Implementing Oral Health Screening and Dental Referral at a Medical Respite Facility for Homeless Persons
Date
2023
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Problem Statement: Oral health screening and dental referral are not routine components of homeless medical respite care despite widespread prevalence of poor oral health and underutilization of dental services among the homeless population. Purpose: The purpose of this evidence-based practice project was to increase linkages to dental care for persons admitted to the Hawai‘i Homeless Healthcare Hui (H4) Pūnāwai medical respite and to demonstrate the value of oral health screening and referral as part of usual respite care.
Methods: Retrospective chart review of a random sample of 21 previous respite admissions was done to determine baseline oral health activities offered with usual respite care. The intervention involved the development and administration of an evidence-based, four-item oral health screening and referral questionnaire (OHQ-4) offered to 22 eligible respite patients admitted between July – October 2022. Data from patient OHQ-4s and corresponding charts were compared to baseline results to determine the intervention’s effect on linkages to dental care.
Results: Twenty-one patients (95.5%) agreed to participate. Compared to usual respite care, which offers no oral health screening, implementation of the OHQ-4 dramatically improved linkages to needed dental care. By the conclusion of the pilot, 16 patients (72.7%) were scheduled with a dentist and 8 (36.4%) completed at least one visit during their respite stay, compared to 1 (4.8%) scheduled dental appointment and no completed visits (0%) at baseline.
Discussion: Medical respite patients are amenable to dental screening and referral; however, fulfilment of dental visits is constrained by patient health condition, dental clinic availability, and cost. Respite programs are uniquely poised to integrate oral health screening and dental care coordination into their existing service model. Oral health promotion activities are within nurses’ scope of practice, and the OHQ-4 could be adapted for other settings and patient populations.
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Nursing, Dentistry, Health sciences, Dental, Homeless, Medical respite, Oral health, Referral, Screening
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117 pages
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