title: Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland.
abstract: To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers.
  
  
  
  Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format.
  
  
  
  Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care.
  
  
  
  Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively.
  
  
  
  Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records.
  
  
  
  NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children.
authors.affiliation: Center for Research to Evaluate and Eliminate Dental Disparities, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.|Department of Community Health Sciences, Boston University School of Public Health, Boston University, Boston, Massachusetts, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Bernstein
authors.affiliation: Center for Research to Evaluate and Eliminate Dental Disparities, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.|Department of Community Health Sciences, Boston University School of Public Health, Boston University, Boston, Massachusetts, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Gebel
authors.affiliation: Center for Research to Evaluate and Eliminate Dental Disparities, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.|Department of Orthodontics and Pediatric Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland, USA.
authors.forename: Clemencia
authors.initials: C
authors.lastname: Vargas
authors.affiliation: Center for Research to Evaluate and Eliminate Dental Disparities, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Geltman
authors.affiliation: Center for Research to Evaluate and Eliminate Dental Disparities, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.|Department of Community Health Sciences, Boston University School of Public Health, Boston University, Boston, Massachusetts, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Walter
authors.affiliation: Center for Research to Evaluate and Eliminate Dental Disparities, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.
authors.forename: Raul
authors.initials: R
authors.lastname: Garcia
authors.affiliation: Center for Research to Evaluate and Eliminate Dental Disparities, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.|Department of Orthodontics and Pediatric Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland, USA.
authors.forename: Norman
authors.initials: N
authors.lastname: Tinanoff
mesh_terms: D000554:Ambulatory Care Facilities; D001291:Attitude of Health Personnel; D002648:Child; D002654:Child Care / Q000458:organization & administration; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008396:Maryland; D008404:Massachusetts; D009718:Nurse Administrators / Q000458:organization & administration / Q000523:psychology; D009722:Nurse Practitioners / Q000458:organization & administration / Q000523:psychology; D024802:Nurse's Role; D000072222:Nurses, Pediatric / Q000458:organization & administration / Q000523:psychology; D009909:Oral Health; D010371:Pediatric Nursing / Q000458:organization & administration; D057184:Practice Patterns, Nurses' / Q000458:organization & administration*; D059017:Primary Care Nursing / Q000379:methods*; D012941:Social Responsibility
keywords: Collaborative practice; Interprofessional relations; Pediatric oral health