title: Efficiency at the resident's level of the NABUCCOD nutrition and oral health care training program in nursing homes.
abstract: OBJECTIVE
  To assess the impact of a nutrition and oral care training program on nursing home (NH) policies and residents.
  
  
  METHODS
  Cross-sectional surveys before/after intervention.
  
  
  METHODS
  One hundred thirty-eight NHs participated in the initial training.
  
  
  METHODS
  Training sessions for staff, director, and medical practitioners for nutritional and oral care in NH.
  
  
  METHODS
  Two waves of self-assessments over a 6- to 8-month interval described NH policies (Institution questionnaire), quality of care in newly admitted residents (Admission questionnaire), and in those present for more than 6 months (Stay questionnaire).
  
  
  RESULTS
  Questionnaires were completed at both waves in 24 NHs (17.8%) for Institution, in 42 NHs including 646 residents for Admission, and in 34 NHs including 287 residents for Stay. There was no significant difference in bed capacity and resident dependency between NHs, which performed both assessments, and nonresponders. No change was observed for Institution. Malnutrition screening was carried out in almost all residents. Two risk factors were better screened after training: pressure ulcers (39.4% to 49.1%, P = .014) and dysphagia (33.5% to 41.0%, P = .049). Oral examination improved quantitatively (38.5% of residents to 48.5%) and qualitatively: risk factors for malnutrition and dysphagia were better sought (loss of posterior teeth (P < .0001), asialia (P < .0001), and candidosis (P = .002)). Similar improvements were seen in Stay assessments. Actions to counteract weight loss or low dietary intake records were not found in one third of resident records.
  
  
  CONCLUSIONS
  Training program improved staff knowledge with positive results at the level of residents but no significant changes were seen within NH policies.
authors.affiliation: Department of Dentistry and Oral Health, CHU of Bordeaux, Bordeaux, France; Department of Oral Public Health, UFR of Odontology, Bordeaux Segalen University, Bordeaux, France; EA 4136 Handicap and Nervous System, Bordeaux Segalen University, Bordeaux, France; Agricultural Social Security (Mutualite Sociale Agricole) of Dordogne, Lot et Garonne, Perigueux, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Poisson
authors.affiliation: University Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
authors.affiliation: University Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Aurore
authors.initials: A
authors.lastname: Tulon
authors.affiliation: Dietetics Department, CHU of Bordeaux, Bordeaux, France.
authors.forename: Sandra
authors.initials: S
authors.lastname: Campos
authors.affiliation: Department of Dentistry and Oral Health, CHU of Bordeaux, Bordeaux, France; Department of Prosthodontics, UFR of Odontology, Bordeaux Segalen University, Bordeaux, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Dupuis
authors.affiliation: Department of Gerontology, CHU of Bordeaux, Bordeaux, France; RMSB, UMR 5536 CNRS, Bordeaux, France; RMSB, UMR 5536 Bordeaux Segalen University, Bordeaux, France. Electronic address: isabelle.bourdel-marchasson@chu-bordeaux.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bourdel-Marchasson
mesh_terms: D002983:Clinical Competence; D003430:Cross-Sectional Studies; D006801:Humans; D007318:Inservice Training / Q000592:standards*; D044342:Malnutrition / Q000175:diagnosis; D008503:Medical Staff / Q000193:education*; D009735:Nursing Homes; D015596:Nutrition Assessment; D009909:Oral Health / Q000193:education*; D016134:Organizational Policy; D058996:Quality Improvement; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Oral health; nursing homes; quality improvement