Oral Health Care for Disabled Children

Introduction Before proceeding with the Capstone project, I contacted several agencies one week prior to the project in order to determine where I would apply it. Ultimately, Hyun soon Kim, the director of the Youli Daycare Center, allowed me to proceed my project at the agency. The Agency accommodates about 20 to 30 disabled children and is divided into 5 classes, each with 6 to 7 students. Pre-school children (about 3 to 9 years old) were organized, and each of children had various types of disability including cognitive disability, developmental disability, intellectual disability and physical disability due to encephalopathy and other brain damages. Hyun soon Kim, the director, and some of tutors at the Daycare Center helped me run the Capstone Project. This include necessity of project, correlation between children’s teeth status and caregivers’ background knowledge, target population’s barrier to access dental clinic, proper oral care management and the most overlooked aspects of the oral health care management.

Dziwak et al. noted that disabled children are particularly underserved population when it comes to oral healthcare, and children with disabilities have a higher incidence rate of dental caries and periodontal disease by about 10% compared to Healthy children. Norwood and Slayton (2013) emphasized the necessity of oral health care for disabled children who need Special Health Care Need (SHCN) and noted that oral health should be maintained soundly to lead basic living such as smiling, expressing oneself and eating. However, oral health condition might be easily deteriorated by the malfunctioning behaviors such as grinding teeth and sucking the thumb that most disabled children do. found that the higher the interest level of parents, the more accurately parents follow standard tooth brushing method and guideline.

As shown in a study conducted by Shanbhag, Ram, & Gupta (2014), caregivers responded that increased intake of sugar contained food and inability to rinse mouth properly while children brush their teeth are the main causes of teeth decay and periodontal disease. Also, a number of caregivers answered that some of them tend to assist complete oral care process due to the child's limited range of mobility. However, on top of that, about 80% of caregivers were not aware of the importance of fluoride in the oral health care of a child - fluoride plays significant role in preventing cavities. Shanbhag, Ram& Gupta 2014). Thesis Statement and Theory Developing a thesis statement would be the first step before proceeding with my project. I used the PICOT format and considered an objective measurement to evaluate the outcome of the project.

The underserved Population (P) of the Capstone Project is disabled children, including children with mental retardation, cognitive disorders, and developmental disabilities. Interventions (I) include the use of appropriate oral healthcare guidelines which are: advising on regular visits to the dentist, proper teeth-brushing methods, and intake of proper amount of fluoride. Comparison (C) is the children’s oral health condition when the guided intervention is not applied. Empirical ways of knowing can be applied by searching for academic literatures that support the statement of project. Finally, the Aesthetic way of knowing can be utilized by making sustainable artifacts and modifying the system to the agency during the six-week period of the project. As mentioned earlier, this Capstone project focuses on reducing the incidence of cavities in disabled children, which can be explained by Betty Neumann’s theory.

This theory states that human beings are protected by multiple layers, which shield external disturbances. In order to maintain each protection layer, different levels of intervention are necessary; also known as primary, secondary, and tertiary care. Many identified factors exacerbate oral healthcare management in disabled children. The social determinants include low financial income in household, poor literacy and educational levels, physical barriers, and problems related to access to dental clinic. For oral health care for children with disabilities, cultural and generational aspects should be considered. Although this project targets disabled children in Korean society, the Korean-American is a rapidly growing immigration group in the US community, which is composed of 1. million people in the US and plays a very important role in community (Choi & Ostendorf, 2015).

Communication As mentioned above, communication involving both parents and disabled children plays a very important role in the healthcare management process. In every communication process, there is a sender and a receiver, all of which tend to be affected by internal and external climates during the process. It should be noted that these interruptions might distort the original intent of the message. Communication can be classified into various types i. e. Finally, there was non-verbal communication. This involves use of gestures and facial expressions. I used it in childrenas it was more effective to perform repetitive gestures such as demonstrations rather than long-term face-to-face communication; considering their cognitive abilities, which are significantly low. According to Marquis and Houston (2015), in order to lead an effective communication, the leaders or managers must be aware of the exact structure through the assessment of the organization's communication system and recognize who will be affected by decisions.

After all, it is important to eliminate unnecessary information and deliver a simple and accurate intention to an audience. By monitoring the agency thoroughly, and analyzing the institution, I decided the overall direction of the project and discussed the issue with the staff. However, one of the decisive obstacles was that I only focused on system improvement and process, as well as the typical Laissez-faire leadership type, rather than focusing on feedback, mistakes and objective outcome that this agency is not the subject. To overcome these shortcomings, I adopted the Leading-By-Walking-Around (LBWA) leadership style which is mainly used in long-term facilities. LBWA types of leadership is based on; “Observe team members interacting with residents and families, Let your staff know you are interested in them and their work, Evaluate the quality of care being delivered, and Demonstrate your interest in daily operations” (AANAC, 2014, p.

Professional Standards Corresponding professional standards and attitudes are important in the process of the project as it is aimed at the underserved population. Information Management (IM) should be seen as the conscious process by which information is gathered and used to assist in decision making ( Hinton, 2011). Information Management (IM) also involves transferring the information from known sources and distributing them to the appropriate audiences that require the information. In my Capstone project, Information Management (IM) is a very vital factor. Information management skills have been applied to carry out optimal outcome and enhance quality of the project. Data collected shows that about 80% of caregivers were not aware of the importance of fluoride in the oral health care of a child. Doing this would reduce the cases of dental caries and tooth cavities hence improve healthcare of the disabled children.

The above shows that Information Management (IM) can greatly help in improving patient healthcare if only the decisions made are implemented. Conclusions & Recommendations & Reflection In conclusion, I must admit that I’ve learned a lot through this Capstone project. It was through academic literature search, that I got expertise knowledge related to oral healthcare. Bedside nurses often overlook the importance of dental care, since it is not within a major realm. References American Academy of Pediatric Dentistry. Guideline on management of dental patients with special health care needs. Retrieved from http://www. aapd. org/media/Policies_Guidelines/G_SHCN1. B. Madison, H. E. Nursing: The ways of knowing. Retrieved from Excelsior College website: http://nurses. doi:10. scd. Center for Disease Control and Prevention (CDC).

Children’s oral health. Retrieved from https://www. net/publication/272885874_Perceptions_of_disability_and_special_education_services_The_perspectives_of_KoreanAmerican_parents_of_children_with_disabilities Dziwak, M. Heinrich-Weltzien, R. Limberger, K. Ifland, S. Gottstein, I. Hinton, M. Introducing information management: the business approach. Abingdon, Oxon: Routledge, 2. Lamba, R. Rajvanshi, H. Feijoo, J. Ramos, I. Liñares, A. Diz, P. A new indicator of the oral hygiene habits of disabled persons: relevance of the career's personal appearance and interest in oral health. H. Chen, C. C. Lin, P. C. Nahar, S. G. Hossain, M. A. Howlader, M. Retrieved from http://pediatrics. aappublications. org/content/131/3/614 Shanbhag, P. P. Ram, S. A mom’s guide to fluoride. American Dental Association. Retrieved from http://www. mouthhealthy. org/en/babies-and-kids/moms-guide-to-fluoride.