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Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile)

BACKGROUND: Childsmile is Scotland’s national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive car...

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Autores principales: Gnich, Wendy, Deas, Leigh, Mackenzie, Sarah, Burns, Jacqueline, Conway, David I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280710/
https://www.ncbi.nlm.nih.gov/pubmed/25421225
http://dx.doi.org/10.1186/1472-6831-14-137
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author Gnich, Wendy
Deas, Leigh
Mackenzie, Sarah
Burns, Jacqueline
Conway, David I
author_facet Gnich, Wendy
Deas, Leigh
Mackenzie, Sarah
Burns, Jacqueline
Conway, David I
author_sort Gnich, Wendy
collection PubMed
description BACKGROUND: Childsmile is Scotland’s national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses’ ability to fully deliver their extended roles is necessary to ensure nurses’ potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs’ roles by EDDNs, in general dental practice across Scotland. METHODS: A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses’: role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. RESULTS: Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). CONCLUSIONS: This study has provided insight into EDDNs’ experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs’ roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1472-6831-14-137) contains supplementary material, which is available to authorized users.
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spelling pubmed-42807102015-01-01 Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile) Gnich, Wendy Deas, Leigh Mackenzie, Sarah Burns, Jacqueline Conway, David I BMC Oral Health Research Article BACKGROUND: Childsmile is Scotland’s national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses’ ability to fully deliver their extended roles is necessary to ensure nurses’ potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs’ roles by EDDNs, in general dental practice across Scotland. METHODS: A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses’: role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. RESULTS: Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). CONCLUSIONS: This study has provided insight into EDDNs’ experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs’ roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1472-6831-14-137) contains supplementary material, which is available to authorized users. BioMed Central 2014-11-25 /pmc/articles/PMC4280710/ /pubmed/25421225 http://dx.doi.org/10.1186/1472-6831-14-137 Text en © Gnich et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Gnich, Wendy
Deas, Leigh
Mackenzie, Sarah
Burns, Jacqueline
Conway, David I
Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile)
title Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile)
title_full Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile)
title_fullStr Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile)
title_full_unstemmed Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile)
title_short Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile)
title_sort extending dental nurses’ duties: a national survey investigating skill-mix in scotland’s child oral health improvement programme (childsmile)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280710/
https://www.ncbi.nlm.nih.gov/pubmed/25421225
http://dx.doi.org/10.1186/1472-6831-14-137
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