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Nursing Students' Knowledge of the Importance of Oral Hygiene for Patients with Dysphagia Courtney Montgomery, M.A., Martin Diebold, Ed.D., Karen Brown, Ph.D., Tamara Cranfill, Ph.D. Eastern Kentucky University, Richmond, KY . Questionnaire (See handout for answer choices)
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Nursing Students' Knowledge of the Importance of Oral Hygiene for Patients with Dysphagia Courtney Montgomery, M.A., Martin Diebold, Ed.D., Karen Brown, Ph.D., Tamara Cranfill, Ph.D. Eastern Kentucky University, Richmond, KY Questionnaire (See handout for answer choices) 1. Dysphagia is the medical term for... 2. When a swallowing disorder is suspected, who has the primary responsibility for assessing, diagnosing, and providing direct intervention for dysphagia? 3. How important is it to perform daily oral hygiene for elders who are being tube fed? 4. What is the leading cause of death in the elderly population living in nursing homes? 5. Swallowing difficulties are most common in (age level)... 6. Who has the primary responsibility for developing routine oral hygiene care plans for individuals with dsyphagia in long-term care facilities? 7. Who has primary responsibility for performing routine oral hygiene care for individuals in long-term facilities? 8. How often do elders with dentures need to have them brushed/cleaned? 9. What is the relationship between individuals with dysphagia and the risk for pneumonia in long-term facilities? 10. Aspiration is the term that means... 11. What percentage of individuals with dsyphagia experience aspiration? 12. How often do elders with their natural teeth need to have them brushed? 13. Aspiration is most closely associated with... 14-16. See handout 17. The percent of nursing home residents who have swallowing difficulties is... 18. What is the relationship between dependency for oral hygiene care and the risk for pneumonia in long-term care facilities? • Introduction • Swallowing difficulties (dysphagia) and inadequate oral care are two risk factors for pneumonia in elderly individuals (Terpenning, 2005; Quagliarello, 2005; Langmore, 1998). • Aspiration pneumonia is primarily caused by the aspiration of bacteria from the oral cavity (Marik & Kaplan, 2003; Langmore, 1998). • Most nursing home residents rely on nursing home personnel to assist them with activities such as oral hygiene. • Little is known about how knowledgeable nursing home personnel are for dysphagia, oral hygiene, and the relationship between the two as they pertain to aspiration pneumonia. • Summary of Results • Knowledge about the importance of oral hygiene for patients with dysphagia, is different among CNA, LPN, ADRN, and BDRN students. • Significant differences exist between group means for correct answers. • Significantly more correct responses from LPNs, ADRNs, and BDRNs than from CNAs. • Significant differences between CNA, LPN, ADRN, and BDRN students for four of 16 questionnaire items. Objective This study was conducted to determine if the depth of knowledge about dysphagia, oral hygiene, and their association with aspiration pneumonia varies according to level of nursing education. • Discussion/Future Research • Findings indicate a discrepancy in nursing training programs for information related to oral hygiene, dysphagia, and the relationship between the two and patient outcomes. • May be due to greater time/emphasis on the topic during various training programs. • Care providers with the least knowledge of these areas may be the ones providing most of the oral hygiene care (CNA). • All four study groups lack complete understanding of the importance of oral hygiene for patients with dysphagia. • The need for further research: • Replication of study across more nursing training programs • Item analysis • Review of nursing training programs • Questionnaire evaluated/modified for validity/reliability • Methods • 228 nursing students from four colleges/universities enrolled in their last semester/phase of training. • Certified Nursing Assistant (CNA) • Licensed Practical Nurse (LPN) • Associate Degree Registered Nurse (ADRN) • Baccalaureate Degree Registered Nurse (BDRN) • Students completed a multiple choice questionnaire pertaining to dysphagia, oral hygiene, and relationship between oral hygiene, dysphagia, and aspiration pneumonia. Results/Analysis Analysis of Variance (ANOVA) revealed significant differences (p=<.05) between CNA, LPN, ADRN, and BDRN students for the group means for correct responses. The group of CNA students had significantly fewer correct responses than the groups of LPN, ADRN, and BDRN students. A Chi-Square item analysis showed the greatest degree of variability, with significant differences between the groups (p=.0028), on four questionnaire items: #6, #7, #10, and #18. Contact Information Courtney Montgomery courtney.montgomery@bourbon.kyschools.us