Professional Issues-1 Week 1 PDF

Professional Issues-1 Week 1 The Profession of Dental Hygiene Himanshu Laul RDH BDSc Welcome to Professional Issues-1 Professional Issues 1 u Introductions u Review of course outline u Review of expectations and learning outcomes u Review assignments u Review e...

Professional Issues-1 Week 1 The Profession of Dental Hygiene Himanshu Laul RDH BDSc Welcome to Professional Issues-1 Professional Issues 1 u Introductions u Review of course outline u Review of expectations and learning outcomes u Review assignments u Review evaluation criteria (including uploaded rubrics) Week 1 Introduction to Professional Issues and the Profession of Dental Hygiene Required Reading: Darby & Walsh, Chapter 1,2 & 6 Upon successful completion of the unit, the student will be able to: u Describe the role of dental hygiene as a profession in health care u Describe the characteristics of a true professional as they apply to dentistry and dental hygiene u Describe five professional roles of the dental hygienist u Identify the four major concepts of the Dental Hygiene Paradigm u Explain the conceptual models of dental hygiene u Identify the dental hygiene process of care (ADPIE) u Identify the concepts of evidenced-based decision making What Is Dental Hygiene? “The study and practice of preventive oral healthcare” Includes management of client behaviors' to prevent oral disease & to promote health Is concerned with the public good & with advocating methods of preserving oral health The profession has evolved over the years by becoming self-regulated, and by acquiring an increased scope of practice What Is A Dental Hygienist? Defined as: u “A preventive oral health care professional” A Dental Hygienist is a Professional u A licensed oral healthcare professional: u Must have a diploma/degree from a higher- education program u Demonstrates knowledge, skills, & behaviours required by their profession u Has completed a National Board Examination u Has received a license to practice from their province u Follows the ethical principles laid out by their governing body u Promotes and maintain oral wellness, contributing to the quality of life  A Dental Hygienist is a Professional u Professional: “an expert with specialized knowledge and skill in a field of human endeavor.” u Having reached a desired level of competency and quality performance  Characteristics of a True Profession 1. Specialized body of knowledge & skill of great value to society 2. Intensive academic course of study 3. Standards of practice determined and regulated by the group 4. External recognition by society 5. Code of ethics 6. Organized association 7. Service orientation  Professional Traits for the Dental Hygienist: (All rooted in beneficence) Application of the principles of u Clinical Competence professionalism: u Interpersonal Communication 1. Excellence u Ethical and legal 2. Humanism- human needs understanding theory u Critical thinking ability 3. Accountability u Honesty & Integrity 4. Altruism u Caring & Compassion Beneficence = putting the u Reliability & Responsibility needs, values and interests u Maturity & Self-Analysis of the client first and providing services in a u Loyalty caring, respectful and safe manner. u Tolerance For Others Respect For Self POOR examples of Professionalism □ Arrives late and unprepared for class □ Fails to attend class. □ Fails to inform receptionist/instructor/Program Coordinator of absence or lateness. □ Fails to provide doctor’s note if ill. □ Fails to wear appropriate school attire. □ Fails to wear appropriate foot wear. □ Wears inappropriate make-up. □ Fails to adhere to school policy on eating/drinking in the classroom. □ Fails to complete all assigned tasks in class. □ Attitude is poor and does not accept constructive feedback from Faculty/Staff. □ Displays disrespect to fellow classmates. □ Displays disrespect to Faculty/Administration and Dispensary Staff. □ Uses cell phone (only allowed in lunch or locker room). □ Wears perfume and or scented lotions or body sprays. □ Wears jewelry other than a watch (clinic and pre-clinic only) □ Nails not properly groomed, wears nail polish, not finger tip length. □ Hair not pulled back and off face and shoulders. (clinic and pre-clinic only) □ Failure to properly fill out forms for independent work in Radiology/Pre-Clinic Labs Professionalism The relationship or contract with society: u Social responsibility u The ethics of care u Access to care u Places the needs of the client ahead of the provider and aims to provide the best care to every client, as well as society at large Professionalism u The conduct, aims, or qualities that characterize a profession or a professional person u There are three moral models of professionalism which provide insight into the moral basis of the relationship of the client and the provider in dental care. 3 Moral Models of Professionalism: Moral Obligations 