Developing a Basic Package of Oral Care Training Program for Primary Health Care Nurses

Abstract

Introduction:

Nurses are key in the delivery of the basic package of oral care in the primary health care system. Whereas oral health care training is essential for apt oral care delivery, the scope and training approaches for the primary health care nurse are not well established. A mentorship approach has rarely been explored for oral health training.

Objective:

This study aimed to develop a basic package of oral health care training program for primary health care nurses in Kenya. It also evaluated and compared the effects of workshop and mentorship approaches on a basic package of oral care training outcomes.

Methods:

The Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional model was used to develop the training program. This used a scoping review approach to inform the design and development stages of the training. Implementation followed a quasi-experimental design to deliver a 1-y postworkshop mentorship program (experiment) against a workshop-only (control) group. The Kirkpatrick framework was used for evaluation.

Results:

A training program with 7 learning areas and 37 subtopics covering nurses’ basic package of oral care tasks was developed and evaluated. Summative analysis included 67 nurses (experiment, n = 33; control, n = 34) and 1,128 parents (experiment, n = 570; control, n = 558). Improvement was noted in nurses’ overall knowledge (47.9% to 64.7%), confidence (77.3% to 92.2%), and oral health care services delivery (0.3% to 35.8%). Overall parental child oral health practices improved from 31.3% to 44.4%. The experiment group exhibited significantly higher scores for confidence, oral health care services delivery, and parental child oral health practices. Longitudinal decay in knowledge and confidence was lower in the experiment group.

Conclusion:

A basic package of oral health care training program for primary health care nurses in Kenya was successfully developed and evaluated. For all outcomes evaluated, the mentorship approach yielded better results than the workshop approach did. These results highlight mentorship as an integral component in a basic package of oral care training.

Knowledge Transfer Statement:

This study of primary health care nurses in Kenya provides insights to inform oral health and primary health care policy makers about oral health education, oral urgent treatment, referral, and oral health service documentation training requirements. It shows how planning and prioritization for in-service oral health training sessions could be maximized with limited resources. It also demonstrates the benefit of a mentorship training approach over a workshop-only approach to ensure optimal outcomes of oral health indicators.