干预的效果将通过干预后4周、8周和12周时牙齿和义齿上的菌斑数量来衡量。重复测量的方差分析将被检验，以确定教育干预对NH长者斑块得分的影响。模型中的术语将包括护理设施和时间。斑块得分从基线测量到第4周的下降将被解释为关于教育干预的有效性的直接测量。持续的效果将通过在第8周和第12周测量的斑块评分来衡量。

DESCRIPTION (provided by applicant): The purpose of this research is to measure the effect of an educational intervention for certified nursing assistants (CNAs) on the oral care of frail and functionally dependent nursing home (NH) elders. The specific aims of the study are: 1) Collect and analyze data surrounding the knowledge, opinions, and practices of CNAs providing oral hygiene care to frail and functionally dependent elders; 2) Develop an oral care educational program to address deficits in the knowledge, opinions, and practices of CNAs who provide oral care for cognitively impaired NH residents; and 3) Pilot test the educational program in two facilities that differ in ownership, geographic location, and resident demographics. All of the CNAs in 2 NHs will be surveyed in order to meet specific aim #1. A sample of 39 NH residents residing on the Alzheimer's Units of both NHs will be recruited for the study. Denture and dental plaque, functional status, resistance to care, and cognitive impairment will be measured and recorded. The quantity and quality of the oral care provided by a sample of 48 CNAs from both Alzheimer's Units will be measured. The CNAs will receive a 1-hour training session on providing oral care to cognitively impaired and care resistant elders followed by an hour of oneon- one structured support during their usual working hours, where the investigator or research assistant will help the CNAs apply the strategies they learned to real-life patient care situations. The effectiveness of the intervention will be measured by the amount of plaque on the teeth and dentures at 4 weeks, 8 weeks, and 12 weeks post-intervention. Repeated measures ANOVA will be examined to determine the impact of the educational intervention on the plaque scores of the NH elders. Terms in the model will include the nursing facility and time. A decrease in plaque scores from the baseline measurement to week 4 will be interpreted as an immediate measure of efficacy regarding the educational intervention. A sustained effect will be measured by the plaque scores measured at weeks 8 and 12.