NEEDS ASSESMENT COMMUNITY

A. General data
1. Description of site
The Hughen Center is located in Port Arthur, Texas is celebrating 80 years of
service to children and adults with physical disabilities and other functional impairments.
It started back in 1922 when a committee was formed in the interest of “crippled”
youngsters. The Port Arthur Society of Crystal Children was organized in 1933 because
there was a crucial need for these children to get an education. Back then, school
houses were not built to accommodate children in wheelchairs, crutches, and wearing
heavy metal braces. Currently, the Hughes Center is home for up 452 boys and girls
with physical disabilities and other functional impairments. It is now licensed as a
general residential operation by the Texas Department of Family and protective services.
The organization consists of an executive director, program director, Chief Financial
Officer, bookkeeper, administrative assistant, and activities director. The Hebert Adult
Center, a licensed Adult Day Care Facility, also called a day activity and Health Services
Provides daytime services to clients who live in the community. Services address their
physical, mental, medical, and social needs. All services are administered by their
friendly and caring staff. It is funded by fundraisers and national and local donations. It is
located at 2849 9th Avenue, Port Arthur Texas 77642 (4).

2. Description of target of group

The organization aims to reach registered or licensed nurses, caregivers, and
nursing assistants to broaden the accessibility to those with disabilities. There are
currently 14 at this location as well as volunteers who also participate.

3. Description of staff population

The staff consists of 32 employees. 1 executive director, 1 assistant director/
activities professional, 7 caregivers and nurse assistants, 7 registered and licensed
nurses, 4 dietary consultants, 3 social workers, and 9 volunteers. The education level of
the staff population ranges from having a high school diploma to a master's degree. The
executive director has many responsibilities including directing and supervising all
aspects of the Day Care Program. He determines admission eligibility of recipients and
discharges them, he develops and implements in-services for staff. He also supervises
the staff and maintains daily census levels. Caregivers and nurses assistants assist
recipients with eating, hair styling, using the toilet, and other personal care tasks.
Assistant director/activities professional helps develop personalized exercise programs
such as art, Recreation, Discussion and support groups, social events, outside
community activities and events, games, exercise, and fitness programs. A registered
and licensed nurse administers prescribed medications, delivers educational programs,
manages day-to-day health needs, attends to an emergency. There are also social
workers who provide family support, assist in developing care plans, counseling when
needed, develop programs to assist with wandering, incontinence, hallucinations,
sexually inappropriate behavior, or speech difficulties. There are also dietary consultants
who design meal plans and check for specified diets. Lastly, the volunteers drive the
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recipients to and from outside events, assist in activities when needed, help during meal
times, sing and Lead fun groups when needed (2).

4. Description of services provided

The person in charge of coordinating the activities is the registered and licensed
nurses to the clients of the adult daycare ages 18 and up. Currently, there are no special
events at this time. Their daily activity consists of Breakfast Brunch from 8 to 9 a.m.
current events and devotionals from 9 to 10 a.m. programming which is the movement of
Hands-On activities from 10 to 12 p.m., Then followed by a lunch brunch From 12 p.m.
to 1 p.m., Then a rest from 1 to 2 p.m. followed by another program from 2 to 3:30 p.m
(2).

5. Water fluoridation
The Hughen Center currently is fluoridated at .7 ppm per the CDC.

B. Information related to dental health

The services at this location are based on educating such as the importance of
brushing, brushing after meals, and how to brush. The preventive measures taken
include educating patients about their oral health status, home care instructions,
nutritional counseling, dietary supplements, fluoridation, and plaque control. The Hughen
Center does not provide supplies for its members. Description and results of previous
dental programs are unknown. The staff's knowledge and awareness of dental health is
also unknown. The staff is required to inform the caretakers when a dentist's
appointment is needed because some patients have partial/ full dentures along with
tooth decay (2).

C. Dental health status

Due to their socio-economic status, this group is more at risk for dental caries,
gingivitis, as well as periodontitis. If the oral hygiene is not kept up with by the caretaker,
then this will put the members at a higher risk. Malocclusion is generalized in special
needs patients, therefore making plaque removal more difficult. The staff members need
to utilize dental education services such as dietician counseling and prevention
precaution. A routine also needs to be developed for the members with special needs
(2).

D. Goals and objectives

Our goals and objective are to provide the knowledge and skills in maintaining
optimum oral health for the staff and residents of the Hughen Center.
-To increase the dental health knowledge of plaque to the residents and staff by the end
of the program 75%.
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-Incorporate oral hygiene procedures such as tooth brushing methods into a daily routine
for the staff and residents by the end of the program
-To increase the dental health knowledge of fluoride to the staff and residents by the end
of the program 75%.

E. Rationale

Oral disease is a major health problem for adults with disabilities,5 who have a higher
prevalence and severity of oral disease when compared to the general population.6 High
rates of dental caries, missing teeth, periodontal disease, prolonged retention of primary
teeth, misaligned or supernumerary teeth, and malocclusion are all indicators of poor oral
health in adults with disabilities.7 Poor oral health has a negative impact on nutrition,
digestion, the ability to chew and enjoy food, facial shape, and speech.8 Under-diagnosis
and differential oral health treatment contribute to the poor oral health of adults with
disabilities.9,10 (5)

F. Program design

Our goal is to provide the knowledge and skills in maintaining optimum oral
health for the staff and residents of the Hughen Center. The discussions will include
basic oral health education such as plaque and biofilm, incorporating disclosing solution,
evaluating plaque score, determining the most efficient tooth brushing technique, and
nutritional counseling.

