ch8Patient Reception and Ergonomic Practice

Learning Objectives

• Interpret and internalize six core aims of the session:

  1. Describe rules of etiquette

  2. Describe ergonomic practice

  3. Identify the range of working positions

  4. Describe elements of a neutral working position

  5. Explain musculoskeletal disorders (MSDs)

  6. Explain ergonomic risk factors

• Significance

  • These objectives map directly to competence in patient safety, personal safety, and professional comportment.

  • Mastery allows both reduction of MSD incidence and improvement of patient perception/comfort.

Faculty Oversight & Accountability

• Professors continually observe students (“Your Professors… are always watching”).

  • Emphasizes the need for consistent professionalism, even when unsupervised.

• Wilkins, Ch. 8 (text reference) provides foundational reading that complements live feedback.

• Clinical evaluation rubrics typically embed etiquette, chair-side manner, and ergonomic checkpoints.

Preparation for the Patient

• Treatment-Area Setup

  • Disinfect and organize surfaces before the patient arrives.

  • Instruments placed on the side table but remain sealed until the patient is seated.

• Record Review

  • Examine electronic health record (EPIC):

  • Medical history (med-hx)

  • Previous visit notes

  • Draft today’s note template in advance to streamline documentation.

• Equipment Checklist

  • Patient chair: adjust height/back to ease entry.

  • Clinician’s stool: preset approximate neutral position.

  • Ancillary equipment: light, ultrasonic, radiographic devices, PPE.

Patient Confirmation Call (Pre-Visit)

• Purpose: verify medical updates, appointment time, consent questions.

• Privacy & HIPAA compliance

  • Use patient’s ID #—never the full name—on written call logs.

  • Free services (e.g., Google Voice) can mask personal phone number.

• Documentation: confirm call outcome in EPIC without exposing PHI.

Patient Reception & Initial Contact

• Physical Greeting

  • Smile, eye contact, and professional attire (“Look Presentable”).

  • Preferred addressing protocol:

  • Default to formal (Mr./Ms./Dr.).

  • Politely ask for preferred name/pronunciation.

  • Reference article: KevinMD 10/2013 primer on addressing patients.

• Escort Process

  • Chair remains upright for safe seating.

  • Offer to place purse/belongings in patient’s sightline for security.

  • Provide protective eyewear immediately.

  • Introduce role and today’s planned procedures.

Chairside Check-In & Infection Control Sequence

• Log patient in with front-desk coordinator (Liz) to change EPIC status:

  • $\text{Blue}$ = Scheduled

  • $\text{Periwinkle Blue}+\checkmark$ = Arrived/checked-in

  • $\text{Yellow}$ = Patient seated; visit started

  • $\text{Tan}$ = Visit completed

• Pre-procedural hygiene directives

  • Patient washes hands for $20\ \text{seconds}$ (CDC guideline).

  • Patient performs pre-procedural rinse for $60\ \text{seconds}$ (reduces bioload).

Ergonomic Practice Overview

• Although details appear in future slides/lectures, key preview concepts include:

  • Neutral Working Position (NWP)

  • Head tilt < $20^{\circ}$

  • Trunk flexion 0–$20^{\circ}$

  • Elbows at $90^{\circ}$–$110^{\circ}$; shoulders relaxed.

  • Importance: minimizes compressive disk forces and muscle fatigue.

  • Range of Working Positions

  • Upright, semi-supine, supine, Trendelenburg for patient;

  • 8-, 9-, 10-, 11-, 12-o’clock operator zones for right-handed clinician (mirror for left-handed).

  • Musculoskeletal Disorders (MSDs)

  • Common in dentistry: carpal tunnel, thoracic outlet, tendinitis, low-back pain.

  • Multifactorial etiology: static load, pinch force, repetitive motion.

  • Ergonomic Risk Factors

  • Prolonged static postures

  • Awkward neck/trunk angles

  • Forceful grasp of small instruments

  • Insufficient lighting leading to forward head posture

• Proactive strategies

  • Use of magnification loupes and coaxial headlights to maintain NWP.

  • Micro-breaks every 30 min; stretching protocols.

  • Selecting lightweight, balanced hand instruments.

Etiquette & Professionalism Highlights

• Smile and courteous tone foster patient trust.

• Consistent naming etiquette prevents embarrassment and promotes inclusivity.

• Protect privacy at every step: verbal, written, and digital.

Quick Reference Checklist (Chronological)

• [ ] Disinfect operatory → set-up sealed trays.

• [ ] Review EPIC med-hx & notes; pre-draft today’s form.

• [ ] Pre-appointment phone confirmation (use ID # only).

• [ ] Welcome patient, introduce self, verify preferred name.

• [ ] Log arrival with Liz; EPIC status = Periwinkle Blue + ✓.

• [ ] Handwash $20\,\text{s}$ → pre-rinse $60\,\text{s}$.

• [ ] Seat patient; chair upright; provide eyewear; belongings in view.

• [ ] Open sealed instruments only now.

• [ ] Maintain neutral posture during procedure.

• [ ] Document clinical findings; complete visit → EPIC status Tan.

Ethical & Practical Implications

• HIPAA compliance avoids legal repercussions and preserves patient trust.

• Ergonomic diligence prolongs career longevity; reduces sick leave and treatment errors.

• Proper greeting and formality respect cultural diversity, enhancing patient satisfaction and retention.

Key Numbers & Symbols Recap

• Handwash: $20\ \text{seconds}$

• Pre-rinse: $60\ \text{seconds}$

• Head tilt guidelines: <20^{\circ}

• Operator zones: 8–12 o’clock (right-handed)

Self-Assessment Prompts

• Can I list the six learning objectives without notes?

• Can I demonstrate correct EPIC color coding for each appointment phase?

• In front of a mirror, can I hold NWP for 2 min without discomfort?

• Have I rehearsed a formal greeting for names I find difficult to pronounce?

End-of-Lecture Q&A Cue

• “Any Questions?”—prepare at least one thoughtful query linking ergonomics to clinical performance metrics (e.g., probing depth accuracy under fatigue).