In this reflection, I am going to reflect on my personal experience during my community placement as a trainee nurse to demonstrate the process of infection control in dental care and oral hygiene. The placement simulation group which I was enrolled went to a multi-skills laboratory to practise comprehensive oral health and hygiene. The role of community campaign was to educate the rural people living under poor hygienic set-up to understand the importance of dental hygiene. My role was to work under the instructions of the registered nurse or to assist them in delivering oral hygiene. It was one month long community placement and during the second week of my placement, I was asked by a senior registered nurse to demonstrate proper skills for the maintenance of oral hygiene. I was assigned a colleague and was asked to brush his teeth with the help of tooth brush and toothpaste. The first thing which I did was, I put on gloves in order to prevent hand contamination. I also followed effective hand decontamination even after wearing gloves. As per the NICE guidelines effective hand decontamination cause significant reductions in the transmission of potential harmful pathogens present in hand. This in turn reduces the rate of occurrence of preventable healthcare-associated infections and thereby reducing rate of mortality and morbidity (National Institute for Health and Care Excellence 2014). I initiated my work after taking consent form my colleague. This is because as per the ethical norms and code of conduct of Nursing and Midwifery Council UK, a nurse needs to act in best interest of people in all time (code 4). This code emphasize on taking informed consent from the patient before the initiation of the treatment Nursing and Midwifery Council UK 2017). After taking informed consent, I undertook a quick visual assessment of his buccal cavity. 13th code of conduct of Nursing and Midwifery Board UK (2017), instruct a nurse to accurately access the normal signs and symptoms or worsening physical condition before the initiation of the treatment. I then positioned him in such a comfortable position so that he could tolerate the wash. According to the Nursing & Midwifery Board UK (2017), special pay and attention must be given in order to satisfy the physical needs. I that point of time, physical comfort was one of his prime needs and hence emphasized on it. Thereafter I brushed his teeth via proper moving the brush through the edges and corners or each tooth and via carefully side passing the gums and tongue. I finished off via helping his to rinse his mouth first with water and then with mouth wash to clean his gums and tongue. I treated my partner in such a way, pretending that he was physically unable to hold the brush and perform the oral hygiene all by himself. However, I was allowed to communicate with my colleague and he was allowed to assist me in terms of gargling and spitting with water at the end of the procedure.
When I was first informed that I will be asked to perform this task, I felt extremely anxious and concerned. The first thing which came to my mind that I haven’t brushed anyone’s teeth apart from myself and since mouth is a personal and intimate part of the body and is not exposed to anyone other than a dentist, I felt more conscious. I was concerned about how my partner about whom I was not personally involved, will react to my approach of examining his mouth. Moreover, I felt that I am not competent enough to carry out this role, going against the “preserve safety” ethics of Nursing & Midwifery Board. I was also concerned that my own range of anxiety might affect my partner who also passing through an awkward and embarrassed phase. My share of anxiety increased further after the initiation of the treatment when I noticed that my partner suddenly started coughing as an affect of distress. This made me further hesitant to carry forward the procedure. This is the common response coming from the carers when they observe that their patient is in distress (Schultz 2013). I immediately call my senior registered nurse in order help me out with the situation. This was the part of the informed decision making process. According to Oshima, Lee and Emanuel (2013), shared decision making in health care practise helps in procuring improved care with reduce cost. The registered nurse asked me stop the act for a while and to resume after his cough subsides. I followed her directions and ask my partner to spit the entire forth in the basic and then resumed brushing after he felt conformable. After this act, there was no notable mishaps in my community placement acts and after the completion of the act, I felt relieved.
That major learning outcome after the completion of this act was a sense of satisfaction that I was successful in providing the care in a comprehensive manner. I also after completion of the act, I also realized that patients value supportive and caring dentist. The feeling of having a supportive, dedicated and caring dentist can help the patients to take the supreme control of their own oral health (Sbaraini et al. 2012). The experience also helped me to understand that proper oral hygiene is important for avoiding unnecessary infections. It also helped me to understand that it is difficult for the people with physical disability to observed comprehensive oral hygiene. Inadequate oral hygiene may be made worse via systemic diseases and medication that may eventually produce rapid decline in oral health. This decline in oral health and hygiene affects both the quality of life and general health of the patients along with their carers (Zuluaga et al. 2012). Despite my initial discomfort, my experience under this process highlighted the complex problems that I might have solved in advanced under the provision of care to the patients with whom I might not have previous contact This task also helped me work on my communication skills and I understood the importance of proper communication skills in delivering comprehensive care to the patients. Proper nursing communication helps in ascertaining patient satisfaction and thereby modifying the therapy plan accordingly (Radtke 2013).
