Need this by 1200 eng

Prepared For

Dr. Jane Doe

Owner/Dentist

XYZ Dentistry

Prepared by

Student Name

May 20, 2018

Weighted Blanket Proposal for XYZ Dentistry 1

Student Name Comment by Natascha: Use business formatting for the transmittal letter/memo. Use a letter if you do not currently work for the company (external communication). Use a memo if you work for the company (internal communication).The purpose of this transmittal letter/memo is to enable the reader to act on receipt of your report by immediately understanding the report’s purpose, what prompted the report, and how to act on the report.

1234 Street Address

City, State 10001

May 20, 2018

Dr. Jane Doe

XYZ Dentistry

5678 Street Address

City, State 10001

Dear Dr. Doe,

The attached report proposes the purchase of weighted blankets by XYZ Dentistry to decrease dental anxiety. These blankets can help combat stress and anxiety during exams and treatments, thus aiding both patient, dentist, and staff. Comment by Natascha: Summarize the purpose.

Weighted blankets have been used in medical treatments and therapy to relieve anxiety by providing a deep-pressure sensation. Weighted blankets come in a variety of sizes, colors, material as well as weights, making them a customizable resource. Comment by Natascha: Provide background.

The report analyzes the effectiveness, safety, and costs of using such blankets using peer-reviewed journals based on professional experiences in dentistry and other medical practices. Weighted blankets can positively improve your current practices, reduce anxiety, build a more trusting patient-dentist relationship, reduce missed appointments, increase future visits, and are cost effective. Comment by Natascha: Provide details.

Consider purchasing weighted blankets for XYZ Dentistry to provide a more customized and non-pharmacological approach to aiding dental anxiety. If you have any questions or comments about this proposal, please feel free to email me. Comment by Natascha: Recommend action.

Sincerely,

Student Signature

Student Name

[email protected]

TABLE OF CONTENTS

EXECUTIVE SUMMARY iv Comment by Natascha: Although pages before the introduction are not numbered, they are counted to determine the page number for the executive summary on this table of contents.

INTRODUCTION 1 Comment by Natascha: The introduction begins on page 1.

Problems of current practice 1

benefits of weighted blankets 2

REDUCED ANXIETY 2

IMPROVED PATIENT-DENTIST RELATIONSHIP 2

FEWER MISSED APPOINTMENTS 3

MORE FUTURE VISITS 3

COST EFFECTIVENESS 4

CONCLUSION/Recommendation 5

REFERENCES 7

APPENDIX A 8

EXECUTIVE SUMMARY Comment by Natascha: Executives often read the summary and not the report. Provide all details (but omit the proof/support). Do not indicate what the report “will” do. Summarize what the report does.

Dental anxiety for patients range from mild to so severe that coming to the dentist is impossible. Patients who experience anxiety and stress during a dental visit can be jumpy, worried, fidgety, and terrified. Due to anxious patients, the staff and the dentist also face obstacles of uneasiness, stress, lack of cooperation, no-shows, cancelled appointments, and missed revenue.

Weighted blankets can be a great non-pharmacological approach to help relieve patient anxiety by distributing weight over the body, which creates pressure that is very calming.

The use of weights blankets leads to the following benefits:

1. Reduced anxiety

2. Improved patient-dentist relationship

3. Fewer missed appointments

4. More future visits

5. Cost effectiveness

Weighted blankets come in a variety of sizes, colors, and materials, which make them a very versatile resource to have. Compared to pharmacological and psychological resources, weighted blankets are more budget friendly and can be easily purchased from many companies online.

Due to the increase in dental anxiety among dental patients, XYZ Dentistry should purchase weighted blankets to reduce stress and anxiety. Purchasing this new equipment will aid the staff and Dr. Doe in her endeavors to treat all patients and dental issues with the utmost care.

INTRODUCTION

With the assistance of five employees and the availability of five patient chairs, XYZ Dentistry sees many patients in one day. XYZ Dentistry is dedicated to the needs of all patients. Currently the clinic offers a calming environment, psychological techniques, and pharmacological interventions like local anesthetics and sedation for all patients. XYZ Dentistry has created a calming atmosphere by providing televisions, window views, and a calming fish tank. The office uses the show-tell-do approach, which is helpful for patients who want to be a part of their treatment. The clinic also offers pharmacological methods like local anesthetics, which aid in pain reduction and relaxation. Comment by Natascha: Describe the situation/problem. Do NOT offer a recommendation/solution (not yet). Notice that the introduction does not state that weighted blankets are the solution but only describes the situation and weighted blankets.

