Running head: NURSING STUDENT ORAL HEALTH EDUCATION 1

Nursing Student Oral Health Education

Assessment, Diagnosis, Planning, Implementation, and Evaluation Phases

by

Kari Burdick

Kalia Crook

Nicole Hommer

In partial fulfillment

of the requirements for

DHYG 425: Community Health IV

Winter Quarter 2019

February 5th, 2019

NURSING STUDENT ORAL HEALTH EDUCATION 2

Assessment

The oral cavity is a gateway to the rest of the body. The importance of oral health and

how it is related to systemic diseases is not stressed enough in nursing schools. After contacting

Chitra Sharifian, director of the nursing program at Lake Washington we were confident that

there is a need for nursing students to be better educated in oral health. By educating RN and

CNA students at Lake Washington Institute of Technology we hope to increase their knowledge

in oral health and emphasize the importance of caring for patient’s oral hygiene. Research

performed for this project demonstrates that oral hygiene care performed by nurses tends to be

neglected due to their lack of knowledge of its link to systemic diseases.

Community profile

Our target population is CNA and RN students at Lake Washington Institute of

Technology in Kirkland, WA. Most of the students are between 20 and 30 years old, with a

majority being female. There is a wide range of ethnicity and cultural background, but all are

able to speak and understand English. RN students have an associate’s degree in pre-nursing.

Most students come from a middle-class family.

Needs Assessment

Our audience will be the RN and CNA students at Lake Washington Institute of

Technology. This is an important population to present to because many will be working with

long-term, hospital-bound patients, many of whom will be elderly and heavily dependent on the

nursing staff to help them perform daily activities. The nursing director at Lake Washington

Institute of Technology, Chitra Sharifian, originally discussed the need for us to discuss the links

between oral health and systemic health with the RN and CNA students, as well as the link
NURSING STUDENT ORAL HEALTH EDUCATION 3

between oral health and nosocomial infections. From those subjects we developed our goal to

increase the RN and CNA students’ knowledge of oral health. We also discussed that it would be

beneficial to discuss what oral healthcare interventions can be used to prevent disease and how to

use them. After doing some research, we noticed that many articles discussed these very needs in

healthcare. One article brought out that “Nosocomial and ventilator associated pneumonias that

plague critically ill, elderly and long-term care residents could be reduced with effective oral

hygiene practices” (Barnes, 2014, p. 103). Therefore, nosocomial infections and oral health and

their link needs to be discussed, because they really do affect one another. Another article

discussed systemic disease stating, “Literature confirms that the high incidence of certain

systemic conditions in long-term older patients may be linked to poor oral hygiene, which

include: diabetes, cardiovascular diseases, nursing home aspiration pneumonia and

physical/mental disorders” (Dahm, Bruhn, & LeMaster, 2015, p. 229). The link between

systemic health and oral health must be discussed because when someone overlooks a patient's

oral health, they can increase their risk of developing a more detrimental systemic illness. As

well as discussing oral health and its link to nosocomial infections and systemic disease, it is

important we discuss how to implement oral healthcare interventions with the audience because

in the workforce it was noted in one article that “only 1 to 3% of the nursing workforce is trained

in older adult oral care,” (Dahm et al., 2015, p. 232) and that nurses only considered oral

care/interventions when conducting evening rounds about a third of the time (Carter, Coker,

Kaasalainen, & Ploeg, 2017). Discussing the need to implement oral healthcare in the healthcare

environment is a necessity because it is often looked over and not taken seriously, but it has

serious implications. These are the needs we will discuss in our presentation to the RN and CNA

students.
NURSING STUDENT ORAL HEALTH EDUCATION 4

Literature Review

In the process of identifying disparities and needs within the community for oral health

and education, there is substantial literature and research regarding the oral health needs of older

patients in long-term care facilities (LTCFs), as well as in hospital settings. According to Dahm

et al. (2015), “It is estimated that the older population, aged 65 and older, will make up over 20%

of the U.S. population by the year 2030” (p. 229). This is a huge anticipated increase in aging

patients. The authors also stated that “by the year 2040, 4 million geriatric residents are predicted

to move into LTCFs in the U.S.” (p. 229). The patients in these long-term care facilities are

primarily cared for by the nursing staff (certified nursing assistants and registered nurses). The

Surgeon General reported that patients in long-term care facilities, when compared to other

populations, have a greater need for oral hygiene care due to root caries, periodontal disease,

xerostomia etc. It also states that there is high incidence rates with serious systemic health

conditions that link to poor oral hygiene.

