Oral Health Care In Adult Care Facilities

Transcription

1 Community Care Facilities Licensing Oral Health Care In Adult Care Facilities Helping persons in care to maintain a reasonable level of daily oral hygiene and to access professional dental services are requirements of the Adult Care Regulations. Community Care Facilities Licensing Promoting and protecting the health and safety of children and adults in licensed community care facilities Helga Thordarson Licensing Dental Hygienist Phone: Fax: Helga.thordarson@fraserhealth.ca Maintenance of oral health and hygiene contributes significantly to a person s cleanliness, comfort, and overall health and well-being. Research has shown us time and again that oral infections, lesions, ill-fitting dentures and other mouth related problems impact quality of life because of their effects on general health, relationships with others, level of satisfaction with life and desire to be as active as possible. An individual suffering from a mouth condition, making it difficult to eat, is at risk for weight loss and decline in overall physical health. The regulations were developed to underscore the importance of oral health care and the relationship oral health has on overall health. 1 (ACR Introduction, Lynn Guest) This pamphlet may be used as a resource for those developing an oral care program for persons residing in licensed facilities. It contains tools and practical information that will guide you toward meeting the oral care section of the Adult Care Regulations. There are samples of policies, procedures, and oral care plans as well as a variety of resources listed. Please note that the examples contained in the booklet are provided for your consideration and are examples of the type of information that licensing officers are looking for during their inspections. /seng Nov 2004; revised Jan

2 The adult care regulations ask you to do six basic things to promote and maintain good oral health among the people you provide care for: 6 Simple Things To Do 1. Create written policies to guide staff in all matters of care including oral health care. 2. Encourage persons in care to obtain an annual dental examination. 3. Assist a person in care to maintain oral health and hygiene. 4. Assist a person in care to obtain professional services as required. 5. Assist a person in care to follow orders of dental professional. 6. Plan for the person s oral health care. Help Guide Your Staff: Check your policies & procedures Your staff provide ongoing support for oral health care by following the policies and procedures set out by the facility and the person in care s individualized oral care plan. Yes No 1. Has your facility established access to on-going oral health care from dental health care professionals in the community? 2. Is there an admission policy for oral assessment? 3. Is each person in care encouraged to obtain an examination by a dental health care professional (dentist, dental hygienist, or denturist) at least once every year? 4. Does each person in care have a plan for oral health care developed and is it reviewed regularly? 5. Are residents consistently assisted in maintaining daily oral health? (Observing and partial assistance are frequently needed to ensure thorough care.) 6. Do you assist residents to obtain professional dental services as required? Hint: helping with appointments, transportation, mobile dental services, recording present and future appointments. 7. Do you help residents to follow recommendations or orders made by dental health care professionals. 8. Are activities related to implementation of oral health care plans and visits made to a dental professional documented? (including refusals to visit a dental health care professional) 9. Are there established methods of communication between care staff to ensure that oral health issues are identified and addressed? 10. Are necessary oral care supplies available? Does the facility replace as needed? (Is there a policy on frequency of replacement of brushes, and who is responsible to replace them)? 11. Is there a policy regarding storage of oral care items such as brushes, toothpaste, aids, and dentures? Are brushes and dentures labeled? - 2 -

3 Oral Health Care Plans Care plans are essential to coordinate delivery of services and programs to meet the needs those in care. The care plan is a source of information to the care providers, a record of care to be provided, and a basis for care evaluation and revision. When developing oral care plans, consider first, the unique needs and abilities and the cultural and spiritual preferences of the person in care. Complete the care plan within six weeks of admission to the residence. Review the plan on a regular basis, with the participation of the person in care, and modify it according to the needs and abilities of the person in care. Make sure that the oral care plan is accessible to staff who are providing direct care. (A sample oral health care plan format is provided on page 4.) Check It Out: How is your plan? Yes No 1. Is there a mechanism to assess oral health and dental status upon admission? (Hint: natural teeth, dentures, lips, gums, tongue, soft tissues and the overall condition of mouth should be assessed as per Fraser Health Standards.) 2. Is the name of the dental health care professional, contact information, and the last dental visit recorded upon admission? 3. Are the daily oral care instructions for each resident accessible to staff? 4. Is a mechanism in place to ensure daily oral hygiene procedures as described in the care plan are completed? (Hint: flow sheets or daily record of care can be used to record daily care.) 5. Is a mechanism in place to ensure that the oral care plan is reviewed on a regular basis and modified accordingly? 6. Do you encourage annual oral examinations? (Hint: Do you remind residents in writing and do you record refusals for professional oral exams?) 7. Do you have written information regarding oral care appointments? (Hint: How does the person in care get to their appointment? Are there special considerations such as financial arrangements, frequency of visits, consent issues, or concerns of the person in care that need to be addressed? 8. Do you request written summaries of services provided and outcome of the dental visit? (Hint: it is helpful to send a form with the resident to the dental office to ensure that there is communication regarding dental care provision and post treatment needs.) 9. If a person in care refuses oral care from staff and oral care professionals, do you record this? - 3 -

