Impact of changes to breast cancer screening guidelines on healthcare providers and patients

In October 2015, the American Cancer Society (ACS) updated its evidence-based breast cancer screening guidelines for women at average risk for breast cancer. These guidelines introduced significant changes to the age to begin breast cancer screening, as well as the frequency between screenings and duration of screening. Not long afterward, in January 2016, the U.S. Preventive Services Task Force released its updated breast cancer screening guidelines, which differ from those of the ACS. The varying guidelines present challenges for healthcare providers and patients, particularly women aged 40–49 years. At a Glance • With the American Cancer Society’s update of its breast cancer screening guidelines for average-risk women, a major change has occurred regarding the initiation and frequency of screening. • Many breast cancer screening guidelines, with varying recommendations, exis t.• Nurses must continue to educate themselves on new breast cancer screening guidelines and be able to help women make informed decisions based on the available evidence, as well as each patient’s risk factors and personal values

Preventive dental care : an educational program to integrate oral care into pediatric oncology

BACKGROUND: Early childhood dental caries (dental cavities) is an infectious process. The development of oral problems during cancer care results in pain, fever, and delay in treatment. OBJECTIVES:The objective of this project was to integrate preventive oral care into pediatric oncology care. METHODS: This project consisted of an educational program for pediatric oncology providers who completed pre- and postprogram surveys assessing oral health knowledge, attitudes, and practice; attended an oral health education session; and performed oral assessment and fluoride varnish application on children during cancer treatment. FINDINGS: Three major outcomes resulted from this project: (a) 15 nondental healthcare providers attended the education session and 11 became certified by the American Academy of Pediatrics, (b) 53 pediatric patients with cancer received an oral assessment and fluoride varnish during the two-month project, and (c) oral health assessment and fluoride varnish was instituted as a standard of care

Promoting oral health for mothers and children : A nurse home visitor education program

The objective of this project was to determine if Nurse Family Partnership (NFP) nurses who received an oral health education session increased their oral health knowledge and practice behavior contributing to positive client oral health out-comes. A quasi-experimental design was used to investigate the impact of expo-sure to the oral health evidence-based curriculum on NFP nurses and clients. The oral health interventions took place during nurse home visits. The sample included 4 nurses from the Miami Florida NFP, a comparison group of 10 non-Miami NFP nurses, and 27 Miami NFP clients. A web-based 13-item nurse pre-post survey was used to assess the impact of oral health education on NFP nurs-es’ oral health knowledge and practice behaviors. A 10-item pre-post telephone survey was conducted with NFP clients to assess their oral health behaviors for self and child. Following an oral health educational session, NFP nurses demon-strated an increase in their oral health knowledge and developed evidence-based oral health practice behaviors. Clients who were given oral health education incorporated this into their childcare, which was associated with significantly improved oral health outcomes. It is recommended that NFP nurses integrate oral health as a standard of patient care in home visit assessments, education, and documentation throughout pregnancy, infancy, and toddlerhood

Improving oral health during pregnancy : a call to action

Improving the health and wellness of all children begins with comprehensive prenatal care and optimal oral health during pregnancy. Associations between oral health, pregnancy outcomes, and children’s oral health are compelling. Evidence supports the standpoint that the parent’s oral health status is a predictor of their child’s oral health. Furthermore, poor oral health in childhood can lead to poor educational and social outcomes for the child, as well as long-term overall health effects into adulthood. Poor oral health during pregnancy is also associated with more immediate negative birth outcomes including low birth weight and prematurity. Equally important, people deserve to have their oral health preserved, as poor oral health can lead to pain, loss of employment, poor quality of life, and worsening of chronic health conditions such as diabetes and heart disease. Common oral health conditions affected by hormonal changes especially during pregnancy include gingivitis, oral lesions, loose teeth, tooth erosion, periodontitis, and dental caries. With these important health issues at stake for parent and child, increased attention to oral health is warranted throughout the life span and particularly during the prenatal period

Integrating oral health curricula into nurse practitioner graduate programs : results of a US survey

Background and purpose: Nurse practitioners (NPs) are a significant segment of the US primary care workforce and have a pivotal role in improving access to oral health (OH) care. The purpose of this research was to assess OH curricular integration in primary care NP programs and to examine factors that influence integration and satisfaction with graduates’ level of OH competence. Methods: A cross-sectional, national survey of NP programs (N = 466) was conducted using an electronically distributed 19-item, self-administered questionnaire. Data analysis included univariate, bivariate, multivariate statistics, and logistic regression modeling. Conclusions: The large majority of pediatric, family, and adult–gerontology primary care programs are educating NP graduates about OH. Significant factors promoting integration and satisfaction with graduates’ level of competence included the presence of a faculty champion and routine teaching by a dental professional or nondental OH expert. Implications for practice: With adequate OH education, NPs are ideally positioned to integrate OH and primary care services in practice, thereby, improving access to OH care

Integrating Oral Health Curricula into Midwifery Graduate Programs: Results of a US Survey

Introduction: Midwives are a significant segment of the US maternal and primary health care workforce and play a pivotal role in addressing women's oral health care needs during pregnancy and throughout their life span. The purpose of this research was to assess oral health curricular integration in midwifery programs and examine factors that influence integration and satisfaction with graduates’ level of oral health competence. Methods: A cross-sectional, national survey of midwifery programs was conducted using an electronically distributed 19-item, self-administered questionnaire completed by the Directors of Midwifery Education. Data analysis included univariate and bivariate statistics. Results: All of the responding midwifery programs (N = 33) were educating their graduates about oral health; however, less than a quarter (22.6%) of program directors were satisfied with their graduates’ competency. Significant factors promoting integration were routine teaching by a dental professional and a formal relationship with a dental school, dental residency, or dental hygiene program. Programs with 4 or more hours of oral health curriculum were more likely to have a faculty oral health champion, use simulation in evaluation of their learners, and include interprofessional oral health education. Discussion: With adequate oral health education, midwives are ideally positioned to integrate oral health in pregnancy care as well as well woman care throughout the life span, thereby expanding access to oral health care