In addition to the needs of patients in long term care facilities, hospital sourced infections

(nosocomial), especially ventilator-associated pneumonias are affecting critically ill patients, and

these could be reduced with effective oral hygiene practices (Barnes, 2014). Research shows that

there are changes that can occur in a patient’s oral cavity and its flora while in a hospital setting.

Some challenges exist when it comes to nurses and oral care, and there are various barriers to

getting care to patients. Nevertheless, there are interventions that could potentially be

implemented by either a dental hygienist or nursing staff.

In previous years, the oral cavity has been viewed as separate from the rest of the body,

and oral care was considered elective and not medically necessary. Research has proven this

view to be wrong. There is a direct link between oral health and the overall health and is referred
NURSING STUDENT ORAL HEALTH EDUCATION 5

to as the oral-systemic link. For this project, we have agreed that this link should be discussed

with the nursing students to help them understand their role in providing oral care and how

important it is for the overall health of the patients in their care. It is important to discuss that

while some oral infections are considered common, “these bacteria may also metastasize from

the local site through the bloodstream to infect a variety of organ systems, including heart valves,

brain, spleen, pancreas, liver, and bone” (Scannapieco, 2013, p. 166). Atherosclerosis,

cardiovascular disease, strokes, respiratory infections, and diabetes have all been linked with

poor oral health.

Regardless of the supporting science behind the oral-systemic link, it was found that oral

hygiene care performed by nurses tends to be neglected due to their lack of knowledge of its link

to systemic diseases. Even though there are existing guidelines in place for nurses, they may not

be adequate or be up to date with the advancement in knowledge and research (Coker, Ploeg,

Kaasalainen, & Fisher, 2013). Although oral care is a crucial means for prevention of infection,

it is still being viewed as “comfort care” (Carter et al., 2017).

To address this deficiency, we found there is a need for a new oral hygiene education

model program to help nurses working in nursing homes to be able to provide proficient oral care

to the patients. A study was done that discussed a new education model that focuses on lectures

and visuals, hands-on training, and increasing the oral health knowledge base. By use of detailed

instructions, discussion groups, and theoretical lectures about oral health with the caretakers, it

increases nurse’s motivation and confidence to provide daily oral care and improves the overall

health status of the elderly patients (Forsella, Kullberga, Hoogstraateb, Johansson, & Sjögrend,

2011).
NURSING STUDENT ORAL HEALTH EDUCATION 6

Therefore, we see more than enough research-proven support for the need to educate and

collaborate with nursing students, both RN’s and CNA’s, regarding oral care as part of their

comprehensive care for patients. The plan for this project is to develop a presentation that can be

used in all future nursing classes as part of the standard curriculum to stress the link between oral

health and systemic health. Therefore, enabling the students to educate their patients on the

importance of oral care. We also hope to provide the students with tips and techniques to help

them be more comfortable and confident in providing the care patients need.

Diagnosis

Our target population are CNA and RN students located in Kirkland, WA. There is about

24-30 students per class and we will be educating multiple different classes, of which will be at

different points in their program. We picked this group because they are students who are also

learning how to care for the community. Since there is a link between systemic disease and the

oral cavity, there is also a demand for nurses and dental professionals to collaborate.

