Fidelity and sustainability of Mouth Care Without a Battle and lessons for other innovations in care

Sheryl Zimmerman; Christopher J Wretman; Kimberly Ward; Meera Tandan; Philip D Sloane; John S Preisser

doi:10.1016/j.gerinurse.2020.06.002

Fidelity and sustainability of Mouth Care Without a Battle and lessons for other innovations in care

Geriatr Nurs. 2020 Nov-Dec;41(6):878-884. doi: 10.1016/j.gerinurse.2020.06.002. Epub 2020 Jun 24.

Authors

Sheryl Zimmerman¹, Christopher J Wretman², Kimberly Ward³, Meera Tandan³, Philip D Sloane⁴, John S Preisser⁵

Affiliations

¹ The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill; School of Social Work, University of North Carolina at Chapel Hill; Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Electronic address: Sheryl_Zimmerman@unc.edu.
² The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill; School of Social Work, University of North Carolina at Chapel Hill.
³ The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
⁴ The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill.
⁵ Gillings School of Global Public Health, University of North Carolina at Chapel Hill.

PMID: 32593489
DOI: 10.1016/j.gerinurse.2020.06.002

Abstract

There are countless efficacious interventions that improve outcomes when conducted in controlled situations. Many fewer are effective when implemented in real-world situations, largely because they are not implemented with fidelity. Still fewer are sustained over time, for reasons including lack of institutional support and fit with existing values, among others. It is especially important to examine fidelity and sustainability when efficacious interventions are being implemented, because these interventions are the ones that hold the most promise. This project examined the fidelity and sustainability of Mouth Care Without a Battle (MCWB), an evidence-based program conducted in a two-year cluster randomized trial in 14 nursing homes. Results that triangulated two sources of data indicated that fidelity decreased after the first year; they provide guidance to promote fidelity and sustainability of this and other new care practices in nursing homes, including ongoing education, coaching, evaluation, feedback, and sufficient resources.

Keywords: Fidelity; Mouth care; Nursing home; Oral hygiene; Sustainability.

Publication types

Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Humans
Mouth*
Nursing Homes*

Grants and funding

R01 HS022298/HS/AHRQ HHS/United States