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The OHNEP Interprofessional Oral Health Faculty Toolkit

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The OHNEP Interprofessional Oral Health Faculty Toolkit The OHNEP Interprofessional Oral Health Faculty Toolkit Adult-Gerontology Nurse Practitioner Program CURRICULUM INTEGRATION OF INTERPROFESSIONAL ORAL HEALTH CORE COMPETENCIES: • Adult-Gerontology Health Assessment • Adult-Gerontology Health Promotion • Adult-GerontologyPrimary Care • Resources © Oral Health Nursing Education and Practice (OHNEP) INTRODUCTION The Oral Health Nursing Education and Practice (OHNEP) program has developed an Interprofessional Oral Health Faculty Tool Kit to S! provide you with user friendly curriculum templates and teaching-learning resources to use when integrating oral health and its links to ! overall health in your Adult-Gerontology Nurse Practitioner program. ! Oral health and its relation to overall health has been identified as an important population health issue. Healthy People 2020 (2011), the IOM Reports, Advancing Oral Health in America (2011) and Building Workforce Capacity in Oral Health (2011), as well as the IPEC Competencies ! (2011), challenged HRSA to develop interprofessional oral health core competencies for primary care providers. Publication of the report, ! Integrating Oral Health in Primary Care Practice (2014), reflects those interprofessional oral health competencies that can be used by Adult- Gerontology Nurse Practitioners for faculty development, curriculum integration and establishment of “best practices” in clinical settings. ! The HRSA interprofessional oral health core competencies, the IPEC competencies and the NONPF core competencies provide the framework for the curriculum templates and resources. Exciting teaching-learning strategies that take students from Exposure to Immersion to Competence can begin in the classroom, link to simulated or live clinical experiences and involve community-based service learning, advocacy and policy initiatives as venues you can readily use to integrate oral health into your existing primary care curriculum. The Adult- Gerontology Nurse Practitioner curriculum template illustrates how oral health can be integrated into health promotion, health assessment and clinical management courses. The Smiles for Life interprofessional oral health curriculum provides a robust web-based resource for you to use that articulates with the oral health curriculum template for each course. A good place to begin oral health integration is by transitioning the HEENT component of the history and physical exam to the HEENOT approach. In that way, you and your students will NOT forget about including oral health in patients encounters. Research evidence continues to reveal an integral relationship between oral and systemic health. Chronic diseases managed by Adult Gerontology Nurse Practitioners, such as diabetes, Celiac and HIV, are but a few of the health problems that have oral manifestations that can be treated or referred to our dental colleagues. It is important for nurse practitioners on the frontline of primary care to have the oral health competencies necessary to recognize both normal and abnormal oral conditions and provide patients with education, prevention, diagnosis, treatment and referral as needed. We encourage you and your students to explore the resources in the templates as you “weave” oral health and its links to overall health into your Adult-Gerontology Nurse Practitioner program. If you need additional technical assistance, please feel free to contact us at [email protected] A-GNP Curriculum Integration of Interprofessional Oral Health Competencies in Health Assessment ADULT - 1) EXPOSURE: INTRODUCTION 2) IMMERSION: DEVELOPMENT 3) COMPETENCE: ENTRY-TO-PRACTICE GERONTOLOGY HEALTH KNOWLEDGE: ORAL EXAM SKILL/BEHAVIOR ASSESSMENT SKILL/BEHAVIOR Goal: Understand the oral exam Goal: Describe best practices in dental caries Goal: Demonstrate integration of HEENOT management across the lifespan competency in physical exam of adult in clinical • Complete Smiles for Life Module #7 experience IPEC Competencies: • Submit SFL Certificate of Completion Read: Values and Ethics, • CAMBRA: Best Practices in Dental Roles and • Complete SFL Quiz for Module #7 • Read Responsibilities Caries Management (Hurlbutt, 2011) (Appendix 1) • Adult Caries Risk Assessment Tool Putting the Mouth Back in the Head: HEENT to Interprofessional HEENOT (Haber et al, 2015) Communication, CAMBRA for patients over age 6 E (Appendix 7) S • Perform oral examination of adult in clinical Teams & Teamwork N U experience, identifying any oral abnormalities T M R M Y A T SKILL/BEHAVIOR L KNOWLEDGE: ORAL CARE OF ADULT SKILL/BEHAVIOR I E Goal: Understand issues in oral care of adults Goal: Demonstrate integration of HEENOT in V Goal: Demonstrate integration of HEENOT HRSA Oral Health V oral health history, risk assessment and E competency in health history of adult in Competencies: E • Complete Smiles for Life Modules #1, 3, 5 physical exam of adults during simulation clinical experience Oral Health Risk L lab A Assessment, Oral • Submit SFL Certificates of Completion • Identify oral pathologies in adult S Health Evaluation, A • Complete SFL Quizzes for Modules #1, 3, 5 S • Perform appropriate oral health history of Oral Health Preventive photographs (Appendix 8) S (Appendix 2, 3, 4) E adult, including frequency of sugar/ Intervention, S • Present electronic health record of adult S tobacco/alcohol intake Communication E • Download SFL Adult Oral Health Pocket with oral health included in history, risk S and Education S Card (Appendix 5) for use in clinical setting assessment, exam and plan (HEENOT) M S E M N E T PARTNERSHIP & COLLABORATIVE PRACTICE FOR & COLLABORATIVE PARTNERSHIP N KNOWLEDGE: ORAL CARE OF OLDER ADULT T Goal: Understand issues in oral care of older SKILL/BEHAVIOR NONPF Competencies: adults Goal: Demonstrate integration of HEENOT in SKILL/BEHAVIOR Delivers evidence- based • Complete Smiles for Life Module #8 oral health history, risk assessment and Goal: Demonstrate integration of HEENOT practice for patients • Submit SFL Certificate of Completion physical exam of older adults during simulation throughout lifespan; lab competency in oral health assessments of Accurately documents • Complete SFL Module #8 Quiz (Appendix 6) older adult in clinical experience relevant comrehensive • Complete: • Identify oral pathologies in geriatric and problem-focused • NICHE, OHNEP, & HIGN Geriatric health histories; Performs photographs (Appendix 9) • Perform oral health history, physical Oral Health Webinar Series (NICHE exam and complete risk and accurately OUTCOMES HEALTH OF CIENT/PATIENT OPTIMIZATION 2014) • Present electronic health record of older assessment of older adult, with documents partinent, adult with oral health included in history, comprehensive and accurate documentation of oral INTER-PROFESSIONAL • APTR Oral Health Learning Module risk assessment, exam and plan (HEENOT) focused physical, mental Part 4: Older Adults health assessment findings health and cognitive assessment • Read: Our Current Geriatric Population (Douglass & Jimenez, 2014) CONSTRUCTS © Oral Health Nursing Education and Practice (OHNEP) APPENDIX 1 Adult-Gerontology Health Assessment Smiles for Life Module 7 Quiz: Oral Examination S! 1. What constitutes a tooth’s outer layer? 5. Oral cancer is most common in which area 8. When examining a 9 month old child’s mouth, what is a reason for an early referral to A. Enamel of the mouth? ! a dentist? B. Dentin A. Hard palate A. The child has only 4 incisors ! C. Pulp B. Surface of tongue C. Inside of cheek B. Developmental tooth defects are present ! C. No molars have erupted 2. What is a full complement of adult teeth? D. Posterolateral tongue D. No canine teeth have erupted ! A. 26 E. Counting less than 20 teeth ! B. 28 6. When performing the “knee-to-knee” oral exam on a young child, in what position C. 30 9. You are performing an oral exam on your D. 32 should the child start? 21 year old patient who has been using A. Facing the examiner smokeless tobacco for 4 years. What part of 3. A caregiver asks you how many teeth B. Standing up this patient’s oral cavity is especially her 3 year old child should have. What C. Sitting on the exam table important for you to examine? would you respond? D. Facing the caregiver A. The sun-exposed areas of the patient’s cheeks A. 20 B. The inner aspect of the patient’s lips and cheeks B. 22 7. Which of the following is NOT needed by a C. Any discoloration or pitting of the patient’s teeth C. 24 primary care clinician to conduct a thorough D. Any plaque build-up along the patient’s gum line D. 28 oral exam? E. The patient’s posterior pharynx A. An exam light to illuminate key 4. At what age do teeth typically features in the mouth 10. A complete oral examination includes each begin to erupt in children? B. Tongue depressors to lift the lip of the following EXCEPT: A. 3-9 months and retract the cheek A. Temporomandibular joint (TMJ) exam B. 9-15 months C. A mouth mirror to view lingual surfaces of B. Cervical node exam C. 15-21 months teeth C. Palpation of the floor of the mouth D. 21-27 months D. Dental explorer D. Sinus exam E. Gauze pads to grasp the tongue E. Exam of the skin around the mouth (Clark et al, 2010) APPENDIX 2 Adult-Gerontology Health Assessment Smiles for Life Module 1 Quiz: The Relationship of Oral to Systemic Health S! 1. What is the most common chronic 5. What can a primary care clinician do to 8. Which of the following infections ! disease of childhood? promote oral health? is NOT potentially caused by direct A. Asthma A. Collaborate with dental and other health extension from a dental source? ! B. Seasonal allergies professionals A. Otitis media ! C. Dental caries B. Apply dental sealants B. Sinusitis D. Cefuroxime C. Prescribe oral fluoride supplements to every C. Brain abscess ! patient D. Facial cellulitis ! 2. What is a consequence of untreated D. Apply fluoride varnish to the teeth of all dental caries? adults 9. What is the suggested common A. Osteonecrosis of alveolar bone pathway linking chronic periodontitis 6. Which of these classes of medications and conditions such as diabetes, B. Gingival hyperplasia is NOT generally associated with C. Oral mucositis coronary artery disease and adverse decreased salivary flow? pregnancy outcomes? D. Tooth fractures A.
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