Development Of Practice Guidelines For Daily Oral Care In Care-Dependent Older Adults To Complement The Interrai Suite Of Instruments Using A Modified Delphi Approach

Aim: To develop practice guidelines for nursing assistants who provide daily oral care to older adults.Background: The interRAI suite of instruments is internationally used in professional health care to assess the needs of care-dependent older persons. An optimised oral health section was developed recently to identify care clients with poor oral health and hygiene. Internationally shared guidelines for daily oral care are needed to complement the optimised oral health section of the interRAI suite of instruments.Material and methods: The modified Delphi approach started with the preparation of an initial draft. Subsequently, an online survey and a face-to-face discussion were conducted with international experts. Their feedback was used to revise the draft. Two additional online surveys were conducted with the experts to reach consensus agreement for each item of the revised version. The same group of experts was invited to the different study phases.Results: The three surveys were completed by 26, 27 and 23 international experts, respectively. A group of 18 experts completed each survey, whereof a subgroup of 11 experts also took part in the face-to-face discussion. Experts were dental hygienists, dentists, nursing scientists, physicians and psychologists from 14 different countries. After the final survey, consensus agreement was reached for 54 of the 57 (94.7%) items, representing the final version of the guidelines.Conclusion: Available evidence was combined with practical feedback from international experts to develop clear and concise practice guidelines for daily oral care in older adults. Implications for practice The guidelines will help to improve knowledge and reduce barriers of nursing assistants to provide daily oral care.