Weighted blankets are made of a wipeable material and come in a variety of different weights depending on the user. The weight of the blanket material is typically due to the inclusion of glass or plastic beads. Weighted blankets only need to be wiped down between each patient. Generally, the blankets are just big enough for one person to use, resembling a throw more than a blanket.

This report will analyze the effect and cost of weighted blankets on XYZ Dentistry’s patients, dentist, and staff. The cost, effectiveness, and safety of weighted blankets were analyzed using professional research from the Journals of Dentistry, Occupational Therapy in Mental Health; Clinical, Cosmetic and Investigational Dentistry; and Journal of Dental Hygiene. Comment by Natascha: Explain the scope of the report, namely what issues you considered. Do NOT indicate the conclusions reached concerning these issues (not yet). Notice that the introduction does not state that weighted blankets are safe, effective, and cheap; it just explains that these issues of safety, effectiveness, and cost were the focus of the report’s analysis.Explain the sources used. In other words, show that your methodology for analyzing the situation/problem is sound; therefore, your conclusion/recommendation should be trusted because your methods and sources were good.

PROBLEMS OF CURRENT PRACTICE Comment by Natascha: Use short, focused business paragraphs.

XYZ Dentistry has had problems dealing with anxious patients, such as loss of patients, lack of repeat patients, and the endangered safety of the dentist and staff.

In 2017, the dental clinic had 300 new patients; however only 135 booked a follow up appointment. The missed profits of the 165 patients who did not rebook is roughly $33,000 in lost revenue, if all patients were only coming in for a basic cleaning at $200.00.

On at least twelve occasions, an anxious patient has either had to stop treatment and reschedule or ask for a break, delaying the procedure and causing appointments to run behind. Many patients who rescheduled did not follow through and continue care with the dental clinic. Dental anxiety can cause a never-ending cycle of avoidance that will only require more extensive and traumatic treatments in the future.

The dentist and the staff have experienced a great deal of stress when patients are anxious and jumpy, putting everyone at risk of getting hurt. For instance, a dental hygienist recently reported needing to schedule her lunch break after especially anxious patients so that she could decompress and prepare for the next patient.

Statistically, anxiety plagues many people, but dental visits are the “fifth-most common cause of anxiety” (Appukuttan, 2016). White, Giblin, & Boyd (2017) concluded that out of 308 scheduled dental appointments, 19% experienced a heightened level of anxiety.

BENEFITS OF WEIGHTED BLANKETS

Reduced Anxiety

Weighted blankets are a safe means of anxiety control. According to Champagne et al. (2015), weighted blankets lead to 60% of patients having less anxiety based on the measurements of their vital statistics. Anxiety reduction was seen in 18 of the 30 adult participants in the study (Champagne et al., 2015). Therefore, weighted blankets could have helped turn the 165 anxious patients who did not return in 2017 into 165 future appointments and 165 happy smiles.

The anxiety reduction is due to the role the weighted blanket plays in the sympathetic nervous system which triggers the “fight or flight” response (Champagne et al., 2015). By distributing weight over the body, the calming pressure can be so relaxing that patients are less likely to stress about their surrounds or the situation at hand.

Weighted blankets aid in the reduction of stress and anxiety via deep touch pressure. Deep touch pressure releases serotonin, which helps a person relax. The weight of a weighted blanket mimics that of an X-Ray bib which offers a sensation that puts the body and mind at ease.

Thus, the weighted blankets help to build a Snoezelen environment, which aids in the reduction of stress and anxiety by focusing on the many senses of the body. The Snoezelen environment deploys the use of a vest that offers a relaxing deep-pressure sensation. The deep-pressure provided by the vest aids in relaxation, especially for those who suffer from an array of illness, disorders, or disabilities (Appukuttan et al., 2016). For patients with anxiety, serotonin levels could be low, preventing them from relaxing. A weighted blanket would act in the same way as this vest.

