WILK ch8ch10 Ergonomics & Documentation

Describe the etiquette a clinician should follow when introducing a new patient to office staff.

Use the patient's preferred name and correct pronoun; state the older person's name before the younger person's when the age difference is obvious; and generally state the patient's name before the name of dental personnel.

Why should a clinician be cautious about assuming eye contact norms with patients?

Cultural groups view direct eye contact differently, so what seems respectful in one culture may not be received the same way by a patient from another culture.

What steps should a clinician take when helping a patient into the dental chair?

Invite the patient to be seated, ask how you may assist if additional help is needed, guide elderly, disabled, or very small children into the chair, assist with wheelchair transfer if needed, place personal items in a safe place within the patient's view, and provide protective eyewear.

Define neutral working position (NWP) and state its main objective.

NWP is the posture a clinician maintains to preserve health while providing efficient, effective patient care; its main objective is to preserve rather than detract from the clinician's health and wellness while reducing risk of overexertion and injury.

How does neutral working position relate to a dental hygienist's career longevity?

Without habitually practicing NWP, clinicians can develop discomfort, pain, and work-related stress disorders that shorten or compromise career longevity.

Describe the position of the back and head in a neutral seated position.

The back is in neutral alignment with its natural spinal curves (cervical lordosis, thoracic kyphosis, lumbar lordosis), and the head sits on top of the neutral spine with forward neck flexion of 15 to 20 degrees or less.

What is the working distance, and what range is considered correct?

Working distance is the distance from the clinician's eyes to the patient's oral cavity when the clinician is in neutral position; it should be within 15 to 22 inches, and it is used to fit magnification loupes.

Identify the clock position range associated with a right-handed clinician.

8:00 to 12:00.

Identify the clock position range associated with a left-handed clinician.

12:00 to 4:00.

What causes carpal tunnel syndrome, and what are its symptoms?

It is caused by deviations of the wrist from neutral position and pinch grasp with insufficient rest; symptoms include numbness and tingling in the thumb, index, and middle fingers.

What causes thoracic outlet syndrome, and what are its symptoms?

It is caused by tilting the head forward, hunched or rounded forward shoulders, and continuously reaching overhead; symptoms include numbness, tingling, and/or pain in the hand or wrist.

What distinguishes tendonitis from carpal tunnel syndrome in terms of symptom location?

Tendonitis causes pain in the wrist especially along the outer edges of the hand, rather than through the center of the wrist as with carpal tunnel syndrome.

What causes disk herniation in dental hygienists, and what are its symptoms?

It is caused by prolonged, static postures of forward flexion, hyperextension, lateral bending, or rotation of the spine; symptoms include pain, numbness, and tingling of the arm, fingers, lower back, hip, or leg.

List the ergonomic risk factors that intensify potential for musculoskeletal injury.

Prolonged awkward position, static positions, repetition, force/grasp, environmental factors, vibration, insufficient rest, stress, and poor physical fitness.

How do intensity, frequency, and duration relate to ergonomic risk factors?

These three characteristics of exposure to a risk factor are related to its detrimental effects, and a combination of risk factors intensifies risk and increases the potential for injury.

What must documentation in a patient record always be, according to standards of care?

Accurate and comprehensive, legible, and objective, such that a third party could read and understand what is written.

List the required components of a complete patient record.

Signed acknowledgment of privacy/confidentiality, medical and dental history and vital signs, risk assessment, clinical assessment (charting, periodontal exam, images, radiographs), diagnosis and prognosis, treatment recommendations, informed consent or refusal, and treatment notes for each visit.

Distinguish the HIPAA Privacy Rule from the HIPAA Security Rule.

The Privacy Rule establishes a national standard protecting individuals' privacy and access to their health information; the Security Rule establishes standards (administrative, physical, and technical safeguards) to protect electronically held or transferred health information.

What are the three types of safeguards under the HIPAA Security Rule?

Administrative safeguards, physical safeguards, and technical safeguards.

Describe the Universal Numbering System for permanent teeth.

Numbers 1 through 32 are used, starting at the patient's right maxillary third molar (1), following around to the left maxillary third molar (16), descending to the left mandibular third molar (17), and continuing around to the right mandibular third molar (32).

Describe the FDI (International) two-digit tooth numbering system.

The first digit indicates the quadrant (1 through 4 for permanent teeth), and the second digit identifies the specific tooth within that quadrant (1 through 8), counted from the central incisor.

Describe the Palmer Notation System.

Each tooth is designated using numbers 1 (central incisor) through 8 (third molar) within a quadrant, and the quadrant is indicated using a specific pattern of vertical and horizontal lines rather than a digit.

What does each letter of the SOAP documentation format stand for?

S = Subjective, O = Objective, A = Assessment, P = Plan (or Procedures).

Give two examples of information recorded under the "Subjective" component of a SOAP note.

Examples include the patient's chief complaint and the patient's medical history as reported by the patient (other acceptable examples: age/gender, medications/allergies, oral self-care regimen, social history).

Give two examples of information recorded under the "Objective" component of a SOAP note.

Examples include periodontal examination findings and radiographic findings (other acceptable examples: vital signs, head and neck exam findings, hard tissue exam findings).

Why is comprehensive documentation described as important for legal risk reduction?

Because malpractice allegations or complaints can occur years after a patient visit when details may be forgotten, so thorough documentation in each record entry is the clinician's best protection against allegations of wrongdoing.