Development and evaluation of simulation-based scenario education program for professional oral hygiene care in intubated patient.

PURPOSE: This study was conducted to develop a professional oral hygiene care (POHC) simulation education program for intubated patients and to evaluate the suitability of education by evaluating the performance confidence (PC), critical thinking disposition (CT), and learning satisfaction (LS) of dental hygiene students. METHODS: This study developed a POHC simulation education program (theory, skill training, scenario education, and debriefing) for intubated patients through expert validation and consisted of a single-group pre- and postexperiment design. The subjects were 3rd and 4th year students at the Department of Dental Hygiene in Wonju City, and a total of 30 people were enrolled. The collected data were analyzed using the PASW Statistics version 23.0. The content validity test was measured by the CVI (Content validity index) value, and the PC, CT, and LS of the subjects before and after participating in the program were analyzed using a paired t-test. The significance level (α) was based on .05. RESULTS: After the program, the PC improved from 4.29 ± 0.43 to 4.54 ± 0.44, and there was a significant difference (p = .004). CT improved from 3.73 ± 0.36 to 3.84 ± 0.36, but there was no significant difference (p = .062), and prudence improved from 4.21 ± 0.33 to 4.43 ± 0.27, and there was significant difference. (p = .001). LS increased from 4.66 ± 0.36 to 4.90 ± 0.16 after education, and there was a significant difference (p = .002). CONCLUSION(S): Simulation education program improved dental hygiene students' POHC performance confidence. Various scenarios will need to be developed in the future, and it is necessary to evaluate simulation education within the dental hygiene curriculum and identify areas for improvement.

Differences in Korean adult inpatients' oral care behaviour in daily life and hospitals.

OBJECTIVES: The objectives of the study were to identify the differences in oral care methods between current and past hospitalizations and to investigate the need for inpatient oral care education for South Korean adults who have been hospitalized for more than 24 h. METHODS: This study employed a cross-sectional design. Between 23 December 2019 and 4 May 2020, a questionnaire was administered to 200 adult inpatients awaiting treatment and their guardians at university hospitals or clinics. Of these, the data of 195 patients were analysed. Frequency analysis, descriptive statistics and chi-square tests were used for data analysis. RESULTS: In daily life, the participants reported brushing their teeth thrice a day (52.3%) for 2 min (60%). A single product was the most used (51.3%). During hospitalization, 40% of the participants brushed their teeth thrice or more a day, 84.1% brushed for <1 min, and 83.6% did not use additional oral care products. CONCLUSIONS: Differences were observed between South Korean adults' oral care behaviours in daily life and those performed in hospitals. Oral hygiene habits, the frequency and duration of tooth brushing, and the use of oral care products decreased during hospitalization. Our findings can be applied to the development of oral care interventions for inpatients, while considering changes in the hospitalization environment and physical activity levels during hospitalization.

Learning outcomes of a mobile application for dental infection control education.

PURPOSE/OBJECTIVES: This study aimed to apply and verify the effectiveness of a mobile-based dental infection control education application to enable students majoring in dental hygiene to learning dental infection control education without time and space constraints. METHODS: This study used a nonequivalent control group pretest-posttest design to examine differences in learning outcomes between an experimental group that learned through the mobile application and a control group that learned with handouts. The Infection Prevention and Control Mobile Application (IPC App) and handouts were developed by referring to the Center for Disease Control's (CDC) guidelines for Infection Prevention and Control in Dental Settings. Both the experimental and control groups were guided to perform self-regulated learning, where they independently led and managed their learning for two weeks. The study was conducted at the D university college with 42 students from the second grade in the Department of Dental Hygiene from August to October 2021. Differences in knowledge, self-efficacy, and summative evaluation were analyzed using an independent sample t-test and repeated measures analysis of variance (p < 0.05). RESULTS: The findings confirmed that the experimental group who learned through the IPC mobile application had improved their knowledge and indicated a higher summative evaluation than the control group that learned via learning documents (p < 0.05). CONCLUSIONS: Owing to the high accessibility and repeatability of the learning content, the mobile application recommended in this study may serve as an effective self-directed learning tool for students to gain knowledge on the standard precautions for dental infection control.

Development of a competency for professional oral hygiene care of endotracheally-intubated patients in the intensive care unit: development and validity evidence.