1. Commercial Model 2. Guild Model 3. Interactive Model  Commercial Model: $$$ u Describes a relationship in which dentistry is a commodity u A simple buying & selling of services u Client is the consumer, dentist is the producer u Dental needs are not as important as compared to how much profit the dentist can make u Care is based on what the client can afford vs. needs u All dentists are in competition (offering better deals) u No obligation exists between the dentist, the client, other dentists, or the community Guild Model: Paternalistic Presents dentistry as an “all knowing”” profession Dentist provides care to meet the needs of the client Client has needs, but is uninformed & passive; not involved in the decisions Resembles medieval guild of old in which those who were members of the group controlled knowledge, skill, and competency Interactive Model: Partnership u Client and dental care provider are partners in the decision making of oral care needs u A delicate balance must be maintained between the expertise of the professional and the choice of the client u Fundamental obligation is for the professional to treat each client well & to support the profession u Clients determine their needs & health care choices based on personal values & priorities u Seek care of the dental professional because of their knowledge and skill Dental Hygiene: uses an Interactive Model u It presents the client and provider as partners who make different contributions to the partnership u Creates equal respect u Work as a team moving towards attaining and maintaining oral health  Conceptual Models Conceptual models explain dental hygiene from different perspectives: u The Oral Health Related Quality of Life Model: oral health, comfort and function is integral element of general health u The Client Self-Care Commitment: clients are co-therapists in their oral health u The DH Human Needs Conceptual Model: defines dental hygiene actions in terms of the human needs theory Oral Health Related Quality of Life u General Quality of Life Domain u Health and Preclinical Disease Domain u Health Perception Domain u Functional Status Domain u Symptom Status Domain u Biologic and Physical Clinical Variables Client Self Care Commitment u Initiation Domain: Pre-existing beliefs/values u Assessment Domain: Assess patient self care practices and symptoms u Negotiation Domain: Becoming co- therapists u Commitment Domain: Committing to self selected goals u Evaluation Domain: Self report of self care practices Occupational model of DH = dental auxiliary u Technically based, Tooth cleaner only = OHI, scale, prophy, fluoride u Gathers data but DDS develops dental diagnosis and formulates the treatment plan u Implements tx plans and isolated duties as directed by the supervising dentist u Expertise, decision making and evaluation of the outcomes are not stressed u The dental hygienist is accountable to the supervising dentist u Only the dentist is accountable to the client Professional Model of DH = Process of Care u Dental Hygienist is accountable to the client u Dental Hygienist makes decisions based on knowledge u Dental Hygienist follows the process of care and implements self- generated preventive care regimens Collaborative Practice Model = Co-Therapist Relationship u The dentist and dental hygienist work together as colleagues u Each are considered experts and each have specific roles that complements and augments the effectiveness of the other u Mutual goal is to provide optimum oral healthcare u Dental Hygienist are expected to make clinical decisions and are given the freedom to create the dental hygiene component of the overall care plan Human Needs Conceptual Model of Dental Hygiene Defines four major concepts of the dental hygiene paradigm in terms of the human needs theory and provides a comprehensive and client-centered approach to dental hygiene. Based on Maslow’s Hierarchy of Needs Human Needs Conceptual Model u Includes all components of the collaborative practice model u Bases the client’s treatment plan on the human needs theory u Most up-to-date model and is used here at VCDH Maslow’s Hierarchy of Needs u Physiologic Needs: u Self-Esteem Needs: food, fluid, sleep and feeling of confidence, exercise usefulness, achievement and self- u Safety needs: physical worth and psychologic security. Stability, protection, structure and freedom from fear u Self-actualization and anxiety needs: a state in which each person is fully u Love and Belonging achieving his or her needs: affectionate potential and is able to relationships, place solve problems and within one’s culture, cope realistically with group or family life’s situations 8 Human Needs (Examples are when need is UNMET) 1. Protection from Health Risks: Premedication needed, HBP uncontrolled, uncontrolled illness (anything that can risk a Medical Emergency) 2. Freedom from Stress: bad experiences in the past, anxiety, fear