SmartJournal for Improved Oral Care in Nursing Homes

Summary

Poor oral health is common in care-dependent older adults, and healthcare professionals report numerous barriers when it comes to provision of oral care for elderly patients. Frequently reported barriers are lack of oral health knowledge/skills and care resistant behaviors (CRB) in patients suffering from dementia. Other barriers include lack of adequate oral care routines and satisfactory systems for documentation of issues related to oral health, a high workload and unclear responsibilities. To overcome these barriers, an easy-to-use digital tool named SmartJournal has been developed to assist health personnel in preserving the older patient's oral health. SmartJournal has three components: one for documentation of oral hygiene routines, one for monthly oral health assessment and one for e-learning (a digital knowledge base with information on geriatric oral health and handling of CRB). The objectives of the present study are to assess: 1) the effectiveness of SmartJournal in enhancing nursing home caregivers' capability, opportunity, motivation and routines related to oral care, 2) whether SmartJournal usage may result in improved oral health for nursing home residents and 3) whether SmartJournal usage may result in changes in documentation of oral health related issues in patient journals.

A cluster randomized controlled trial (C-RCT) will be employed to assess effects of SmartJournal usage as specified in the study objectives. Nursing homes located in Rogaland, Norway, will be recruited and randomly assigned to an intervention- and a control group. The intervention group will be provided with tablets containing SmartJournal, while the control group will continue with existing oral care routines. The intervention will last for 12 weeks. Measurements will be performed in both groups at baseline, immediately post-intervention (3 months) and at follow-up (9 months) and include: 1) a survey assessing caregivers' capability, opportunity, motivation and routines related to oral care, 2) oral examinations in residents using mucosal-plaque score (MPS) as a primary outcome variable for assessing oral health status, and 3) examination of patient journals to assess the frequency and quality of reported oral health related issues. We hypothesize that SmartJournal usage will have a positive effect as measured by favorable changes in study variable scores.

Conditions

• Oral Health

Interventions

DEVICE

SmartJournal

SmartJournal is a tablet application with three modules: Module 1 offers a system for simple check-box registration of daily oral hygiene routines. This module also includes an open text field where the caregiver can give a brief description of strategies used if the patient shows resistant behaviors. Module 2 offers a system for monitoring the patient's oral health through monthly check-ups. This module is an image-based, interactive learning- and assessment tool. Upon completion of the monthly oral health assessment health personnel receive a summary report with suggestions for tailored preventive and/or curative measures to be initiated. Module 3 offers an easily accessible knowledge base which includes information on geriatric oral health, standard equipment and procedures for daily oral hygiene routines for patients with various care needs. It also includes scientifically documented strategies that may be used to approach patients with dementia refusing oral care assistance.

Sponsors & Collaborators

• University of Bergen

  collaborator OTHER

• University of Stavanger

  collaborator OTHER

• Regional Research Funds Rogaland, Norway

  collaborator UNKNOWN

• Oral Health Center of Expertise Rogaland, Norway

  lead OTHER

Principal Investigators

• Elisabeth Lind Melbye, PhD · Oral Health Centre of Expertise Rogaland, Norway

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

60 Years

Max Age

110 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-03-01

Primary Completion

2024-06-05

Completion

2024-07-03

Countries

• Norway

Study Locations