The use of such physical forms of anxiety reduction are preferable to pharmacological methods. According to Appukuttan (2016), using psychological measures rather than that of medicine tend to be more tolerated and approved by those who suffer from anxiety. Weighted blankets can be used alongside medicine to aid further in the patient's relaxation (Burghardt, 2018).

Less stress on the patient means less stress for the dentist and staff. Once a patient is relaxed, it becomes more difficult for that patient to experience stress, thus significantly impacting the patient’s perspective and conclusion of the dental visits (Appukuttan, 2016).

Improved Patient-Dentist Relationship

A positive patient-dentist relationship is the foundation of a successful dental clinic, for, without reoccurring patients, a dental clinic could fail to exist. According to Appukuttan (2016), “a good patient-dentist relationship is crucial for the management of anxiety.” According to Min Ching et al. (2017), patients viewed the dentist and staff as playing a huge role in “recognizing” the anxiety and handling stress during their visits.

Weighted blankets improve the patient-dentist relationships by making the patient’s comfort a priority. If a patient feels like the dentist and staff are going above and beyond for the patient’s comfort and peace of mind, the patient will see the dentist and staff as accommodating and caring.

Because a weighted blanket helps relax the anxious patient, the dentist can execute the procedure as planned with full cooperation. Anxious dental patients tend to create stress, so the timing and resources to execute a simple treatment may increase significantly.

Weighted blankets can give patients a more personalized approach to dental care, which further builds trust between the patient and the dentist by showing the patient that the dentist cares about the patient’s sense of autonomy. For instance, the patient can have a choice in color and weight, expressing the patient’s personality.

Fewer Missed Appointments

Anxious patients frequently cancel their visits. White, Giblin, & Boyd (2017) showed that of 308 scheduled dental appointments, 26 were cancelled because of dental anxiety. The patients reported missing a scheduled appointment due to worrying about the experience itself or receiving bad news as well as previous negative experiences (White, Giblin, & Boyd, 2017). Dental anxiety for many patients are rooted from previous experiences and feelings that are associated with “pain, embarrassment, and fright” (McMaster & Garisto, 2012).

Due to anxiety, patients become fear dental visits. Such fear can trigger the flight or fight response of the body. If a weighted blanket can soothe the response by anxiety, it could also alleviate fear.

Therefore, because weighted blankets reduce anxiety, they also reduce the patients’ fear, resulting in fewer missed appointments. A repeat patient who experiences a more relaxed state when going to the dentist would be less likely to become anxious or fearful, leading the patient to cancel a scheduled appointment. If XYZ Dentistry can remove or ease the patients’ negative feelings with the use of a weighted blanket, potential long-term patients can be achieved.

More Future Visits

The use of weighted blankets by XYZ Dentistry would increase the anxious patients’ comfort as part of the dental experience, increasing the likelihood the patient would recommend the practice to others. Ng et al. (2011) conclude that for intangible services, word of mouth recommendations are most influential in purchasing decisions made by potential customers. Potential customers are more likely to trust the advice of someone who has experienced the service than trust the word of that business itself.

In addition to word of mouth promotion, XYZ Dentistry can also advertise the use of weighted blankets on the dental clinic’s website, which would promote the staff’s commitment to helping patients with dental anxiety.

Cost Effectiveness

The only cost associated with weighted blankets is the initial purchase cost and future replacement costs of blankets when they become unusable. A medical grade weighted dental blanket is typically resistant to bacteria and fungus, waterproof, fire retardant, stain resistant, and washable. Due to these qualities of a weighted blanket, future replacement would be unnecessary unless the blanket is damaged, which is unlikely with everyday use. Each blanket costs an average of $234.

Because XYZ Dentistry has five dental chairs and assuming that blankets are washed weekly, 15 blankets would be needed so at any time, each dental chair would have three weight options for adults and one for a child, keeping in mind that not every patient would always want a blanket. The cost of 15 weighted blankets is $3510.

Figure 1 shows the weight selection based on bodyweight and ranging from 5 to 25 pounds. To find the correct weight, calculate 10% of the patient’s body weight and add a few pounds.

