Chapter 25: The Dental Hygiene Care Plan
What is involved in explaining the plan to the patient?
-Good communication skills are important -Motivational interview approach -Inform... in a caring manner. Informed consent protocol. -Reinforce patients role, work with the patient and create goals
What is involved when presenting the plan to the dentist?
-Integrate with overall dental care plan -Coordinate with dentist... summarize ALL data collected, summarize risk factors, discuss planned interventions, goals, and expected outcomes, outline planned appointments -*be prepared to give detail and answer questions*
What are the objectives related to sequencing and prioritizing care?
-Prove evidence-based, individualized care -Eliminate or control etiologic and predisposing disease factors -Eliminate the signs and symptoms of disease -Promote oral health and prevent recurrence of disease
What are the factors affecting sequence of care?
-Urgency -Existing etiologic factors -Severity and extent of the condition -Individual patient requirements
Factors to teach the patient:
-Why a dental hygiene care plan is made. -Why patient input into the final care plan is important. -Which parts of the plan are to be carried out by the pt. -How the roles of patient and dental team members are interrelated in eliminating the patient's oral problems. -The patient's rights and responsibilities regarding informed consent.
What two major objectives are involved in presenting the dental hygiene care plan?
1. Presenting the plan to the dentist prior to dental hygiene treatment 2. Explaining the plan to the patient
What are the three things to keep in mind when preparing a dental hygiene care plan?
1. To focus on individualized needs 2. Make flexible and realistic interventions 3. Interventions are goals with added education and treatment
Within informed consent, what information is disclosed?
Diagnosis: description of the patients problem(s) Treatment Alternatives Consequences Prognosis: expected outcome with treatment(s), alternative treatments, and without treatment
Preparation of a Dental Hygiene Care Plan:
-Assess entire oral cavity -Oral Mucosa -Teeth -Periodontal supporting structures -Patient's individual health factors -Basic 3 part plan: 1. Periodontal/Gingival care 2. Dental caries control 3. Other... Supplemental care (Other interventions)
Implied Consent
Granted by the person's presence in the dental chair, only applies to nontreatment procedures, such as data collection and treatment planning
What are the components of a written care plan?
I. Demographic data including patients name, births, designation of initial or maintenance therapy, name of dh, date, patient's CC II. Assessment findings and risk factors including med/dental/social histories, clinical exam, link to risk factors III. Periodontal diagnosis and status including classifications of perio, deposits, caries risk, and ASA IV. Cambra V. Diagnostic statements including the 8 human needs deficiencies VI. Planned interventions VII. Expected Outcomes including at least one goal per intervention with realistic time frame VIII. Evaluation Methods including comparisons IX. The appointment plan including an outline in order of clinical appearance X. Re-evaluation XI. Can be recall/recare or re-eval with post active treatment
What is important to remember about informed consent?
Patients do not always remember the information they received during informed consent; therefore, written documentation of all information provided for the patient is essential
Informed Consent
The legal concept that can exist even with a written document -Informing the patient of all treatment options available and consents to follow the recommendation in the agreed-upon care plan
Informed Refusal
The patient's right to autonomy in making decisions regarding oral treatment requires that the practitioners respect a patient's decision to refuse treatment. -Refusal of care as well as any recommended treatment options are documented in the patient's record