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Implementation of a standardized oral screening tool by paediatric cardiologists

Published online by Cambridge University Press:  22 September 2020

Shelley I. McCargar Open the ORCID record for Shelley I. McCargar [Opens in a new window] ,
Joanne Olsen ,
Robert J. Steelman ,
Jennifer H. Huang Open the ORCID record for Jennifer H. Huang [Opens in a new window] ,
Elizabeth A. Palmer ,
Grant H. Burch ,
Richard Reed  and
Sara K. LaBarge
Shelley I. McCargar*
Affiliation:
School of Nursing, Doctoral Program, University of Portland, Portland, OR, USA Paediatric Cardiac Surgery, Doernbecher Children’s Hospital at Oregon Health & Science University, Portland, OR, USA
Joanne Olsen
Affiliation:
School of Nursing, Doctoral Program, University of Portland, Portland, OR, USA
Robert J. Steelman
Affiliation:
Paediatric Dentistry, Doernbecher Children’s Hospital at Oregon Health & Science University, Portland, OR, USA
Jennifer H. Huang
Affiliation:
Paediatric Cardiology, Doernbecher Children’s Hospital at Oregon Health & Science University, Portland, OR, USA
Elizabeth A. Palmer
Affiliation:
Paediatric Dentistry, Doernbecher Children’s Hospital at Oregon Health & Science University, Portland, OR, USA
Grant H. Burch
Affiliation:
Paediatric Cardiology, Doernbecher Children’s Hospital at Oregon Health & Science University, Portland, OR, USA
Richard Reed
Affiliation:
Paediatric Cardiac Surgery, Doernbecher Children’s Hospital at Oregon Health & Science University, Portland, OR, USA
Sara K. LaBarge
Affiliation:
Paediatric Cardiology, Doernbecher Children’s Hospital at Oregon Health & Science University, Portland, OR, USA
*
Author for correspondence: Shelley I. McCargar, 7929 N Wall Ave., Portland, OR97203, USA. Tel: +1 503 317 8717. E-mail: mccargar@ohsu.edu; shelleymccargar@yahoo.com
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Abstract

Background:

An examination of invasive procedure cancellations found that the lack of pre-procedural oral screening was a preventable cause, for children with congenital heart disease. The purpose of this study was to implement an oral screening tool within the paediatric cardiology clinic, with referral to paediatric dental providers for positive screens. The target population were children aged ≥6 months to <18 years old, being referred for cardiac procedures.

Methods:

The quality implementation framework method was used for this study design. The multi-modal intervention included education, audit and feedback, screening guidelines, environmental support, and interdisciplinary collaboration. Baseline rates for oral screenings were determined by retrospective chart audit from January 2018 to January 2019 (n = 211). Provider adherence to the oral screening tool was the outcome measure. Positive oral screens, resulting in referral to the paediatric dental clinic, were measured as a secondary outcome. Provider adherence rates were used as a process measure.

Results:

Data collected over 14 weeks showed a 29% increase in documentation of oral screenings prior to referral, as compared to the retrospective chart audit. During the study period, 13% of completed screenings were positive (n = 5). Provider compliance for the period was averaged at 70% adherence.

Conclusion:

A substantial increase in pre-procedural oral screenings by paediatric cardiologists was achieved using the quality implementation framework and targeted interventions.

Keywords

Congenital heart diseasesoral healthpreventative medicinepractice patternsphysiciansendocarditisbacterial
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1815 - 1820
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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