of treatment, fear of needles 3. Wholesome Facial Image: facial disfigurement, yellow teeth, unhappy with dentures, facial changes with age (can affect self-worth) 4. Skin and Mucous Membrane Integrity of Head and Neck: periodontal disease, gingival disease (focus here is evidence of inflammation) intraoral/extraoral lesions (caused by? Nutritional or medication deficiencies, or poor OH? ) 5. Biologically Sound Dentition: anything to do with the dentition (teeth). Broken restorations, ill-fitting partial dentures or crowns and bridges, caries, calculus, plaque and stain 6. Conceptualization and Problem Solving: the client’s level of understanding and knowledge level of the subject matter e.g. caries, periodontal disease, smoking… 7. Freedom from Head and Neck Pain: pain during instrumentation, jaw pain (maybe has limited opening or TMJ issues) 8. Responsibility for Oral Health: does the client have poor OSC on a daily basis?, no dental exam/ care within 2 years, poor parental supervision for child’s OSC… Meta-Paradigm for Dental Hygiene ***Oral Health Promotion AND Prevention of Oral Diseases*** What Does a Dental Hygienist Do? u Oral health promotion and education u Disease prevention u Facilitates client’s self-care u Arrests the disease process u Maintains client’s health with recare appointments u Decreases the incidence of oral disease Roles of The Dental Hygienist u Meta-Paradigm: “Oral Health promotion AND prevention of oral diseases.” u Clinician u Educator u Administrator/Manager u Health promoter/Advocate/ change agent u Researcher CLINICIAN u ADPIE (Assessment, Diagnosis, Planning, Implementation and Evaluation) u Responsible for providing preventive, therapeutic, and educational services u Provides dental hygiene care in collaboration with other health care professionals u Work in hospitals, extended care facilities, community health, clinical practice, specialty practices  EDUCATOR/ ORAL HEALTH PROMOTER u Clients want & need extensive information to promote oral health & prevent oral disease u RDH’s must meet the clients learning needs u Explain concepts regarding oral health & disease and their relationship to general health, u Demonstrates self-care procedures, determines client understanding, motivates behavioural change and evaluates progress u Can be chairside or in the community, to dentists or other healthcare professionals or families u Educators who teach in schools or public health ADMINISTRATOR/MANAGER u Includes various settings in which dental hygiene care is provided u Guides and directs the work of others u Planning, decision making, organizing, staffing, directing, controlling u Can be chairside: e.g. client periodontal care u Can be directing educational programs, dean of schools, public health programs CLIENT ADVOCATE u Protecting the clients rights & well-being u Clients have the right to participate in their own health care u Facilitates client decision making by providing the information they need –informed choice u Interprets findings to the client, identifies other options to consider and involves other health professionals u Protects the client by maintaining a safe environment, prevents injury, & ensures that the client does not endure adverse effects u Respects client’s decisions u Can also advocate at a political level for policy changes  Advocate/Change Agent Focuses on a systematic approach to creating change i.e. More successful when change is viewed as evolutionary rather than revolutionary Promotes the need for innovation and change in healthcare Helps to changes attitudes, beliefs, and values in regards to dental care At a political level- may lobby for legislative changes RESEARCHER (Accountability to the public) u Throughout a professional career, the RDH is required to maintain the most current evidence-based knowledge u Efficient and effective online searching skills to find relevant evidence and critically appraise, in order to evaluate what is valid (PICO) u Implement critical thinking skills alongside evidence- based information u May also work directly in research institutions Dental Hygiene’s Paradigm Paradigms Paradigms shape shape the the direction direction and and method method of of practice practice Four Four major major paradigms paradigms for for the the discipline discipline of of dental dental hygiene: hygiene: 1. 1. Client Client 2. 2. Environment Environment 3. 3. Health Health and and oral oral health health 4. 