提昇身障住民於長期照護機構口腔照護品質

Enhancing Oral Health Care Quality among Disabled Residents in the Long-term Care Facilities

本單位為北部某醫學中心居家護理，護理訪視時發現合約照護機構身障住民口腔狀況普遍欠佳，有口臭、牙結石等口腔問題，且機構照顧服務員對口腔照護認知及技能不足，許多研究亦發現口腔內細菌與肺炎有密切關係，期望透過專案改善來提昇機構身障住民口腔衛生狀況，以減少合併症發生。本專案透過：（一）制訂「口腔照護標準作業」及設立稽核制度；（二）舉辦「口腔照護教育訓練」指導機構照顧服務員口腔照護知識及一對一技能指導，直至正確率達100％；（三）製作「身障住民口腔照護DVD示範教學影片」提供機構照顧服務員隨時參考等改善措施。專案實施後發現，機構身障住民牙菌斑檢查指數由75.2％下降至52.6％（下降22.6％），口臭強度由1.7級降至1級，肺炎住院率則由4.3％下降至1.6％（下降2.7％），確實有效提昇住民口腔衛生狀況，建議其他居家護理單位在執行護理訪視時，亦能主動指導口腔照護技能，以減少合併症發生並提昇身障住民口腔照護品質。

The poor oral health condition was commonly in found the disabled residents living in long-term care facilities. The knowledge of oral health care among caregivers in facility was relatively low. Research studies have suggested that the amount of oral bacterial was correlated with the occurrence of pneumonia. Through professional intervention, including setting up standard protocol for oral health care and inspecting scheme, providing oral health care education, and training facility caregivers one by one on the oral health knowledge, as well as producing demonstration tutorial video for facility caregivers, we intended to improve oral health condition of the residents in order to reduce related complications. After the intervention, the oral health condition improved as the plaque control record (PCR) of the residents reduced from 75.2% to 52.6% (22.6% decreased), halitosis level reduced from level 1.7 to level 1, and hospitalization rate due to pneumonia reduced from 4.3% to 1.6% (2.7% decreased). It is suggested that other health care professional could provide oral health care instruction spontaneously when visiting residents in facilities to enhance the quality of oral health care.