SOHC Better Oral Care in LTC

Better Oral Carein Long Term Care

Saskatchewan Oral Health CoalitionOctober 27, 2014

Better Oral Care in Long Term Care

Best Practice Standards in Saskatchewan

Historically…


History of Saskatchewan Oral Health Projects in Long Term Care

oDental Health Educators working within their health regions have provided assistance to LTC patients and/or staff.

o Individual dental therapists were providing care in a few homes.



o In 2005 team discussions occurred.

o In 2007 the CDSS initiated the “Senior Oral Services (S.O.S.)” project.

o 2008 – “Access to Care” seminar.



In 2006 the SDAA proposed a

“Dental Assistant Care Plan” for LTC” Radiography (if available)

Fluoride

Oral hygiene instructions

Place Provisional Restorations

Desensitizing

Labeling dentures

Remove sutures, etc.



College of Dental Surgeons of Saskatchewan

2007-2008


Regina: Saskatoon:

Santa Maria Senior Citizens Home St. Ann’s Senior Citizens Home

Full Dental Operatory Portage Dental Equipment

Dr. Maureen Lefebvre Dr. Raj Bhargava

Better Oral Care

in LongTermCare

Initiatives such as poster’s were sent to each LTC home in Saskatchewan advocating oral care



Saskatchewan Dental Hygienists Associationo Skill set

o Workplaces

o Oral Systemic Link

o Diabetes Link and Perio Brochure


Saskatoon Oral Health Coalition

o May, 2010 Coalition formed

o May, 2011 Oral Care in Long Term Care was identified as a significant goal

o (transcended to Saskatchewan Oral Health Coalition – 2013)


Steering Committee - SHR

In 2011, the Saskatoon Health Region and the U. of S College of Dentistry partnered with Santa Maria and St. Ann’s, (Community Wellness Grant) to provide:

o administration

o human resources (dental assistant)

o Operation of a pilot project for oral health care


Project Overview:

o provided education to long term care staff at two long term care homes.

o Residents and their families were surveyed on basic oral health information.

o The dental assistant works in two long term care homes and facilitates treatment by:

Getting clients to the dental suiteAssists the dentist visiting the homeWorks with staff to promote daily oral care


Saskatchewan Oral Health Professions

o January, 2012

o Saskatchewan made Long Term Care Strategy

o Our strategy would be based on the ‘best practices’

o Present our strategy to the Saskatoon Oral Health Coalition… health district personnel… Saskatchewan Health


Saskatchewan Oral Health Professions

o College of Dental Surgeons of Saskatchewan

o Saskatchewan Dental Therapists Association

o Saskatchewan Dental Hygienists’ Association

o Saskatchewan Dental Assistants’ Association

o Dental Director, Saskatoon Health Region


Collaboration:

o The committee developed a proposal for a LTC Strategy for presentation to Saskatchewan Health;

o Reviewed “best practices” in LTC from around the world;

o Acquired access to the Australian model to be amended to reflect our model for care;

o Secured funding from the SOHP Conference fund to contract development;

o Hired a Masters in Public Health to develop the proposal /presentation.


SOHP Overall Strategy:

oResources made available to every health region

oResources made available to every long term care home in Saskatchewan.

oEndorsed by government


SOHP Goal #1

That the Saskatchewan Government, Ministry of Health endorse the Saskatchewan Seniors Oral Health and Long Term Care Strategy developed by the Saskatchewan Oral Health Professions collaboratively with Long Term Care.


SOHP Goal #2

That legislated Oral Health Care Policies/Standards for Long Term Care and Personal Care Homes are established based on best practice to strive for optimal oral and overall health for the people of Saskatchewan. Policies should ensure that every senior and long term care resident has the right and access to oral health care services:2.1 An individualized oral health care plan2.2 Basic oral hygiene supplies2.3 Daily oral hygiene 2.3 Professional dental services 2.4 Oral health record included within the resident’s health record 2.5 Dental recommendations/orders are followed

Note: As per Section 23 of the current Personal Care Home Regulation, each resident receive a dental examination, as necessary.


SOHP Goal #3

That an Oral Health Coordinator (OHC)(s), who is a licensed oral health professional, should be employed in each health region to facilitate the delivery of initial oral assessments, dental examinations and treatment, daily oral hygiene for residents and oral health education. The Oral Health Coordinator will work collaboratively with the long term care, multi-disciplinary team to improve the oral and overall health of residents.


SOHP Goal #4

That upon entry into a Long-Term Care (LTC) home, an initial oral assessment must be completed by a licensed oral health professional, through the general/medical consent provided by the long term care home.

4.1 Oral assessments should be routinely performed every 6 months thereafter, by an oral health professional or a health care professional trained in oral health.

4.2 Non-oral health professionals performing oral health assessments or care will receive appropriate training developed by this project.

4.3 All training will be provided by oral health professionals.


SOHP Goal #5

That initial oral assessments may trigger a referral to a dentist for a full dental examination to include:

5.1 Personal client record, including consent for dental examination

5.2 Review of medical and dental history

5.3 Complete examination of the oral cavity, to include:

5.3.1 Assessment of hard and soft tissues

5.3.2 Assessment of oral hygiene care

5.3.3 Oral cancer screening

5.3.4 Denture Assessment

5.4 Treatment plan/progress notes

5.5 Estimate/Consent for financial responsibility

5.6 Consent for treatment


SOHP Goal #6

Treatment needs based on the dental examination, may be provided by dentists, denturists, dental hygienists, dental therapists and/or dental assistants. Residents may access dental services through their personal oral health professional or through dental services as available through the long term care home.


SOHP Goal #7

That the Saskatchewan government establish a safety net program for more equitable access to oral health services for low income residents.


That the Saskatchewan Seniors Oral Health and Long Term Care Strategy is incorporated into post-secondary educational health training programs, orientation, and continuing professional development (i.e. for physicians, nurses, care aides, etc).


SOHP Goal #8

SOHP Goal #9

That the standard for new long term care homes includes provision for a treatment room suitable for a variety of health professionals including access to portable dental equipment to facilitate dental treatment.


SOHP Goal #10

That the implementation of a Saskatchewan electronic health record includes an oral health component.


SOHP Goal #11

That surveillance, evaluation and continuous quality improvement be performed on an ongoing basis to demonstrate improved health and oral health status outcomes.


Together, making a difference


Healthcare

SOHC Better Oral Care in LTC