Objective

1
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.
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• 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 (plt.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.

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Contact Information Courtney Montgomery courtney.m
ontgomery_at_bourbon.kyschools.us