Transcript Document 7234692

Dental Hygiene Process
of Care Model
B.Leggett
5/22/2016
Dental Hygiene
Program...Algonquin College
1
What is this model?
It provides a logical, systematic
approach to care
It is characterized by its client-centered
collaborative concept of care
It is based on the Human Needs
Conceptual model (Darby, 1990)
Dental Hygiene
5/22/2016
2
OUTCOMES
EVALUATION
IMPLEMENTATION
PLANNING
ASSESSMENT
ASSESSMENT
Dental Hygiene
5/22/2016
3
Human Needs Theory
Explains that :
human activity is
motivated by a
perceived need
AND
 Human behaviour is
GOAL directed

Dental Hygiene
5/22/2016
4
A Human Needs Approach
There are 11 human needs relevant to
dental hygiene care
If these needs are unfulfilled, specific
behaviours will be activated in order to
eliminate any perceived deficit
Dental Hygiene
5/22/2016
5
#1.. Safety
Freedom from potential harm
Unmet need may be indicated by:


Abnormal vital signs
Potential for antibiotic premedication
Dental Hygiene
5/22/2016
6
#2 Pain and Stress
Freedom from physical/emotional
discomfort
Unmet need may:



Be displayed by verbal OR non-verbal
behaviour
Involve fear or anxiety or
Discomfort prior to or during care
Dental Hygiene
5/22/2016
7
#3 ..Wholesome facial image
Client may express
dissatifaction with
appearance of
teeth,or concerns re
breathe odour
Dental Hygiene
5/22/2016
8
#4 ..Head and Neck –
Integrity of tissues
Deficits may be
discovered during
extra/intraoral
examination… such
as :



Presence of lesions
Gingival
inflammation
Bleeding on probing
Dental Hygiene
5/22/2016
9
#5.. Functional dentition
A biologically sound and functionally
intact dentition
Signs of need deficit could include:



Difficulty in chewing
Teeth with signs of abrasion, caries,
trauma
Presence of plaque, calculus or stains
Dental Hygiene
5/22/2016
10
Unmet Oral Health Needs
Dental Hygiene
5/22/2016
11
#6 Adequate Nutrition
The need to ingest adequate nutrients
for body growth, repair and
maintenance
Deficits may include signs of:



Eating disorders
Rampant caries
Malnutrition
Dental Hygiene
5/22/2016
12
#7 ..Appreciation and Respect
Involves the following aspects of the
dental hygienist - client relationship



Using empathic communication skills
Acting as client advocate
Understanding and accepting client’s
attitudes and emotions
Dental Hygiene
5/22/2016
13
#8 .. Conceptualization and
Problem solving
The need to grasp ideas and concepts
Make sound judgements about own oral
health
D.H. should:



Measure client’s oral health knowledge
Explain disease process
Explain rationale for care
In order to;


Promote client’s self-evaluation
Enable client to understand rationale for treament
Dental Hygiene
5/22/2016
14
# 9 .. Self-determination and
Responsibility
Involves the need for accountability for
one’s own health behaviours
Client must be a committed and active
participant in oral wellness


Involvement in setting goals
Facilitate decision making about role in
oral health
Dental Hygiene
5/22/2016
15
#10 .. Territoriality
Respect for the
client’s personal
space
Awareness of
diverse cultures
Recognize issues
with personal
information
Dental Hygiene
5/22/2016
16
#11 .. Value System
Involves the need to develop one’s own
priorities through experience and
culture


Care providers can advocate the
importance of optimum wellness
Exert influence in order to increase the
value placed on oral health maintenance
Dental Hygiene
5/22/2016
17
Phases of the dental hygiene
process of care
Assessment


Information gathering on current health
status
Sources:
 Observation
 Clinical exams
 X-ray
 Reports from family
 Lab tests etc.
Dental Hygiene
5/22/2016
18
Diagnostic Statement
“ formal statement regarding the actual or
potential problems of a client that are
amenable to treatment through the DH
Process of Care” ( Mueller-Joseph, and
Petersen)
Provides the foundation for preparing the
care plan
Must respect the DH “scope of practice “
Dental Hygiene
5/22/2016
19
DH Diagnosis
Is a two part statement which
describes:


An oral condition &
Possible etiology
Is based on both subjective & objective
data
Is validated with the client
Dental Hygiene
5/22/2016
20
DH Diagnosis
FORMAT of STATEMENT


Describes client’s current condition “related
to” contributing factors
eg .. “potential for clinical attachment
loss related to high levels of periodontal
pathogens”
Dental Hygiene
5/22/2016
21
Diagnostic Statements
Generalized dental abrasion related to
traumatic toothbrushing techniques
Generalized brown stain related to
cigarette smoking
Inflamed palatal mucosa related to
improper denture care
Dental Hygiene
5/22/2016
22
Planning Care
Focus of care is meeting client’s needs
as identified in diagnostic statements
Goal is to resolve oral health problems
(deficits)
Involves analysis and synthesis of data
to develop strategies and interventions
Dental Hygiene
5/22/2016
23
Stages of Planning
Setting priorities in collaboration with
client
Develop goals and establish desired
outcomes
“expected outcomes” language >>>
each should begin with

Client will…demonstrate, perform,
eliminate,stop, choose, remove etc.
Dental Hygiene
5/22/2016
24
Planning Care
D.H. Diagnostic statement:

Increased potential for root exposure related to
incorrect brushing technique
Goal:

Decrease potential for root exposure
Intervention

educate client and demonstrate correct toothbrushing
method
Dental Hygiene
5/22/2016
25
Planning Care
Expected outcome(s)


Client will demonstrate correct method at next
appoinment
Attachment levels will remain unchanged over next 12
months
Documentation

Outcomes should be specific and
measurable ( action language) and
prioritized with time guidelines
Dental Hygiene
5/22/2016
26
Implementation of D.H.
Care Plan
Preparation of treatment area
Performance of “skills” plus
All educational interventions


Information and OHI
Counselling ( dietary, Smoking cessation)
Post treatment care
Record keeping
Dental Hygiene
5/22/2016
27
Evaluation Phase
Failure to evaluate the client’s oral
health status after care may be
considered professional negligence
(Darby & Walsh, 1995)
Each goal should be reviewed—was it:



Fully met?
Partially met?
Not met at all?
Dental Hygiene
5/22/2016
28
Evaluation Phase
Partially or completely unmet Goals




Goals unrealistic?
Time frames too short?
Client non-compliance?
Inaccurate diagnosis?
Dental Hygiene
5/22/2016
29
Evaluation Phase
Goals Fully Met

Client goes on Supportive care plan
 Recare intervals will vary
 Process is on-going at every appointment
 Always refer back to baseline data
 Accurate documentation for continuing
maintenance of oral health
Dental Hygiene
5/22/2016
30
D.H. Process of Care
Assessment
Evaluation
D.H. Diagnosis
Planning
Implementation
Dental Hygiene
5/22/2016
31