Implementation Flashcards
1
Q
what are the 4 stages of developing a dental hygiene care plan
A
- setting priorities
- developing goals/outcomes
- dental hygiene care plan (who what when…)
- documentation
2
Q
what is the blue print
A
- focus on specific needs and strategies to solve problems in the dh diagnosis
3
Q
how can we identify alternatives
A
- weigh all options: select different paths dependent on the pt presentation and desire
- there are different ways to get to the same goal
- patient’s past experiences
- watch stereotype judgments – low income, some pt might be saving to get an implant instead of a partial
- avoid same hard sell (try to sell a cruise to someone who likes a hike)
4
Q
what are the 2 routes an individual can be influences
A
- central route: pt is influenced by education (info he gets on an issue), pt thinks deeply about the topic, careful thought and consideration of the arguments. attitude more long lasting, predictive behaviour
- peripheral route (are influenced by): external cues, lack of informed knowledge, reward (cute hygienist, hot dentist). unpredictable behaviour, message easily forgotten
5
Q
when sending a message, the source of the message must be
A
- quality of the argument
- scientifically based
- manner of the presentation
- listening to the pt
- the issue must have personal importance/value
- susceptibility, the pt needs to believe that there actions will impact disease
6
Q
what is fear arousal
A
- controversial technique
- ex ‘smarten up or you will lose all your teeth’
- can be effective
- a pt who is moderately anxious about a current or potential condition is more likely to be ready to accept involvement in care plan
- does not work well with fearful patients
7
Q
what is the what if game
A
- a tool for making decisions
- educate client on determining consequences
- to find options based on the goal
- create a win/win vs yes/no (pt has pockets, low income, can’t go to specialist, ins not covering 3m scale, educate good home care, not expensive, create win/win situation) situations that are preventive rather than reactive
- educate and then decide together
- weight pros and cons
8
Q
what are the 7 steps in decision making
A
- what is the issue? what are the consequences
- state your purpose. what are you trying to achieve
- set criteria. what needs to happen to reach goal
- establish priorities. do this with pte
- search for solutions
- look for alternatives if necessary
- troubleshoot what can go wrong? implications, realistic, pros and cons
9
Q
what must be done for the 7 steps of decision making to work
A
- rapport was established
- understanding was given
- validation for past feelings and behaviours was given
- not judged as a failure
- ‘best’ alternatives were established together
10
Q
what is the dh diagnosis on the care plan
A
- 1st part: problem: this relates to your goal
- 2nd part: etiology/cause: this relates to your interventions
11
Q
what are interventions
A
- designed to assist the patient in reaching a goal
- specific and easy for other dh and pt to follow
- ex. goal: increase tooth surface resistance (decrease risk to caries)
- overall desired result
- interventions: home fluoride rinse, plaque control, dietary counselling, caries progression education, in office fluoride
12
Q
how do we state the goal
A
- state desired effect of dh interventions
- tx required to correct the problem
- ex: decrease risk to caries or increase tooth resistance and improve OHI, interventions will state how (expected outcomes are how you measure achievement of a goal)
13
Q
what are short and long term outcomes
A
- short goals to eventual long term outcomes
- flossing 2x/wk to eventual 7x/week
- specific performance and target date (can be added into outcomes)
- mutually agreeable, work with pt to set goals, ensure it is reasonable/achievable
14
Q
how do we state expected outcomes
A
- must be concise, measurable, understandable
15
Q
what 6 things should the expected outcome statement be
A
- client centered
- clear and concise
- observable and measurable
- time limit
- realistic
- determined by client and DH
16
Q
what are the guidelines for writing expected outcomes
A
- performance+: learning
- conditions+: with which they will do the performance (ie using spool method/pics)
- criteria+: when accomplished, how well (5x/wk)
17
Q
what are the 3 learning categories
A
- cognitive: intellectual process (define, list, etc)
- psychomotor: physical, visual (demonstrate, use)
- affective: values, beliefs (incorporate, appraise), most difficult one to alter
18
Q
what are the expected outcomes
A
- written interventions
- written goal statements
- written expected outcomes: increase detail in pt’s performance, conditions and criteria; increase detail in evaluation method
19
Q
what is the sequence of interventions
A
- simple
- complex: dependent on amount of interventions, status, severity and extent of condition/amount of appts required
- philosophy of the dh and client: scaling before OHI, OHI integrated
20
Q
what are time management skills
A
- appt plan is dependent on time
- procedures
- operators and client needs
21
Q
what is implementation
A
- 4th stage of dh care plan
- care plan: presented, consent gained if not done in care planning stage (P)
22
Q
how do we present the care plan
A
- state in understandable terms: appropriate level of communication, layman’s terms like tartar, professional terms if they have dental IQ, do not offend, visual aids
- describe plan: pros and cons, cost, insurance coverage (% and flexibility, scaling units bs recalls per year, ignoring insurance…. not great)
- identify alternative tx options: ‘best plan’ (for pt needs and values), plan that actually meets client needs
23
Q
before talking about the plan, one needs to establish what
A
- the ‘whys’ of the plan
- have pt tell us what they know so we can determine how to build on their understanding
24
Q
what are the 4 steps of the implementation process
A
- pro the operatory
- performance of procedures
- after care
- recording tx
25
Q
what does preparing the operatory include
A
- proper infection control: personal equipment, tx room, instruments, standard precautions (sterilized, disinfection)
- reduce aerosols
- radiographic equipment: proper disinfections, developing rad, effective and efficient procedure, easily compromised in daily office, well prepared and organized
26
Q
what does the performance of procedures mean
A
- achieve the expected outcomes
- clinical 50%
- educational 50% (most difficult to achieve, requires pt participation)
27
Q
what is the pt performance of expected outcomes dependent on
A
- adequate knowledge (dh dependent)
- adequate skill
- adequate motivation
28
Q
what are the 7 aspects of learning
A
- requires perceiving – important to them
- unique characteristics of learner: we learn in different ways, need alternative strategies (analogies)
- environment: dental chair, stress of environment, take information home
- motivation of learner
- positive reinforcement: positive about small successes
- similar message in old and new situations: continual improvement, consistent message from same heath care provider and same message from others
- practice: at and in between appts, keep motivation going
29
Q
what does the after care process include
A
- recap appt with client
- instructions: must be written down, client will not remember
- update improvements with client
- explanation of next appt
30
Q
what does the recording process include
A
- tx rendered or progress notes
- brief description of procedures
- legal document
- must contain: subjective findings, object findings, medication, local anaesthetic given, complications, results, clients reactions and performance, tx complete or incomplete
31
Q
what is DAR and what does it stand for
A
- format used to record info
- D: data: observations of client status, subjective and objective, assessment phase of care plan
- A: action: consent given, interventions performed and further action, planning and implementation steps of care plan
- R: response: client response to interventions, client measurements and behaviours, evaluation step of care plan
- always include next appt
32
Q
what is SOAP and what does it stand for
A
- S: subjective data: client’s perceptions, complaint of problem. not always relevant? always relevant – need to ask more questions
- O: objective data: measured and observed data
- A: assessment: interpretation of data (obj and subj), diagnosis and client’s condition and progress
- P: plan: specific dental hygiene interventions, instructions given, goals for future, results, successes, future appts, plan to resolve the stated problem
- can also include I = interventions and E = evaluation, always include next appt
