Hilft das zahnmedizinische Bonussystem den stationär Pflegebedürftigen?

Zusammenfassung: Die Mundgesundheit bei Pflegebedürftigen ist mangelhaft. Zufällig ausgewählte Pflegebedürftige (Berlin n=75, Nordrhein-Westfalen n=94, Sachsen n=73) aus 30 stationären Pflegeeinrichtungen wurden u.a. zu ihrem Verhalten der zahnmedizinischen Inanspruchnahme und der Nutzung ihres zahnmedizinischen Bonusheftes (zBH) befragt. Von 242Befragten (Median: 82Jahre, Range: 43-100Jahre, Frauen: 78,5%) besaßen nur 18,6% ein zBH, dabei gab es keine signifikanten geschlechts- und altersspezifischen Unterschiede. Regionale Unterschiede waren signifikant (Berlin 5,3%, Nordrhein-Westfalen 18,1%, Sachsen 32,9%; χ2-Test p<0,01). Die Zahnzahl war bei Bonusheftinhabern größer (Mann-Whitney-Test p=0,01), die Zeitspanne zum letzten Zahnarztbesuch geringer (p<0,01). Von den Bonusheftinhabern gaben 18,6% an, den Zahnarzt länger als 12Monate nicht aufgesucht zu haben (stationär Pflegebedürftige ohne Bonusheft 51,3%). Als Beitrag zur Qualitätssicherung, zur oralen Infektionskontrolle sowie zur Verbesserung der mundbezogenen und allgemeinen Lebensqualität wird die regelmäßige jährliche Durchführung zahnmedizinischer Reihenuntersuchungen mit dem Führen eines zBH für jeden Bewohner vorgeschlage

Cardiovascular imaging 2011 in the International Journal of Cardiovascular Imaging

Cardiovascular Aspects of Radiolog

Hilft das zahnmedizinische Bonussystem den stationär Pflegebedürftigen?

Oral health of long-term care (LTC) residents is often poor. From 30 random German LTC facilities, 242 random residents (Berlin n=75, Northrhine-Westfalia (NRW) n=94, Saxony n=73) (median age: 82 years, female: 78.5%) were interviewed as to their use of dental services, possession of a bonus booklet (BB), and completeness of records. Only 18.6% possessed a BB. Significant regional differences were observed (Berlin=5.3%, NRW=18.1%, Saxony=32.9%) (χ(2) test p<0.01). The number of teeth was higher (Mann-Whitney test p=0.01) and the time since last dental visit shorter (p<0.01) for all residents with a BB. Only 18.6% of people possessing a BB declared not having had a dental appointment within the previous 12 months (LTC residents without BB 51.3%). As a means towards improved quality management in nursing, better oral infection control of residents and increased oral health and general quality of life, the introduction of a regular annual preventive dental screening program including the use of a dental bonus system are suggested

Effect of a Physician-directed Educational Campaign on Performance of Proper Diabetic Foot Exams in an Outpatient Setting

BACKGROUND: The established guidelines for a diabetes foot examination include assessing circulatory, skin, and neurological status to detect problems early and reduce the likelihood of amputation. Physician adherence to the guidelines for proper examination is less than optimal. OBJECTIVE: Our objective was to increase compliance with the performance of a proper foot examination through a predominantly physician-directed interventional campaign. METHODS: The study consisted of 3 parts: a retrospective chart review to estimate background compliance, an educational intervention, and prospective chart review at 3 and 6 months. A properly documented foot examination was defined as assessing at least 2 of the 3 necessary components. The educational intervention consisted of 2 lectures directed at resident physicians and a quality assurance announcement at a general internal medicine staff meeting. Clinic support staff were instructed to remove the shoes and socks of all diabetic patients when they were placed in exam rooms, and signs reminding diabetics were placed in each exam room. RESULTS: There was a significant increase in the performance of proper foot examination over the course of the study (baseline 14.0%, 3 months 58.0%, 6 months 62.1%; P < .001). Documentation of any component of a proper foot examination also increased substantially (32.6%, 67.3%, 72.5%; P < .001). Additionally, performance of each component of a proper exam increased dramatically during the study: neurological (13.5%, 35.8%, 38.5%; P < .001), skin (23.0%, 64.2%, 69.2%; P < .001), and vascular (14.0%, 51.2%, 50.5%; P < .001). CONCLUSIONS: Patients with diabetes are unlikely to have foot examinations in their primary medical care. A simple, low-cost educational intervention significantly improved the adherence to foot examination guidelines for patients with diabetes