Figure 1: Determining Blanket Weight

Source: Scott, J. (2018). Weighted blankets for insomnia and anxiety. Lifehack. Retrieved from https://www.lifehack.org/351993/sleeping-with-weighted-blankets-helps-insomnia-and-anxiety-study-finds

The cost of a weighted blanket is less than that of lost profits the clinic will experience from anxious patients over a period of time. Figure 2 shows a scenario of missed profits of XYZ Dentistry due to anxious patients based on the potential $33,000 of revenue lost due to patients who did not rebook. The scenario outlines missed profit of $2075 for five treatments. Comment by Natascha: Each figure should include a textual reference to it, such as “Figure 1 shows…” Use textual references as support within a paragraph. The figure should then appear immediately after the paragraph that references the figure.

Figure 2: Summary of Cost Benefit Analysis

Weighted blankets compared to pharmacological methods over a period of time are cheaper to use. Pharmacological options require ongoing training for the dentist and staff. Continuing education for pharmacological methods such as laughing gas cost the dental clinic for both the dentist and staff is $1398.00. Laughing gas and local anesthetics may need to be used as a combination to relax a patient thus increasing the amount of resources and time required. Furthermore, not all patients respond well to certain types pharmacological medicine.

Weighted blankets may cost more than psychological methods, such as hypnosis and relaxation techniques, but these other methods require a great deal of ongoing training to master. American Society of Clinical Hypnosis (2015) states the cost of certification for a medical professional is $350 for initial training and then renewal training every three years thereafter.

CONCLUSION/RECOMMENDATION

XYZ Dentistry currently provides resources that aid in reducing stress and anxiety, and a weighted blanket would improve upon those results. XYZ Dentistry should use weighted blankets to achieve the following benefits:

1. Reduced anxiety

2. Improved patient-dentist relationship

3. Fewer missed appointments

4. More future visits

5. Cost effectiveness

XYZ Dentistry should purchase 15 weighted blankets, consisting of five from each of the following weights: 15, 20, and 25 pounds. Appendix A provides a list of companies that sell weighted blankets and their contact information. XYZ Dentistry’s financial budget and projected future revenue needs to be analyzed to determine when such a purchase can be made. Comment by Natascha: Every appendix should have a textual reference to it.

Deploying the use of a weighted blanket during any type of appointment, whether new or reoccurring, can set the stage for a better experience for the patient, and working environment for the dentist and staff. The dentist and staff can significantly impact the lives of many anxious patients by using weighted blankets.

REFERENCES Comment by Natascha: All first-level headers should be formatted the same. “References” is a first-level header like others in the report’s body discussion.

American Society of Clinical Hypnosis. (2015). ASCH Certification Program. American Society of Clinical Hypnosis. Retrieved from http://www.asch.net/Certification/CertificationUpdate.aspx

Appukuttan, D. P. (2016). Strategies to manage patients with dental anxiety and dental phobia: literature review. Clinical, Cosmetic and Investigational Dentistry, 8, 35–50. http://doi.org/10.2147/CCIDE.S63626

Burghardt, S., Koranyi, S., Magnucki, G., Strauss, B., & Rosendahl, J. (2018). Non-pharmacological interventions for reducing mental distress in patients undergoing dental procedures: Systematic review and meta-analysis. Journal of Dentistry, 69, 22-31. doi:http://dx.doi.org.ezproxy1.apus.edu/10.1016/j.jdent.2017.11.005

Champagne, T., Mullen, B., Dickson, D., & Krishnamurty, S. (2015). Evaluating the Safety and Effectiveness of the Weighted Blanket with Adults During an Inpatient Mental Health Hospitalization. Occupational Therapy in Mental Health 31:3, pages 211-233. 

McMaster, R., Garisto, G. (2012). Practical Consideration of Treating the Anxious Patient. Oral Health. Retrieved from https://www.oralhealthgroup.com/features/practical-considerations-for-treating-the-anxious-dental-patient/

Min-Ching, W., Vinall-Collier, K., Csikar, J., & Douglas, G. (2017). A qualitative study of patients’ views of techniques to reduce dental anxiety. Journal of Dentistry, 66, 45-51. doi:http://dx.doi.org.ezproxy1.apus.edu/10.1016/j.jdent.2017.08.012

Ng, S., David, M. E., & Dagger, T. S. (2011). Generating positive word-of-mouth in the service experience. Managing Service Quality, 21(2), 133-151. doi:http://dx.doi.org.ezproxy1.apus.edu/10.1108/09604521111113438