CDHO Entry to Practice Mentorship Program and Quality Assurance PDF

CDHO – Regulatory College CD HO Regulatory  CDHO FrameworkCollege  Entry to Practice Requirements V  CDHO Mentorship Program (no longer required)  Quality Assurance Program Peer SDHOMentorship Program Nologer College of Dental Hygienist of Ontario (CDHO) The mandate of the College of Dental H...

CDHO – Regulatory College CD HO Regulatory  CDHO FrameworkCollege  Entry to Practice Requirements V  CDHO Mentorship Program (no longer required)  Quality Assurance Program Peer SDHOMentorship Program Nologer College of Dental Hygienist of Ontario (CDHO) The mandate of the College of Dental Hygienists of Ontario (CDHO) is to regulate the practice of dental hygiene in the interest of the overall health and safety of the public of Ontario Lecture Learning Outcomes L • Understand the mandate of the CDHO. • Understand the role of the CDHO Council, and Registrar. • Explain the 7 mandatory statutory CDHO Council Committees. • Understand entry-to-practice requirements and the CDHO Mentorship program. • Understand the use of orders, and contraindications to initiating dental hygiene care. • Explain the importance of the CDHO Quality Assurance program. New Registrar & CEO • The Council of the College of Dental Hygienists of Ontario is very pleased to announce the appointment of Dr. Glenn Pettifer to the position of Registrar and Chief Executive Officer. Dr. Pettifer comes to the CDHO with significant leadership experience at the Senior Management level of Ontario Health Profession Regulatory Colleges, most recently serving as Registrar & CEO for the College of Denturists of Ontario. Prior to entering the regulatory world, Dr. Pettifer was an educator and researcher in the field of veterinary anesthesia and pain management and held faculty appointments at several North American universities. • In his regulatory work Dr. Pettifer demonstrates a strong collaborative and educative approach to public protection, engaging regulated health professionals in self-regulation and supporting the work of health profession regulatory Councils and Committees. His work includes a keen attention to legislative mandates, organizational efficiency, data informed governance and transformational engagement strategies. Complementing his significant regulatory experience, Dr. Pettifer holds a Certificate in Strategic Management of Regulatory Agencies from Harvard Kennedy School and the Osgoode Certificate in Health Law from Osgoode Hall Law School. September 2023 Currently 14,784 dental hygienists registered in Ontario General 13,309 Specialty 627 Self- initiated 6,719 e be D adj CDHO Council Committees Who are the Members of CDHO Council ? Dental Hygienists, Dental Hygiene Educators, and Public members r • Meet 4 times per year for Council Meetings – January, March, Sept & December. J • Discuss regulatory policies and debate issues that impact and influence the quality of dental hygiene care in Ontario CDHO Council • Dental Hygienist from the province are elected by their peers (based on districts – Toronto, Peel, York I Region, Ottawa, etc.) • Election of professional members changing to include applicants having to demonstrate a set of competencies to be eligible for election – see Milestone’s article. • Public members appointed by the Provincial government • 7 Statutory Committees – support the regulatory process 7 Statutory Committees • • • • • • • Executive Committee Registration Committee Inquires, Complaints & Reports Committee Quality Assurance Committee Discipline Committee Patient Relations Committee Fitness to Practice Committee The Registrar is the only employee thymagntive What is the Role of the Registrar/CEO? Registrar/Chief Executive Officer (CEO) for the College of Dental Hygienist of Ontario This position can be assumed by a Public or Professional individual The Registrar is the only employee to the entire Council Role is to oversees the day-to-day operations of the College (CDHO) and the employees that work at the CDHO. According to the RHPA the Executive Committee must be 3 DH members & 2 Public members Executive Committee President – public or professional Vice-President – public or professional 3 other Members – public or professional Executive Committee - Currently 3 DH members & 2 Public members • • • • • President - Professional Member Vice President - Professional Member DH – professional member (Toronto District) Public member Public member I • Current Registrar – Glen Pettifer (public member) Previously Lisa Taylor was the Registrar – DH Professional Member (but does not have to be a dental hygienist). Registrar’s of CDHO Fran Richardson – Dental Hygienist 1994 – 2012 Brad Sinclair – Public member 2012 -2015 Lisa Taylor – Dental Hygienist 2012 – 2020 Debra Adams – Public member Jan 2021 – August 2021 Glenn Pettifer –Public member January 2022 CDHO Website - Homework www.cdho.org Review the Council Member Profiles Committees Elections Process Read Articles – Milestones Entry to Practice Current Standards – changed as of October 2023 Entry to Practice Self-Initiation Stream One • the registrant has been self-initiating dental hygiene care under a “standing order” protocol with a DDS for 2 years (min of 3200 hours) must have copy of standing order/ protocol (LTC, Hospital, PH) 320 0 • min of or has been practicing for 2 years and completed the I CDHO clinical refresher course or CDHA self-initiation course within the previous 24 months • the registrant has been practicing in Alberta or British Columbia for 2 years. • Currently authorized to self-initiate in Nova Scotia • Successfully completed the CDHO mentorship program Entry to Practice Self-Initiation Stream