BACKGROUND: Professional oral care in the intensive care unit may reduce the incidence of Ventilator Associated Pneumonia, which increases the patient's mortality rate. This study aimed to develop a competency for professional oral hygiene care of endotracheally-intubated intensive-care patients. METHODS: First, we developed a competency draft by reviewing the literature on oral hygiene care of patients in the intensive care unit. Next, we developed expert validity test questionnaires using this draft and conducted expert validity tests twice on 18 experts. We determined competency as a content validity index of 0.8 or more and received expert additive opinions about competency through an open-questionnaire expert validity test paper in this methodology study. RESULTS: The content validity index ranged from 0.8 ~ 1.0 for all items. The competency of 'professionalism' comprised 2 sub-competencies with 7 behavioral indicators. 'POHC preparation' comprised 3 sub-competencies with 10 behavioral indicators. 'POHC implementation' comprised 3 sub-competencies with 6 behavioral indicators. 'POHC evaluation' comprised 2 sub-competencies with 8 behavioral indicators. Lastly 'Cooperation among experts' comprised 3 sub-competencies with 7 behavioral indicatiors. CONCLUSIONS: To provide patients with high quality oral hygiene care, these competencies should be implemented, and oral hygiene care professionals and related medical personnel should form a cooperative system.

Changes in dental hygiene students' working posture following digital sound feedback.

INTRODUCTION: This study aimed to observe changes in working posture by measuring the REBA (Rapid Entire Body Assessment) score of dental hygiene students according to digital sound feedback linked with a smartphone application. METHODS: This study was conducted on 28 fourth-year dental hygiene students who received theoretical and practical training on dental posture in the second year and then practised on mannequins and patients for about four semesters. Periodontal instrumentation was performed freely by applying digital sound notification feedback for four weeks after baseline, 30 minutes per week. REBA was measured after performing periodic structure construction without providing digital sound notification feedback for the last 1-2 minutes. Follow-up was conducted the same way 2-3 weeks after the intervention period. RESULTS: The REBA score for total, neck and trunk of all subjects showed statistically significant decreases post-intervention compared with the baseline scores (total p < .001, neck p < .001 and trunk p = .042). CONCLUSIONS: A digital sound feedback system was shown to be effective in encouraging correct working posture in dental hygiene students by helping them improve their REBA scores.

Efficacy of mobile health care in patients undergoing fixed orthodontic treatment: A systematic review.

OBJECTIVES: We performed a systematic review of studies that assessed the efficacy of mobile health care in patients undergoing fixed orthodontic treatment, in an attempt to obtain contemporary evidence on the clinical impact of mobile health care on the patients' oral health and orthodontic treatment outcomes. METHODS: A systematic literature search was conducted using the PRISMA guidelines. We performed a comprehensive search using multiple databases (Cochrane Library, MEDLINE, EMBASE, Scopus, Google Scholar and Web of Science) with no restrictions on the language of publication or publication status up until 23 April 2019 to identify eligible studies. RESULTS: We included 11 unique studies. In this review, 9 of the 11 selected studies showed positive effects of mobile healthcare intervention, which resulted in reduced scores of oral hygiene and periodontal indices and white-spot lesions, as well as decreased duration of treatment, sagittal distance and intensity of self-reported pain. CONCLUSIONS: Mobile health care can be utilized as an adjuvant intervention to improve treatment outcomes in patients undergoing fixed orthodontic treatment. Oral healthcare experts should consider novel interventions using mobile devices in addition to the conventional mode of intervention.

Inter-rater agreement among multiple examiners for the assessment of plaque scores between quantitative light-induced fluorescence-digital and two-tone disclosing solution-stained digital images.

BACKGROUND: To utilize plaque scoring indices as objective measures, a certain standard of intra-rater and inter-rater agreement must be met. Achievement of high consistency among several examiners in the assessment of images from Q-ray cam (for quantitative light-induced fluorescence-digital imaging) and digital single-lens reflex camera of stained tooth surfaces might enable more efficient undertaking of large epidemiological studies and oral tests. METHODS: Second-year dental hygiene students and registered dental hygienists 40 examiners were randomly selected, all of whom provided informed consent. Multiple examiners assessed plaque scoring indices from the two types of images of the same 30 patients. The images were observed on a computer monitor, and the area with dental plaque was assessed using the Patient Hygiene Performance Index. The intra-class correlation coefficient was determined to evaluate the agreement among examiners and test methods for dental plaque Q-ray cam and digital single-lens reflex camera measurements were compared using a Bland-Altman plot. The intra-class correlation coefficient was analyzed using SPSS version 24 software (SPSS Inc., Chicago, IL, USA), and the exploratory graph was analyzed with MedCalc. RESULTS: Agreement among 40 examiners was excellent with an intra-class correlation coefficient of 0.990 when the Q-ray cam was used. The intra-class correlation coefficient for the registered dental hygienists group was 0.987 and that for the dental hygiene students group was 0.980. CONCLUSIONS: The study was high agreement in the assessment of Q-ray cam images and digital single-lens reflex camera images of stained dental plaque by multiple examiners, confirming that the two methods are validated both independently and with high mutual agreement.

Oral health care provided by nurses for hospitalized patients in Korea.