Planning

Our priorities in this presentation are to help improve the audience’s knowledge on the

importance of oral healthcare in the nursing field. We will do this by speaking to a class of

nursing students as well as CNA students. After we originally met with the director of the

nursing programs at Lake Washington Institute of Technology, Chitra Sharifian, we discussed

how she feels there is a need for this presentation in her classes. She specifically wanted us to

talk about the links between oral and systemic health and between oral and nosocomial

infections. We also thought it would be beneficial to talk about how and what interventions can

be used regularly by nurses and CNAs to improve patients oral care. We will present this

information to the classes through a PowerPoint presentation and short video clips that discuss
NURSING STUDENT ORAL HEALTH EDUCATION 7

the three subjects the director wanted us to bring out. We will also have a pre and post-test to

help us determine how our presentation impacted the audience. There should also be an activity

during the presentation that some or all of the audience can participate in so there can be some

hands-on experience. To support our presentation, we will be trying to get support and donations

from local dentist offices and nursing homes to demonstrate with real materials how to treat

patients. We will also need support from the CNA instructors as well as the nursing instructors

so they can plan it into their curriculum.

Project Goal and Objectives

Goal: To increase the knowledge of the importance of oral health in RN and CNA students at

Lake Washington Institute of Technology.

Objective 1: To increase the knowledge of the link between oral health and systemic disease that

CNA and RN students have.

Objective 2: To increase the knowledge of the link between oral health and nosocomial

infections that CNA and RN students have.

Objective 3: To increase the awareness of the necessity to implement oral healthcare to prevent

disease into the nursing field of work.

Our objectives will be measured by a pre and post-test that will measure the knowledge the

audience gains.

Timeline
NURSING STUDENT ORAL HEALTH EDUCATION 8

4/4/18 Formed a group and discussed possible

target populations.

4/16/18 Contacted Chitra Sharifian, director of

nursing program at Lake Washington,

who informed us she would love to have

us come in and talk to the class.

4/25/18 Group discussed our areas of focus &

split up who would focus on which

topics more.

5/26/18 Discussed with each other a few articles

we found and how they would be helpful

for our project.

Summer 2018 Formulate lesson plan and send to Chitra

for approval.

Fall 2018 Implementation- presentation to RN and

CNA students at Lake Washington

Institute of Technology.
NURSING STUDENT ORAL HEALTH EDUCATION 9

Winter 2018 Summative assessments.

Winter 2018 Present results to dental hygiene

students.

Lesson Plan

Our overall goal is to increase the knowledge of the importance of oral health in nursing

and CNA students by implementing these objectives: increasing the knowledge of the link

between oral health and systemic health, increasing the knowledge of the link between oral

health and nosocomial infections and increasing awareness of the necessity to implement oral

healthcare to prevent disease. We will be presenting to two classes of students at Lake

Washington Institute of Technology, a registered nursing (RN) class and a certified nurse

assistant (CNA) class. This totals about 60 students. We will be doing a presentation and

discussion over the course of about 45 minutes with these students in fall quarter. We will be

presenting to these classes separately on two different dates in their own individual classrooms.

We plan on developing an interactive, multimedia PowerPoint presentation with videos,

discussions, visual aids, and hands-on activities. We will need a computer for this presentation.

We will also need visual aids like dentoforms and sample denture brushes, which would be nice

learning tools for the students to see and/or practice what they learn. Also, having what is

actually used in hospitals would be helpful. When asking questions during the presentation it

would be nice to have prize candy to encourage participation. A pre and post-test will also be

necessary to gather data on if the audience learns something. At the end of the presentation, it

would be ideal to hand out sample bags full of different oral hygiene tools the audience members
NURSING STUDENT ORAL HEALTH EDUCATION 10

could use in the field, it would also give an incentive for the audience to take the pre and post-

test. The audience should develop a better understanding on the importance of oral healthcare in

the nursing field.

