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Improving Oral Hygiene for Veterans With Dementia in Residential Long-term Care

McConnell, Eleanor, S., PhD, RN, GCNS-BC; Lee, Kyung, Hee, PhD, RN, GNP; Galkowski, Lorraine, MSN, RN, CNL; Downey, Christine, DDS, MS; Spainhour, Mary, Victoria, MSN, A/GNP-BC; Horwitz, Reginaldo, MSN, RN, AGCNS-BC, AGPCNP-BC, CCRN

doi: 10.1097/NCQ.0000000000000303

Oral hygiene care is neglected in long-term care (LTC) due to patient-, staff-, and systems-level barriers. A dementia-specific oral hygiene program, implemented and evaluated in a Department of Veterans Affairs LTC unit, addressed barriers to oral care at multiple levels. Improved staff competency, access to oral care supplies, and standardized documentation systems were accompanied by reduced oral plaque and gingivitis, demonstrating the feasibility and benefits of direct care staff providing improved oral hygiene in LTC.

Duke University School of Nursing, Durham, North Carolina (Dr McConnell); Geriatric Research, Education and Clinical Center (Dr McConnell) and Community Living Center (Ms Galkowski), Department of Veterans Affairs Medical Center (Ms Spainhour and Mr Horwitz), Durham, North Carolina; Yonsei University College of Nursing and Mo-Im Kim Nursing Research Institute, Seoul, Korea (Dr Lee); and University of North Carolina Chapel Hill School of Dentistry (Dr Downey).

Correspondence: Eleanor S. McConnell, PhD, RN, GCNS-BC, Duke University School of Nursing, Box 3322 DUMC, Durham, NC 27710 (

This project was supported by the Department of Veterans Affairs Office of Nursing Services Strategic Pilot Research Funding (McConnell, PI). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

The authors acknowledge the staff in the Community Living Center who contributed their support to this project including Mary Francis, Doris Drafts, and Nwakaego Umozurike.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: September 11, 2017

Published ahead of print: November 8, 2017

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