Senior oral health: A community-based, interprofessional educational experience for nursing and dental students

The current article highlights an interprofessional, older adult oral health community program, created through an Accelerating Interprofessional Community-Based Education and Practice grant from the National Center for Interprofessional Practice and Education, designed to address the gap between older adult health education and care delivery. This project developed an advanced practice, nurse-led partnership among The Hartford Institute for Geriatric Nursing and the Oral Health Nursing Education and Practice Program (both located at New York University Rory Meyers College of Nursing), New York University College of Dentistry, and Regional Aid for Interim Needs (RAIN), a community service organization for older adults in the Bronx. Teams of nursing (n = 26), nurse practitioner (n = 16), and dental (n = 64) students provided oral health education and oral hygiene instruction using Tooth Wisdom® educational materials to older adults, home health aides (HHAs), and volunteers in nine RAIN senior centers. Students demonstrated increases in their self-reported interprofessional competencies based on the Interprofessional Collaborative Competency Attainment Survey. Results also revealed that older adults (n = 500), HHAs (n = 142), and volunteers (n = 21) at the RAIN senior centers who attended the Tooth Wisdom presentation demonstrated an increase in oral health knowledge

The impact of oral-systemic health on advancing interprofessional education outcomes

The aim of this study was to evaluate the ettectiveness ot an interprofessional education (IPE) clinical simulation and case study experience, using oral-systemic health as the clinical population health example, for nurse practitioner/midwifery, dental, and medical students' self-reported attainment of interprofessional competencies. A pretest-posttest evaluation method was employed, using data from the Interprofessional Collaborative Competency Attainment Scale (ICCAS) completed by two large cohorts of nurse practitioner/midwifery, dental, and medical students at one U.S. university. Data from faculty facilitators were collected to assess their perceptions of the value of exposing students to interprofessional clinical simulation experiences focused on oral-systemic health. The results showed that self-reported interprofessional competencies measured by the ICCAS improved significantly from pre- to posttest for all three student types in 2013 (p<0.001) and 2014 (p<0.001). Faculty facilitators reported that the IPE clinical simulation experiences were valuable and positively influenced interprofessional communication, collaboration, patient communication, and student understanding of patient care roles. These results suggest that the Teaching Oral-Systemic Health Program Interprofessional Oral-Systemic Health Clinical Simulation and Case Study Experience was effective as a standardized, replicable curriculum unit using oral-systemic health as a population health exemplar to teach and assess interprofessional competencies with nurse practitioner/midwifery, dental, and medical students

Attaining interprofessional competencies by connecting oral health to overall health

Purpose: The purpose of this study was to evaluate the effectiveness of an annual oral-systemic health interprofessional education (IPE) clinical simulation and case study experience with nurse practitioner/midwifery (NP/MW), dental (DDS), medical (MD), and pharmacy (PharmD) students. Methods: The Interprofessional Collaborative Competency Attainment Scale (ICCAS) was used to measure students’ self-reported attainment of interprofessional competencies before and after the IPE experience. Pre- and post-test surveys were completed by NP/MW, DDS, MD, and PharmD student cohorts from 2017 to 2019. Students also had the opportunity to provide qualitative feedback about their experience at post-test. Data were collected from IPE faculty facilitators to assess their perception of the value of the Teaching Oral-Systemic Health (TOSH) program. Results: Student ICCAS results demonstrated statistically significant improvement in self-reported interprofessional competencies among all types of students across all 3 years (P < 0.001); qualitative student comments reflected positive experiences with the TOSH program. Survey data from IPE faculty facilitators supported the value of the IPE experience for all students. Conclusions: The findings demonstrate the effectiveness of the TOSH program in using oral-systemic health as a clinical exemplar to develop interprofessional competencies. The 2017–2019 data reinforce the credibility of scaling the TOSH model for developing interprofessional competencies with students from different health professions

The Impact of an Interprofessional Pediatric Oral Health Clerkship on Advancing Interprofessional Education Outcomes

The aim of this study was to evaluate the effectiveness of an innovative pediatric interprofessional education clinical experience using oral-systemic health as the clinical population example for improving the self-reported interprofessional competencies of family nurse practitioner, dental, and medical students. The objectives of the interprofessional experience were for students to apply pediatric oral health assessment, identify the pediatric oral-systemic connection, and practice a team-based approach to improve oral-systemic outcomes. In spring 2015, fall 2015, and spring 2016, a total of 162 family nurse practitioner, dental, and medical students participated in this interprofessional experience at Bellevue Pediatric Outpatient Clinics together with a pediatric dental resident. Team members collaborated in reviewing the patient chart, taking the patient's medical and dental history, performing an oral assessment, applying fluoride varnish, and providing education and anticipatory guidance. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was used as a pretest and posttest to evaluate the degree to which students perceived changes in their attitudes about interprofessional competencies following the learning experience. In the results, all students had improved mean scores from pretest to posttest after the experience, and these changes were statistically significant for all students: nurse practitioner (p<0.01), dentistry (p<0.01), and medicine (p<0.001). The mean change from pretest to posttest was statistically significant for each of the six interprofessional competency domains (p<0.01). In both pediatric dental and primary care settings, the changes from pre- to posttest were significant (p<0.001). The experience was similarly effective for all groups of students in increasing their attitudes about interprofessional collaboration. These findings suggest that a clinical approach can be an effective strategy for helping health professions students develop interprofessional competence