Budget

Items Proposed costs Actual costs

Snacks for the class Not originally proposed $45

Gas $0 $0

Printing $0 $2

Candy (to encourage $5 $0

audience in answering

questions/volunteering)

Poster board supplies $10 $0

Summary

We will be discussing the importance of oral healthcare with nursing and CNA students

at Lake Washington Institute of Technology by increasing their knowledge in the link between

oral health and nosocomial infections, the link between oral health and systemic health, and the
NURSING STUDENT ORAL HEALTH EDUCATION 11

importance of implementing oral healthcare in the nursing field. The next step in program

planning is the implementation phase.

Implementation

Our goal of this project was to increase the knowledge of the importance of oral health in

RN and CNA students at Lake Washington Institute of Technology and provide the students with

tools and skills to have the confidence to implement with patients. The objectives of this project

were to increase the knowledge of the link between oral health and systemic disease that RN and

CNA students have; to increase the knowledge of the link between oral health and nosocomial

infections that RN and CNA students have, and to increase the awareness of the necessity to

implement oral healthcare to prevent disease into the nursing field of work. Communication was

initiated with Chitra Sharifan, Director of Nursing Programs and Rosa Wade, full time nursing

faculty at Lake Washington Institute of Technology, during Spring Quarter of 2018. Ms. Wade

invited us to present to her first year MedSurg lab and agreed to help facilitate working with the

CNA class. Unfortunately, Ms. Wade resigned from her position at the beginning of the summer,

and there was not a replacement instructor hired at that time for us to continue our planning. We

emailed Ms. Sharifan at the end of September to get the new instructors contact information to

resume our planning and implementation. Ms. Sharifan promptly responded and was excited for

an opportunity for collaboration between the dental hygiene and nursing programs. After

multiple emails to two different instructors, we were able to obtain permission to present to

Susan Abolafaya’s nursing class. It was a continuous challenge for us to get an implementation

date, as Ms. Abolafaya was not prompt with the correspondence, and we did not get confirmation

on an implementation date until the day prior to our proposed date. Another challenge was that

we were informed when we arrived for the presentation that the students were part of an LPN to

RN program, and most students have been practicing as LPN’s for 8-10 years. This was
NURSING STUDENT ORAL HEALTH EDUCATION 12

unexpected, as our previously planned presentation had been designed around an audience of

first year nursing students or CNA students. Due to that change in the audience, during the

presentation we did have to limit the time we spent on some of the topics, as the instructor

informed us that the students were already knowledgeable in some of the subjects we were

discussing. We presented to a class of eight students and administered the pre-test to them while

we set up the snacks for the class. Our presentation was about 25 minutes long with 5 minutes

dedicated for question and answers at the end. A post-test, and a drawing was held for an Oral-B

electric toothbrush for the students that chose to participate.

Our visual aid included a PowerPoint and large Colgate dentoform, with a toothbrush for

demonstration. The presentation was based around an informative slideshow that began by

talking about the link between oral health and systemic disease. This was elaborated on, while

also talking about the nosocomial infections and periodontal disease. We discussed oral care for

patients, showing pictures of several different aids to use and how to use them, how to help assist

a patient in brushing, proper denture care, and pictures of common oral lesions that could result

from lack of adequate oral and denture care. At the end of the PowerPoint, the audience took a

post-test. Our outcomes will be evaluated by the pre and post-tests. This will help us get a better

idea of prior knowledge of the students, and how much we were able to teach them in our

presentation.

Summary

We visited the Lake Washington Institute of Technology Nursing Program LPN to RN

bridge class with the goal of increasing the students’ knowledge of the oral-systemic link, how

oral hygiene relates to nosocomial infections, and increases their confidence in providing oral

care to patients. The presentation reviewed the relationship between oral health and systemic
NURSING STUDENT ORAL HEALTH EDUCATION 13

well-being, diseases linked to periodontal disease, how oral hygiene can reduce risks of

nosocomial infections, and reviewed techniques for brushing and assisting patients in their oral

hygiene routine. While the audience was small, a number of the students were interested in what

was presented and engaged in the question and answer portion of the presentation. We are

hopeful that the presentation lead to further discussions of how oral care should be implemented

into their nursing practice. Next, we will analyze the pre and post tests administered during the

presentation to evaluate whether we were able to accomplish the objectives of our presentation.