4 A Sample Oral Health Care Plan Format Although this format is not a licensing requirement, it represents a good example of the information that should be readily available in the person in care s records. ORAL HEALTH CARE PLAN Person in Care: Dental Status: Medical Alert: Date Plan Developed: Birth Date: Family/Advocate Consulted: Yes If No, Why? No Concerns: GOAL #1: Encourage persons in care to obtain an examination by a dental health professional once per year. Name of Professional: Dental Profession Type: Address: Phone: Fax: Special Considerations: Person Responsible: Financial: Transportation: Frequency: Consent: GOAL #2: Maintain daily oral health and hygiene. Level of assistance required: None Some Total Supplies required: _ Special Considerations: Procedure: Additional information on file: Yes Where: No - 4 -

5 GOAL #3: Obtaining professional services as required. Services required: Referred to: Address: Phone: Date: Services required: Referred to: Address: Phone: Date: Summary of services provided and outcome Additional Information on file: Yes No Where: GOAL#4: Follow recommendations and orders made by a person in care s dental care professionals. Health Professional: Name: Address: Phone: Date: Recommendations or Orders: * update person in care Profiles and Routines as needed Procedure: Additional Information on file: Yes No Where: Plan Developed By: Review Date: Initial: Review Date: Initial: Review Date: Initial: - 5 -

6 Heads Up: 5 Things a Licensing Officer May Look For When a Licensing Officer is completing an inspection of your community care facility, they may look for the following: 1. Is there is a policy in place and implemented regarding oral care that includes: Encouraging persons in care to have an annual dental exam and assisting them to obtain treatment? Information regarding the oral status of each resident (upon admission and regularly updated). Documentation of the completion of individualized daily oral hygiene care (or refusal of care). Evidence that staff are assisting persons in care to access dental treatment. This may include documentation of issues of consent, finances, behavior, transportation and scheduling? 2. Are there methods of communication/protocols established between care staff and management to ensure oral health issues are identified and addressed? 3. Is information regarding dental assessment, treatment and ongoing care documented and accessible? 4. Is there a routine in place to ensure that all persons in care have the necessary oral care supplies and that they are hygienically and conveniently stored? What is a Licensing Dental Hygienist? Other Resources.. The Licensing Dental Hygienist works as part of the licensing team in Fraser Health. She supports Licensees in their efforts to meet the oral care requirements, as well as assists Licensing Officers as they monitor and inspect facilities with regard to the oral care requirements. The Dental Hygienist is focused on ensuring that the oral care needs of persons in your care are met. The Dental Hygienist responds to general inquiries from facility operators and Licensing Officers regarding the intent and implementation of oral health care requirements specified in the regulations. They are responsible for providing guidance and resources to Licensing Officers as they inspect the oral care section of the regulations. Dental Hygienists also provide educational workshops and resources for operators to assist them in meeting the oral health-related regulatory requirements. Helga Thordarson is the Licensing Dental Hygienist for Fraser Health and she works on Mondays and /Thursdays. If you have any questions regarding available resources to assist you in meeting the oral care component of the regulations, please contact Helga by telephone at (604) helga.thordarson@fraserhealth.ca Integrated Oral Health Standard Fraser Health Authority Dental Health Services for Community Living Fraser East & North (604) Fraser South (604) College of Denturists of BC (604) registrar@cd.bc.ca College of Dental Hygienists of BC cdhbc@cdhbc.com College of Dental Surgeons of BC (604) postmaster@cdsbc.org - 6 -

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