After the completion of the dental care activity, I analysed that communication at the personal level before the initiation of the care plan might have help me and my partner in proper understanding about each other and this will in turn will help to achieve a standard level of co-ordination. According to Kourkouta and Papathanasiou (2014), proper communication between the patient and n nurse is an important factor behind the successful outcome of an individualized nursing care plan. In order to achieve this, the nurses are required to understand and simultaneously help their patients via demonstrating kindness, courtesy and sincerity. I also analysed that selection of soft bristled toothbrush is appropriate towards the prevention of dental trauma or trauma to the gums. Dental decay is the most chronic diseases that is prevalent worldwide. Several factors like microbial, immunological, genetics, environmental contribute to onset of dental caries. However, proper maintenance of dental hygiene can help to reduce the predisposition at significant rate (Peterson et al. 2013; Andreasen et al. 2012).
Conclusion
Maintenance of oral care and hygiene is crucial or dental health and nurses play a crucial role in assisting the patients in maintenance the same. This task identified the role of the nurse in encouraging patient for the maintenance of proper dental hygiene (Alfano 2012). Oral hygiene in nursing homes are required to be improved. The resistant behaviour coming from the patient is the major barrier towards providing optimal dental care (Willumsen et al. 2012). Proper communication is another important role in nursing profession. Quality of communication in interactions between health care professionals and patients has an important impact on patient outcomes. This influence is pivotal in domains like patient health, adherence to hygiene, education towards health and well being and satisfaction with care. As the nurses have the principal role in satisfying the communication needs of the patients, effective communication skills in nursing is regarded as one of the critical element of patient care (O’hagan et al. 2014).
My next plan of action is to read m ore books in relation to dental health and hygiene and effective nursing communication. My aim will be to provide proactive care to my patients in future. I will also make sure that I access all the dental history of the patients before initiation of the therapy. I will also try educating the patients about the importance of dental health in maintenance of proper health and hygiene. I will also try to remember that in the first attempt the patient might feel awkward in sharing his or her dental hygiene data with me or might feel embarrassed while allowing me to access his or her buccal cavity. In such scenarios, I will take help of effective communication to side-pass the sense of awkwardness. Since I love to interact with people, I think my approach of effective communication will act as my strength in providing quality care. I will also participate in more community nursing campaign. Further access towards community care procurement will provide me more exposure to different dental health complications and steps required to overcome such health scenarios.
References
Alfano, M.C., 2012. Connecting dental education to other health professions. Journal of dental education, 76(1), pp.46-50.
Andreasen, J.O., Lauridsen, E., Gerds, T.A. and Ahrensburg, S.S., 2012. Dental Trauma Guide: A source of evidence?based treatment guidelines for dental trauma. Dental Traumatology, 28(5), pp.345-350.
Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice. Materia socio-medica, 26(1), p.65.
National Institute for Health and Care Excellence, 2014, Infection prevention and control: Hand decontamination.National Institute for Health and Care Excellence, England.
Nursing and Midwifery Council, 2017, The Code for nurses and midwives.Nursing and Midwifery Council, UK.
O’hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., Webb, G. and McColl, G., 2014. What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), pp.1344-1355.
Oshima Lee, E. and Emanuel, E.J., 2013. Shared decision making to improve care and reduce costs. New England Journal of Medicine, 368(1), pp.6-8.
Peterson, S.N., Snesrud, E., Liu, J., Ong, A.C., Kilian, M., Schork, N.J. and Bretz, W., 2013. The dental plaque microbiome in health and disease. PloS one, 8(3), p.e58487.
Radtke, K., 2013. Improving patient satisfaction with nursing communication using bedside shift report. Clinical Nurse Specialist, 27(1), pp.19-25.
Sbaraini, A., Carter, S.M., Evans, R.W. and Blinkhorn, A., 2012. Experiences of dental care: what do patients value?. BMC health services research, 12(1), p.177.
Schultz, J.J., 2013. The Doctor’s Dilemma: The Utilitarian Medical Ethics of Nazi Physician Karl Brandt. University of Toronto Medical Journal, 90(4).
Willumsen, T., Karlsen, L., Næss, R. and Bjørntvedt, S., 2012. Are the barriers to good oral hygiene in nursing homes within the nurses or the patients?. Gerodontology, 29(2).
Zuluaga, D.J.M., Ferreira, J., Montoya, J.A.G. and Willumsen, T., 2012. Oral health in institutionalised elderly people in Oslo, Norway and its relationship with dependence and cognitive impairment. Gerodontology, 29(2).
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