OBJECTIVES: To investigate registered nurses' awareness and implementation of oral health care in patients who are hospitalized in general wards or intensive care units (ICUs) in South Korea. METHODS: This research was performed as a descriptive survey of 149 nurses working in nine general hospitals with at least 100 beds in major Korean cities. RESULTS: Approximately half (40.9%) of the survey respondents reported providing oral health care for hospitalized patients but that relevant protocols were not available at most hospitals or wards (89.5%). Nurses working in an ICU were significantly more likely to provide oral health care than those working in general wards (83.9% vs 15.1%; P < .001). Most respondents (83.2%) were aware of the importance of providing oral health care for hospitalized patients; however, the proportion considering that such care should be provided by dental hygienists was greater than that considering it should be provided by nurses (36.4% vs 26.0%; P < .001). Agreement that oral health care should be provided for hospitalized patients by dental hygienists was highest in nurses working in ICUs (53.3%; P < .001). CONCLUSIONS: According to this survey, oral healthcare provision is generally low in hospitalized patients and differs between ICUs and general wards. Most respondents considered that dental hygienists should provide oral health care for hospitalized patients. There is an opportunity for nurses and dental hygienists to work collaboratively towards development of an evidence-based protocol for oral health care in hospitalized patients.

Relationships between dental hygienists' work environment and patient safety culture.

BACKGROUND: Patient safety culture is a core factor in increasing patient safety, is related to the quality of medical service, and can lower the risk of patient safety accidents. However, in dentistry, research has previously focused mostly on reporting of patient safety accidents. Dental professionals' patient safety culture must therefore first be assessed, and related factors analyzed to improve patient safety. METHODS: This cross-sectional study completed a survey on 377 dental hygienists working in dental settings. To assess patient safety culture, we used a survey with proven validity and reliability by translating the Hospital Survey on Patient Safety Culture (HSOPS) developed by Agency for Healthcare Research and Quality (AHRQ) into Korean. Response options on all of the items were on 5-point Likert-type scales. SPSS v21 was used for statistical analysis. The relationships between workplace factors and patient safety culture were examined using t-tests and one-way analysis of variance (ANOVA) tests(p < 0.05). RESULTS: The work environment of dental hygienists has a close relationship with patient safety. Dental hygienists working ≥40 h/week in Korea had a significantly lower for patient safety grade than those working < 40 h/week. When the number of patients per day was less than 8, the safety level of patients was significantly higher. And significant differences were found depending on institution type, institution size. CONCLUSIONS: In order to establish high-quality care and patient safety system practical policies must be enacted. In particular, assurance in the quality of work environment such as sufficient staffing, appropriate work hours, and enough rest must first be realized before patient safety culture can easily be formed.

Estimation of fluoride intake from milk-based infant formulas and baby foods.

The aim of this study was to examine the amount of fluoride ingested from infant formula and baby food in infants aged up to 6 months in South Korea. The fluoride content of 20 commercially available formulas and 8 baby food samples from 4 different brands was measured using a modified microdiffusion method and fluoride ion selective electrode. The amount of fluoride (F) ingested by infants was estimated assuming that the samples were reconstituted with water containing 0, 0.5, 0.8, and 1.0 ppm F. When the reconstituted formulas and baby foods contained 0.8 ppm F water, the infants were estimated to ingest fluoride in the range of 0.018 to 0.298 mg/kg/day. The findings of this study suggest that there is a need for clear guidelines for fluoride consumption by infants that should be followed by manufacturers and parents.

Validation of a Korean version of the Child Oral Health Impact Profile (COHIP) among 8- to 15-year-old school children.

OBJECTIVES: The purpose of this study was to assess reliability, discriminant validity, and convergent validity of the Oral Health Impact Profile (COHIP) Korean version in a representative community sample of 8- to 15-year-old Korean children. METHODS: A Korean version of COHIP was developed according to the standard procedure of cross-cultural adaptation of self-reported instruments. A representative community sample of 2236 schoolchildren was selected by cluster sampling method. RESULTS: Mean age of the participants was 11.8 years. Mean and median of the overall COHIP score were 103.3 (SD 13.3) and 106, respectively. Internal reliability and retest reliability were excellent with Chronbach's alpha 0.88 and intraclass correlation coefficient 0.88. Face validity was confirmed with 98% of participants reporting the COHIP questionnaire was easy to answer. Nonclinical factors such as self-rated oral health or satisfaction with oral health were significantly related with overall COHIP score and five subscale scores (P < 0.001) in a consistent manner. Children with carious permanent teeth and with orthodontic treatment need had highly significantly lower overall COHIP score (P < 0.01). CONCLUSION: The Korean version of the COHIP was successfully developed. The internal reliability, retest reliability, face validity, discriminant validity, and convergent validity of the COHIP Korean version were confirmed.