Evaluation

At the beginning of the presentation we quickly had to make some modifications to the

outline for our presentation. This was necessary based on our formative evaluation of the

students, as they were more knowledgeable than we were anticipating. These modifications

included spending less time explaining aspiration pneumonia and other nosocomial infections,

and a little more time on the impact of chronic inflammation and the link with systemic diseases.

We chose to cut out some of the demonstrations we had planned due to the time limitations we

were given.

Our summative assessment was conducted by means of a pre and post-test. There were

eight students who participated in the pre and post-test. Of those eight students, 5 scored 100%

on the pre and post-test. Two of the students scored 86% on the pre-test and 86% on the post-

test, and one student scored 57% on the pre-test and 86% on the post-test, showing that at least

one student learned something new from our presentation. As seen in Appendix D, of the valid

data we collected, the mean score for the pre-test was 91% and the mean score for the post-test

was 95%, showing a 4% increase in knowledge.

When developing our project, the goal was to increase the knowledge of the importance

of oral health in RN and CNA students. If the project went as planned, we would have presented
NURSING STUDENT ORAL HEALTH EDUCATION 14

to RN and CNA students. The presentation would have had a lot of beneficial information that

would positively impact their future careers. Our PowerPoint was put together nicely, and we

had other visual aids. However, since our audience was changed last minute, the information was

not as relevant. The students generally were still engaged, and we brought in snacks and an Oral-

B toothbrush to help encourage participation. Our strengths in this presentation were that we

were very prepared to demonstrate and explain a variety of complex concepts and procedures in

a basic way to encourage the audience’s role in their patient’s oral health. This would have

impacted our original audience more than our audience we presented to. Another strength would

be our use of visual aids and having the Oral-B toothbrush as an incentive for the audience to

participate. We were passionate about what we were discussing and were able to answer many

questions that the audience had with firm answers and science-based evidence to support them. It

would have been nice to be able to incorporate show-tell-do with the students, but since the

teacher only gave us 30 minutes and the students were not our original audience, we were not

able to implement these activities. Even though the presentation did not go as expected, we still

managed to work with what we had and did our best to keep the audience interested. In the end,

the students were able to take at least one thing away from the presentation that they had learned.

Our pre and post-test did not demonstrate this as much as we would have hoped because many of

the students got 100% on the pre-test. Next time, we think it would be beneficial to create a more

challenging test for our specific audience as the tests we used were intended for first year RN

and CNA students. Had we spoken to our intended audience, our goals and objectives would

have been accomplished more successfully. However, because our audience had a lot of previous

knowledge from work-experience, we were not prepared to increase their knowledge on

nosocomial infections and the link from oral disease to systemic disease as much as we had

hoped. We had only prepared to present very basic information on these topics. However, there
NURSING STUDENT ORAL HEALTH EDUCATION 15

was some new knowledge presented to the audience on oral healthcare and prevention, and what

tools they could implement in their workplaces. This topic brought up some questions from the

audience and was a good reminder for them to continue to implement oral healthcare with their

patients. Overall, we marginally increased our audience’s knowledge of oral healthcare in a

nursing environment, but we mainly just presented a good reminder to all of them on how they

can continue to help their patients.

This project has the potential to make a substantial impact on the demographic, however

the presentation most likely did not make a meaningful impact on those that we presented to. In

the future, better communication with the nursing program instructors would allow for

integration with the curriculum of the nursing students. This would assist in presenting

information that is impactful and help the nursing students develop a solid foundation and

understanding of oral health care in the nursing setting.

Although a lot of the problems that occurred during the presentation process were not in

our control, modifications can always be noted. If this presentation were to be done again, it

would be better to work more closely with the nursing program staff. Also, primarily targeting

CNA students rather than nursing students will yield better results as they may not have as much

prior experience with oral health and systemic diseases. It would also be ideal if our presentation

could be included in the student’s curriculum so the students can expect our presentation and be

mentally prepared so they can absorb more from it. Then, since the presentation could be better

anticipated by the audience, things would flow smoother and we will be able to explain the pre

and post-tests better for accuracy. This would allow us to yield more accurate results. If the

presentation and lesson plan is formatted for the correct audience, hopefully the information will

be new and exciting for the participants.