Two Registrant who are registered with the CDHO and have been in practice for a least 2 years but are not eligible under stream one must complete a CDHO refresher course/CDHA selfinitiation course and enroll with mentor from approved by the CDHO. The course focus is critical thinking, knowledge of pathophysiology, special needs clients and interventions related to medical emergencies, evidence-based decision making, etc. Self-Initiation Stream Three • Currently holds a CDHO certificate, in good standing and graduated from an accredited DH program after Jan 2013, is being mentored by a CDHO approved mentor. • Mentorship contract is a minimum of 6 months. • Must accumulate 500 hours of direct client care. The CDHO Mentorship Program Who can be a mentor? • A dental hygienist in good standing with the CDHO, who is self-initiating status for at least 2 years • Minimum 5-years clinical experience • Currently practising dental hygiene • Professional experience to facilitate the professional development of a colleague • Completed the mentorship course & workshop through the CDHO The Role of the Mentor • Confidante, advisor, and role model • Facilitate professional development • Voluntary (can not be compensated) • 1 -3 mentees at one given time • Develop a plan with mentee to establish learning objectives, communication strategies and evaluation • Assess progress and submit reports Mentorship Program can occur through the following co-discovery process • Clinical & Administrative Management discussions • Client Records Review (mandatory)– min 20 clients • Review Professional Portfolio • Conference calls/e-mail correspondence/skype • Review daily/reflective practice journal Mentor is Required to Evaluate • Application of Dental Hygiene Process of Care to the authorized acts (scaling and root planning). • Familiarity with the indications to perform controlled acts. • Appreciation for the contra-indications of performing the controlled acts. • Client management skills. • Knowledge of when and how to refer a client. • Judgment in handling ethical situations. • Understanding legislation, standards of practice, guidelines and Code of Ethics. Declaration of Statement of Confidence Submitted by the mentor declaring the mentee has the skills, knowledge and professional behaviour to………. Self- initiate care Health History A thorough health and dental history must be taken and discussed with the client or the client’s substitute decision maker prior to providing dental hygiene care. All health history findings must be discussed in detail with the client and collaboration with other health care professional may be necessary depending on the reported findings. Contra-indication Regulation - PART III – Prescribed Contraindications to Scaling Teeth and Root Planing, including curetting surrounding tissue, one member’s own initiative. 7. (1) For the purpose of clause 5 (1) (a) of the Act, the following contraindications are prescribed if the patient has not received clearance from a physician or dentist, or both: 1. Any cardiac condition for which antibiotic prophylaxis is recommended in the guidelines set by the American Heart Association (AHA), as those guidelines are amended from time to time, unless the member has consulted with either the patient's physician, dentist or registered nurse in the extended class (RN(EC)) and determined that it is appropriate to proceed if the patient has taken the prescribed medication per the AHA guidelines. 2. Any other condition for which antibiotic prophylaxis is recommended or required. 3. An unstable medical or oral health condition, where the condition may affect the appropriateness or safety of scaling and root planing, including curetting surrounding tissue. Cont…………document is posted on BB 4. Active chemotherapy or radiation therapy. 5. Significant immunosuppression caused by disease, medications or treatment modalities. 6. Any blood disorders. 7. Active tuberculosis. 8. Drug or alcohol dependency of a type or extent that it may affect the appropriateness or safety of scaling and root planing, including curetting surrounding tissue. 9. High-risk of infective endocarditis. 10. A medical or oral health condition with which the member is unfamiliar or that could affect the appropriateness, efficacy or safety of the procedure. 11. A drug or combination of drugs with which the member is unfamiliar or which could affect the appropriateness, efficacy or safety of the procedure. O. Reg. 501/07, s. 1. (2) Despite subsection (1), a member shall not perform a procedure under the authority of paragraph 1 of section 4 of the Act if the member is in doubt as to the status or accuracy of the medical or oral history of the patient. O. Reg. 501/07, s. 1. Health Conditions to consider….. (this list is not a complete list) • Any cardiac condition that might require prophylactic antibiotics • Any other condition that might require prophylactic antibiotic coverage – renal or live dysfunction, etc…. • Unstable medical or oral health condition – BP • Active chemotherapy or Radiation Therapy • Immune suppression caused by disease, medications or treatment modalities – Rheumatoid Arthritis, Systemic Lupus Erythematosus, etc…. • Blood disorders – sickle cell anemia, hemophilia, etc.. • Active Tuberculosis • Drug or alcohol dependency • High Risk Infective Endocarditis/Bacteremia • Medical or health condition; or drug that the registrant is not familiar with Best Practice for All Clinical Settings - Checklist • Current Infection Procedures in place • Emergency Protocol , supplies and equipment • Written policy for the collection and maintenance of client information (PIPEDA & PHIPA) • Current CPR certification • Appropriate