4. Dental Dental hygiene hygiene actions actions  Dental Hygiene’s Paradigm u Client: recipient of dental hygiene care (gender, all ages, groups, u Health and oral health: client’s communities, sociocultural and state of being on a continuum economic states.) (biological, psychological& spiritual, development) u Environment: factors that can affect attainment of optimal oral u Dental hygiene actions: health ($, culture, geographical) Interventions initiating oral wellness and preventing or controlling oral disease  Dental Hygiene’s Paradigm: Client u Behavior is motivated by human need fulfillment u 8 human needs that are related to dental hygiene care u Human need fulfillment restores a sense of wholeness as a human being Client Concept: Human Needs Conceptual Model Dental Hygiene’s Paradigm: Environment u Influences the manner, mode, and level of human need fulfillment for the person, family, and community u Affects the client and the dental hygienist u The client and the dental hygienist can also affect the environment  Dental Hygiene’s Paradigm: Health and Oral Health uA state of well-being that exists on a continuum from maximal wellness to maximal illness Dental Hygiene’s Paradigm: Dental Hygiene Actions u Interventions of the dental hygienist aimed at assisting clients to meet their eight human needs u Within the DH actions is the dental hygiene process of care = ADPIE u After initial assessments have been completed, findings are evaluated to determine if the 8 human needs are met or not. The Dental Hygiene Process of Care = ADPIE Assessment Diagnosis Planning Implementation Evaluation Article: Uploaded u Discuss uploaded Article: u Applicationof the Human Needs Conceptual Model to Dental Hygiene Practice while using ADPIE. Principles of Evidence-Based Decision Making EBDM focuses on solving clinical problems and involves two fundamental principles: 1. Evidence alone is never sufficient to make a clinical decision. (this is just one key component of the process) 2. Hierarchies of quality and applicability of evidence exist, to guide clinical decision making. Evidenced-based Medicine defined u “the integration of the best research evidence with clinical expertise and client values.” u EBDM requires the clinician to find relevant evidence and be able to critically appraise the evidence to sort out what is valid and useful and what is not. Evidence-based Decision Making The Continuum of Dental Hygiene Care u Dental hygiene care can be thought of as a continuum of care that follows the human needs conceptual model, while using the ADPIE process of care, which includes: 1. Disease treatment 2. Disease prevention 3. Health promotion The Continuum of Dental Hygiene Care The client is the center of dental hygiene care! Application of EBDM (evidence based decision making) is done on a daily basis in dental hygiene practice. Mission Statement To become an excellent hygienist, you must first envision your objectives and set your goals. What Is A Mission Statement? u It is your purpose: A mission statement identifies your professional objectives. u A mission statement defines the core purpose of your organization (the dental or dental hygiene office)- why it exists. u A statement that captures an organization’s purpose, customer orientation and office philosophy. u A dental office’s description of itself. It’s declaration of values, goals and aspirations u A statement of purpose that an office is to carry out u Identifies your professional objectives Examples: CDHA & CDHBC (former college of bc) u The Canadian Dental Hygienists Association, as a collective voice and vision of dental hygiene in Canada, is dedicated to advancing the profession in support of our members and contributing to the health and well- being of the public. u The mission of the College of Dental Hygienists of British Columbia is to protect the public by developing, advocating and regulating safe and ethical dental hygiene practice in British Columbia VCDH Mission Statement u The Vancouver College of Dental Hygiene Inc. provides a learning-centred environment enabling individuals to achieve personal and professional success by offering high standards of current, comprehensive dental education. These standards provide knowledge and skills that reflect current practice and promote ongoing education. Dental Hygiene Mission Statement: u The graduate of the Dental Hygiene Program will provide appropriate client care based on the dental hygiene process of care geared to meet the specific needs of the client. They will use their critical thinking skills to incorporate evidence-based knowledge into their client care, and they will value the importance of life-long learning. They will practice ethically and responsibly according to the BCCOHP practice standards, and the BCCOHP & CDHA code of ethics. How To Develop A Mission Statement u An effective mission statement is best developed with input by all members of the your class. u Should be about 3-4 sentences long. u Identify goals – decide what you truly want to achieve as a class while you are here and when you graduate u Define your objectives and strategies for accomplishing each goal u Make sure you actually believe in your mission statement! In-class assignment: u Develop a mission statement for your VCDH class Next Week: 2 u Determinants of Health u The History of Dental Hygiene u Mission Statement