NURSING STUDENT ORAL HEALTH EDUCATION 16

Although this presentation was developed for an audience with limited oral health

knowledge, we ended up presenting to a group of people who were more experienced in the

patient care field as LPN’s. Yet despite the considerable knowledge they previously had, there

was an 4% increase in knowledge demonstrated by the pre and post-tests, so there was marginal

success in increasing the audience’s knowledge of oral health.

NURSING STUDENT ORAL HEALTH EDUCATION 17

References

Barnes, C. (2014, June). Dental hygiene intervention to prevent nosocomial pneumonias. Journal

of Evidence-Based Dental Practice Special Issue- Annual Report on Dental Hygiene,

14(3), 103-114. Retrieved from https://doi.org/10.1016/j.jebdp.2014.02.002.

Carter N., Coker E., Kaasalainen S., Ploeg J. (2017, January-February). Observations of oral

hygiene care interventions provided by nurses to hospitalized older people. Geriatric

Nursing, 38(1), 17-21. Retrieved from https://doi.org/10.1016/j.gerinurse.2016.06.018

Coker, E., Ploeg, J., Kaasalainen, S., & Fisher, A. (2013). A concept analysis of oral hygiene

care in dependent older adults. Journal of Advanced Nursing, 69(10), 2360-2371.

doi:10.1111/jan.12107

Dahm, T. S., Bruhn, A., & LeMaster, M. (2015, August 01). Oral Care in the Long-Term Care of

Older Patients. Retrieved May 5, 2018, from http://jdh.adha.org/content/89/4/229.full

Forsella M., Kullberga E., Hoogstraateb J., Johansson O., Sjögrend P. (2011, July). An

hygiene care interventions provided by nurses to hospitalized older people. Nurse

Education and Practice, 11(4), 256-259. Retrieved from

https://doi.org/10.1016/j.nepr.2010.11.017

Scannapieco, F. (2013, October 15). The oral microbiome: Its role in health and in oral and

systemic infections. Clinical Microbiology Newsletter, 35(20), 163-169. Retrieved from

https://doi.org/10.11016/j.clinmicnews.2013.09.003.
NURSING STUDENT ORAL HEALTH EDUCATION 18

Appendix A

Lesson Plan
TITLE: “Helping You Help Others” TARGET GROUP: CNA and RN student at Lake
Washington Technical College

ESTIMATED LENGTH: 45 minutes, presenting to each class separately on two different

dates in their own individual classrooms.

INSTRUCTIONAL METHOD: Presentation and discussion

EDUCATIONAL GOAL:
To increase the knowledge of the importance of oral health in RN and CNA students at Lake
Washington Institute of Technology.
INSTRUCTIONAL OBJECTIVES:
1. To increase the knowledge of the link between oral health and systemic disease that CNA
and RN students have.
2. To increase the knowledge of the link between oral health and nosocomial infections that
CNA and RN students have.
3. To increase the awareness of the necessity to implement oral healthcare to prevent
disease into the nursing field of work.

INSTRUCTIONAL MATERIALS:
Dentoforms and denture brushes to demonstrate brushing patients’ teeth with the correct
technique. Flow charts for how to care for a patient’s oral health. Pre and Post Tests “Helping
You Help Others”.

LEARNING ACTIVITY:
Pre and post test—“Helping You Help Others” with multiple choice and true/false questions
about when it is necessary to provide oral care to patients and how to provide the correct care to
patients, including those who have systemic conditions.

Instructional Set:
The career that you all have chosen to be a part of is very demanding and respectable one. You
have a desire to help those who are in need or cannot help themselves. We want to take some
time with you today, as fellow healthcare professionals, to increase the awareness of oral
healthcare in your profession. This way we have an interdisciplinary approach to help all patients
strive for total health.