radiography protocol – Healing Arts Radiation Protection Act (HARP) • Equipment is current • Equipment, instruments and supplies are sufficient to support dental hygiene services • Client care and appointments are documented in accordance with the CDHO Record Keeping Regulation. • Consultation and referral protocol Quality Assurance In Ontario, the Regulated Health Professions Act, 1991 (RHPA) requires all health regulatory colleges under the Act to develop and to maintain a quality assurance program Mandatory Regulatory Practice/Activity Professional Portfolio The Professional Portfolio is the major component of the Quality Assurance Program. It serves as a positive focus for continuous quality improvement and will permit the dental hygienist to review their practice through self and peer assessment Currently working on the development of a “Peer Circle Project” – group discussion using hypothetical cases. Quality Assurance Program • Self Assessment Tool (SMILE PORTAL) – mandatory to complete this tool annually when renewing yearly registration in December of each year (in 2022 this changed to December) • The Assessment tool was developed using the CDHO Dental Hygiene Standards of Practice to provide dental hygienists guidance, selfmonitoring and method of assessment. 3 Assessment Options Dental Hygienist are required to demonstrate skills, knowledge and judgment Each option has 2 components – 1 to assess Knowledge and the 2nd to evaluate skills and judgment Knowledge is assessed by completion of the Learning Portfolio or a written assessment/test (NDHCB). Assessment of skills and judgment is assessed by completion of a Practice Profile or through an Onsite Practice Review. Professional Portfolio • Maintained on a yearly basis • Includes personal information, education profile, employment profile, current practice protocol – reporting on a “Typical Day” of dental hygiene practice, In addition, professional reading, and one’s continual quality improvement plan and activities. • Selection process – random, however, captures all registrants ( each year 2 numbers are select from 0-9 – all registrants whose registration number ends in the 2 numbers are selected for that given year). • (this process is also under review) • Required to submit previous 3 years • Self-assess your dental hygiene practice yearly Personal Learning Plan • Identify areas in your practice that need improvement (ie. infection control/new periodontal classifications/ adjunctive therapies/ desensitizing products) • Develop learning goals that will enhance your practice (SMILE PORTAL can assist you) Goals for those in clinical practice should be directly related to one or more of the following: ▪ Dental hygiene science ▪ Dental hygiene practice ▪ Ethical and legal obligations of dental hygienists ▪ Communication, cultural awareness, inclusive practice ▪ Infection control ▪ Record keeping ▪ Management of Quality Assurance records ▪ Self-initiation ▪ Social justice as it relates to dental hygiene, access to care ▪ Interprofessional collaboration, multidisciplinary practice ▪ Radiography, radiation safety, radiation protection officer training ▪ Health and safety, WHMIS ▪ Process of care • Investigate dentinal hypersensitivity to better assist/educate clients with managing tooth sensitivity Example Goals • Research and evaluate various oral cancer screening tools to implement into regular oral assessments for all clients • Study and investigate occlusal trauma and how it impacts periodontal conditions to better identify these conditions during oral assessment with clients Goals Examples • Research and develop an understanding of intra-and inter-professional collaboration as they relate to client care, dental hygiene practice and health promotion. • Investigate current, scientifically accepted infection control guidelines and make modifications to ensure I am meeting the guidelines. Learning Activities that can be utilized to achieve learning goals • • • • • • • Courses Textbooks Journals Webinars Workshops Lectures Seminars Part of your Learning Plan……. • What have you learned by achieving your established goals and how have you implemented this into your dental hygiene practice? Section 82 of the RHPA Procedural Code • Co-operation with Committee and assessors • 82. (1) Every member shall co-operate with the Quality Assurance Committee and with any assessor it appoints and in particular every member shall, • (a) permit the assessor to enter and inspect the premises where the member practises; • (b) permit the assessor to inspect the member’s records of the care of patients; • (c) give the Committee or the assessor the information in respect of the care of patients or in respect of the member’s records of the care of patients the Committee or assessor requests in the form the Committee or assessor specifies; • (d) confer with the Committee or the assessor if requested to do so by either of them; and • (e) participate in a program designed to evaluate the knowledge, skill and judgment of the member, if requested to do so by the Committee. CDHO Website - Homework www.cdho.org Review discipline case decisions related to not meeting Quality Assurance requirements resulting in professional misconduct Martin, Baker, Noor Darby, Walsh, (2015) Dental Hygiene : Theory and Practice. 4th Edition. W.B. Saunders Company, Toronto. Mueller-Joseph & Peterson., Dental Hygiene Process, Diagnosis and Care Planning, 1995. References Wilkins, E., (2017) Clinical Practice of the Dental Hygienist. 12th Edition, Lippincott Williams and Wilkins, Philadelphia. The College of Dental Hygienists of Ontario Registrants’ Handbook – www.cdho.org www. Googleimages.com Have a great day!