Session 1- Nurses, caretakers, and residents

Plaque presentation video
1. Discuss the need for a preventive dental health program for the patients.
2. Discuss how oral health relates to overall health in this community
3. Discuss the interaction of tooth plaque and sugar
This session will require 45 minutes.

Session 2- Nurses, caretakers, and residents

Disclosing lab activity
1. Explain the process and reasoning of disclosing tablets
2. Demonstrate tablet use to the audience
3. Have residents brush teeth and self-evaluate with a hand mirror, take plaque score
4. Modify brushing technique and remove residual plaque
This session will require 45 minutes.

Session 3- Nurses, caretakers, and residents

Nutritional counseling
1. Discuss monthly menu
2. Relate plaque retentive foods to oral health conditions
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3. Encourage healthier options for less plaque

4. Elaborate on the interaction of tooth plaque and sugar
5. Re-evaluate plaque score and compare
This session will last 45 minutes.

G. Constraints and alternatives strategies

Constraint 1- Lack of dexterity/ Mobility making optimum oral care more difficult to
achieve
Alternative 1- Educate caretakers on the importance of prioritizing OHI as well as proper
techniques

Constraint 2- Lack of motivation among residents

Alternative 2- Educate residents by including fun alternatives

Constraint 2- Lack of interest on the part of the caregiver due to more responsibilities on
their part.
Alternative 2- Engage nurses/ aids with interactive videos.

H. Resources
1. Personnel - Dental volunteers, residents, nurses, and caretakers
2. Visual aids- Giant typodont, plaque presentation video
3. Supplies- Toothbrushes, toothpaste, disclosing tablets, hand mirrors, plastic
cups, gloves, laptop, monthly lunch menu
4. Budget-
Toothbrushes and toothpaste $30
96 Disclosing tablets $17
Gloves $30
Plastic cups $5
Typodont (donated for use by LIT clinic)
Hand mirror (donated for use by LIT clinic)

I. Timetable
All resources will be obtained before each session. There will be three
sessions spanning a three-week period of time. The schedule is as
follows:
Session 1- week of April 7th
Session 2- Week of April 14th
Session 3- Week of April 21st

J. Evaluation

A. Process evaluation (formative)-

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1. A weekly review of toothbrushing methods to ensure the mastery of the skill

2. A weekly review of knowledge from the caretakers and nurses
3. A weekly review of the menu options

B. Product evaluation (Summative)

1. A pre-test and post-test will be administered to the nurses and caretakers to
assess and compare the knowledge of plaque
2. Visual plaque assessment completed with hand mirror on first and last education
session
3. An annual check with administrators will be conducted to verify the utilization of
the nutritional monthly menu

K. References
(1) Maass, taylor A., & Browning, T. (2022, February 24). Oral Health program.
personal.

(2) Browning, Tami. (24 February 2022). Personal Interview

(3) Cdc - Cdc.com. cdc.com. (n.d.). Retrieved February 24, 2022, from
http://www1.cdc.com/

(4) Hughen center - Home. (n.d.). Retrieved February 24, 2022, from
http://www.hughencenter.org/

(5) Altun, C., Guven, G., Akgun, O. M., Akkurt, M. D., Basak, F., & Akbulut, E. (2010,
October). Oral Health Status of disabled individuals attending special schools. European
journal of dentistry. Retrieved February 24, 2022, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948746/

(6) What is biofilm? UOFL outreach video - youtube. (n.d.). Retrieved March 3, 2022,
from https://www.youtube.com/watch?v=9vKzb-JWJfU
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Appendix
 Pre-test and post-test.
 Lesson plans (Session 1-3)
 Youtube video over plaque biofilm
 Plaque scoresheet
 Program evaluation
 Monthly menu
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Pre and Post Test

1. What is plaque?
a. Bacteria
b. Sticky film
c. White sticky film
d. All of the above
2. How long should you brush your teeth?
a. 30 seconds
b. 1 minute
c. 2 minutes
d. 5 minutes
3. How often should you brush your teeth?
a. Every morning
b. After every time you eat
c. Every night
d. Twice a day
4. What type of foods should you eat to reduce acidic exposure?
a. Proteins
b. Sugars
c. Fermentable carbs
5. How often should you get your teeth cleaned?
a. Only when you feel like it
b. Once a year
c. Twice a year
d. Every month
6. You should brush your tongue. True or false?
a. True
b. false
7. What is a cavity?
a. Decay
b. A chip on your tooth
c. A filling
d. An abscess
8. What type of toothbrush should you use?
a. Hard bristles
b. Soft bristles
9. How often should you floss?
a. Once a week
b. Never
c. Only when you have something in
your teeth
d. Every day
10. Brushing your teeth is very important. True or False?
a. True
b. false
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