Body
1. Distribute pre-test “Helping You Help Others”. Allow about 5-8 minutes for everyone to
finish the test and return them to us. Pass out comment cards for students to fill out something
they learned throughout the presentation.
2. Begin the presentation PowerPoint discussing these things:
a. How bacteria affects oral health
b. Oral disease process (periodontal and caries)
c. How oral disease can affect systemic conditions and vice versa
NURSING STUDENT ORAL HEALTH EDUCATION 19

d. Basic prevention techniques that nurses and certified nursing assistants can
implement with their patients
e. Basic brushing and denture care techniques
3. Distribute a post-test “Helping You Help Others” to see what they learned and collect
comment cards.
4. Collect post-tests and allow for a discussion to see if there are any questions and anything that
needs to be clarified. Also, this will give the audience a chance to share what they learned aloud,
and this can benefit the rest of the audience.
Closure:
We’ve talked a lot about how we can “Help You Help Others” today and how, as a team of
healthcare professionals, we can provide a high level of care to those in need. This will give our
patients a better quality of life and an easier path to health. Thank you for your time.
NURSING STUDENT ORAL HEALTH EDUCATION 20

Appendix B

Pre-Test

Dental Hygiene Presentation for RN and CNA students

1) It is unnecessary to provide oral care to patients on a ventilator

a. True
b. False
2) Dental plaque does not accumulate if you don’t eat/drink orally.
a. True
b. False

3) Periodontal disease and its associated bacteria is linked with:

a. heart disease
b. nosocomial infections
c. neither a or b
d. both a and b

4) If a patient is denying or is uninterested in oral care, it is not a CNA or RN’s duty to

educate patients on the benefits of oral care. Oral care is optional and should be left only
to dental professionals.
a. First statement is true, second statement is false.
b. First statement is false, second statement is true.
c. Both statements are true.
d. Both statements are false.

5) Patient’s in a hospital setting don’t need oral care as part of their care plan
a. True
b. False

6) The best way to assist a patient that has dexterity issues brush or floss is to:
a. Brush/Floss for them by positioning yourself in front of the patient
b. Brush/floss for them while they are laying down.
c. Not do anything, patients want to be independent and incomplete
brushing/flossing is better than no brushing or flossing.
d. There is no one-size-fits-all answer, each patient is different and may need
different modalities.

7) Chlorhexidine gluconate swabs or rinse is better at reducing biofilm and bacteria than
brushing.
a. True
b. False
NURSING STUDENT ORAL HEALTH EDUCATION 21

Appendix C
Post-Test

Dental Hygiene Presentation for RN and CNA students

1) It is unnecessary to provide oral care to patients on a ventilator

a. True
b. False

2) Dental plaque does not accumulate if you don’t eat/drink orally.

a. True
b. False

3) Periodontal disease and its associated bacteria is linked with:

a. heart disease
b. nosocomial infections
c. neither a or b
d. both a and b

4) If a patient is denying or is uninterested in oral care, it is not a CNA or RN’s duty to

educate patients on the benefits of oral care. Oral care is optional and should be left only
to dental professionals.
a. First statement is true, second statement is false.
b. First statement is false, second statement is true.
c. Both statements are true.
d. Both statements are false.

5) Patient’s in a hospital setting don’t need oral care as part of their care plan
a. True
b. False

6) The best way to assist a patient that has dexterity issues brush or floss is to:
a. Brush/Floss for them by positioning yourself in front of the patient
b. Brush/floss for them while they are laying down.
c. Not do anything, patients want to be independent and incomplete
brushing/flossing is better than no brushing or flossing.
d. There is no one-size-fits-all answer, each patient is different and may need
different modalities.

7) Chlorhexidine gluconate swabs or rinse is better at reducing biofilm and bacteria than
brushing.
a. True
b. False
NURSING STUDENT ORAL HEALTH EDUCATION 22

Appendix D

Evaluation Results