Abstract：
OBJECTIVE: (1) Explore the challenges of providing daily oral care in care homes; (2) understand oral care practices provided by care home staff; (3) co-design practical resources supporting care home staff in these activities.
METHODS: Three Sheffield care homes were identified via the \"ENRICH Research Ready Care Home Network,\" and three to six staff per site were recruited as co-design partners. Design researchers led three co-design workshops exploring care home staff\'s experiences of providing daily oral care, including challenges, coping strategies and the role of current guidelines. New resources were prototyped to support the use of guidelines in practice. The design researchers developed final resources to enable the use of these guidelines in-practice-in-context.
RESULTS: Care home staff operate under time and resource constraints. The proportion of residents with dementia and other neurodegenerative conditions is rapidly increasing. Care home staff face challenges when residents adopt \"refusal behaviours\" and balancing daily oral care needs with resident and carer safety becomes complex. Care home staff have developed many coping strategies to navigate \"refusal behaviours.\" Supporting resources need to \"fit\" within the complexities of practice-in-context.
CONCLUSIONS: The provision of daily oral care practices in care homes is complex and challenging. The co-design process revealed care home staff have a \"library\" of context-specific practical knowledge and coping strategies. This study offers insights into the process of making guidelines usable for professionals in their contexts of practice, exploring the agenda of implementing evidence-based guidelines.
METHODS: Three Sheffield care homes were identified via the \"ENRICH Research Ready Care Home Network,\" and three to six staff per site were recruited as co-design partners. Design researchers led three co-design workshops exploring care home staff\'s experiences of providing daily oral care, including challenges, coping strategies and the role of current guidelines. New resources were prototyped to support the use of guidelines in practice. The design researchers developed final resources to enable the use of these guidelines in-practice-in-context.
RESULTS: Care home staff operate under time and resource constraints. The proportion of residents with dementia and other neurodegenerative conditions is rapidly increasing. Care home staff face challenges when residents adopt \"refusal behaviours\" and balancing daily oral care needs with resident and carer safety becomes complex. Care home staff have developed many coping strategies to navigate \"refusal behaviours.\" Supporting resources need to \"fit\" within the complexities of practice-in-context.
CONCLUSIONS: The provision of daily oral care practices in care homes is complex and challenging. The co-design process revealed care home staff have a \"library\" of context-specific practical knowledge and coping strategies. This study offers insights into the process of making guidelines usable for professionals in their contexts of practice, exploring the agenda of implementing evidence-based guidelines.
摘要：
目标：（1）探索在护理院提供日常口腔护理的挑战；（2）了解护理院工作人员提供的口腔护理实践；（3）共同设计支持护理院工作人员在这些活动中的实践资源。
方法：通过ENRICHResearchReadyCareHomeNetwork确定了三个Sheffield护理院，每个站点招募了三到六名工作人员作为共同设计合作伙伴。设计研究人员领导了三个共同设计研讨会，探索养老院工作人员提供日常口腔护理的经验，包括挑战,应对策略和现行指导方针的作用。新资源的原型，以支持在实践中使用准则。设计研究人员开发了最终资源，以便在实践中使用这些指南。
结果：养老院工作人员在时间和资源限制下工作。患有痴呆症和其他神经退行性疾病的居民比例正在迅速增加。当居民采取“拒绝行为”时，养老院工作人员面临挑战，并且平衡日常口腔护理需求与居民和护理人员的安全变得很复杂。疗养院的工作人员已经制定了许多应对策略来应对“拒绝行为”。\"支持资源需要\"适合\"在上下文实践的复杂性。
结论：在养老院提供日常口腔护理是复杂且具有挑战性的。共同设计过程表明，养老院的工作人员拥有一个“图书馆”，其中包含特定环境的实践知识和应对策略。这项研究提供了对专业人员在其实践环境中使用指南的过程的见解，探索实施循证指南的议程。
方法：通过ENRICHResearchReadyCareHomeNetwork确定了三个Sheffield护理院，
结果：养老院工作人员在时间和资源限制下工作。
结论：在养老院提供日常口腔护理是复杂且具有挑战性的。
