Pt. OP. Positioning Eval

Preliminary Preparation

Preliminary Preparation

Positions chair for patient arrival Definition

Observe student positioning chair for patient arrival by:

a) Lowering chair to knee level

b) reclining chair back slightly

Positions chair for patient arrival Rationale

To save time and provide easy access for patient to be seated

Clears pathway for patient Definition

Observe student clearing pathway to dental chair by:

a) moving bracket tray out of the way

b) moving rheostat behind chair

c) moving light out of way

d) moving operator stool under counter top

Clears pathway for patient Rationale

To provide unobstructed pathway for the patient to dental chair

Seating the Patient

Seating the Patient

Lowers backrest to achieve knees/nose position Definition

Observe the student lowering the backrest to achieve a knees to nose patient postion

Lowers backrest to achieve knees/nose position Rationale

To insure patient comfort and facilitate procedures

Positions field of operation (oral cavity) at waist level. Definition

Observe student raising/lowering chair to position field of operation (oral cavity) at waist level of operator.

Positions field of operation (oral cavity) at waist level. Rationale

To facilitate operators access and vision.

Positions headrest for access and comfort. Definition

Observe student positioning headrest as follows:

a. raised/lowered to accommodate patient=s head height

Positions headrest for access and comfort. Rationale

To insure patient comfort, access and visibility.

Maintaining Field of Operation

Maintaining Field of Operation

Requests patient to adjust head as necessary. Definition

Observe student requesting patient to adjust head as follows:

a. patient turns away for surfaces toward operator

b. patient turns toward operator for surfaces away

Requests patient to adjust head as necessary. Rationale

To increase access and visibility.

Adjusts backrest/occipital tilt for maxillary arch. Definition

Observe student adjusting backrest/occipital tilt for maxillary arch so occlusal plane is perpendicular to floor. Ask patient to raise chin.

Adjusts backrest/occipital tilt for maxillary arch. Rationale

To increase access and visibility.

Adjust backrest/occipital tilt for mandibular arch. Definition

Observe student adjusting backrest/occipital tilt for mandibular arch so occlusal plane is parallel to floor. Ask patient to lower chin.

Adjust backrest/occipital tilt for mandibular arch. Rationale

To increase access and visibility.

Positions light for maximum illumination. Definition

Observe student positioning light for maximum illumination by:

a. directing light on maxillary arch from in front of patient, angled at 45 degrees

b. directing light on mandibular arch from above patient, angled down (perpendicular).

Positions light for maximum illumination. Rationale

To insure optimum illumination and visibility.

Postoperative Procedures

Postoperative Procedures

Raises backrest to almost upright position slowly

Observe student raising chair backrest to almost upright position slowly.

Raises backrest to almost upright position slowly. (press

To avoid postural hypotension.

Raises/lowers chair to knee level. Definiton

Observe student raising/lowering chair to knee level.

Raises/lowers chair to knee level. Rationale

To facilitate patient=s exit from chair.

Sits patient upright for several minutes before dismissal. Definition

Observe student sitting patient upright for several minutes before dismissal.

Sits patient upright for several minutes before dismissal. Rationale

To avoid postural hypotension.

Clears pathway for patient. Definition

Observe student clearing pathway for patient from dental chair by:

a. moving bracket tray out of the way

b. moving rheostat behind chair

c. moving light out of way

d. moving operator stool under counter top

Clears pathway for patient. Rationale

To provide unobstructed patient departure from dental chair/clinic.

Escorts patient to reception area. Definition

Observe student escorting patient out to reception area.

Escorts patient to reception area. Rationale

To demonstrate concern and encourage positive patient relationship

Operator Positioning

Operator Positioning

Maintains proper operator positioning. Definition

Observe student maintaining proper operator positioning on stool:

a. thighs parallel to floor with slight slope

b. feet flat on floor

c. head erect

d. back straight

e. shoulders relaxed

f. body weight evenly distributed

Maintains proper operator positioning. Rationale

To reduce operator fatigue and increase efficiency

Working Positions

Utilizes proper front position. Definition

Observe student utilizing proper front position as follows:

a. right-handed operator seated 7:00 (5:00)

b. facing patient

c. knees separated and chair straddled

d. hands enter patient's mouth from operator's side (exception is mandibular R lingual)

Utilizes proper front position. Rationale

To increase access, visibility and efficiency

Utilizes proper side position. Definition

Observe student utilizing proper side position as follows:

a. right-handed operator seated 9:00 (3:00)

b. operator sits at side of patient, facing patient's ear c. knees separated straddling stool and chair

d. hands enter patient's mouth from operator's side

Utilizes proper side position. Rationale

To increase access, visibility and efficiency

Utilizes proper back position Definition

Observe student utilizing proper back position as follows: a. right-handed operator seated 11:00 (1:00) b. operator sits behind patient's head

c. knees separated straddling stool and chair

d. hands enter from opposite sides of patient's mouth

Utilizes proper back position Rationale

To increase access, visibility and efficiency

Utilizes proper behind position. Definition

Observe student utilizing proper behind position as follows: a. right-handed and left-handed operators seated at 12:00

b. operator straddles patient's head

c. hands enter from opposite sides of patient's mouth

Utilizes proper behind position. Rationale

To increase access, visibility and efficiency

Utilizes proper crossover position. Definition

Observe student utilizing proper crossover position as follows: a. right-handed operator seated 1:00 (11:00) over patient=s shoulder

b. knees separated straddling stool and chair

c. hands enter from opposite sides of patient=s mouth

Utilizes proper crossover position. Rationale

To increase access, visibility and efficiency