Dental Hygiene Program
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DENTAL HYGIENE PROGRAM
COURSE SYLLABUS
DHG 265 CLINICAL DENTAL HYGIENE IV
CLINICAL DENTAL HYGIENE FACULTY Ms. Jamie Sawyer, CDA, RDH, MEd; Lead Course Instructor Ms. Dawnne R. Donovan, CDA, RDH, AS Ms. Ann Stalvey, CDA, RDH, BS Ms. Denise Thompkins, RDH, BS
SUPERVISING DENTISTS Thomas Kelly, DDS Vance Shields, DDS Daniel Miller III, DMD DHG 265 CLINIC SYLLABUS 2014
HORRY-GEORGETOWN TECHNICAL COLLEGE DENTAL HYGIENE PROGRAM
COURSE TITLE: Clinical Dental Hygiene IV CONTACT/CREDIT HOURS: 0-15-5 SEQUENCE: Spring Semester, Second Year LENGTH: 14 Weeks CLINIC TIMES: Tuesday & Thursday: 8:30-12, 1:30-5:30 CLASSROOM: Speir Dental Complex, Dental Hygiene Clinic
PRE-REQUISITES: 2-0-2 DHG 140 General & Oral Pathology 2-3-3 DHG 230 Public Health Dentistry 2-0-2 DHG 243 Dental Pharmacology 0-3-1 DHG 241 Integrated Dental Hygiene I 0-15-5 DHG 255 Clinical Dental Hygiene III
CO-REQUISITES: 0-3-1 DHG 242 Integrated Dental Hygiene IV 3-0-3 SOC 101 Introduction to Sociology 3-0-3 Humanities
REQUIRED TEXT:
Horry-Georgetown Technical College Clinic Manual, Current Edition
CATALOG DESCRIPTION: This course provides for the development of proficiency in the clinical dental hygiene setting with emphasis on the implementation of treatment plans to meet the individual patient’s oral health needs.
COURSE CONTENT: 1. Assessment Procedures Medical History Evaluation Vital Signs Intraoral and Extraoral Examination Dental and Periodontal Charting Deposit Evaulation Risk Factor Assessment: Caries, Oral Cancer, Tobacco Utilization, etc. 2. Dental Hygiene Diagnosis Formulation of a patient diagnosis utilizing findings from the assessment 3. Planning Establish an evidenced-based sequence of care based on the dental hygiene diagnosis; identified oral conditions and potential risk factors. Obtain medical consultation when appropriate. Make referrals to other health care professionals as needed. Obtain the patient’s informed consent based on a thorough case presentation. DHG 265 CLINIC SYLLABUS 2014
4. Implementation Provide a high standard of care to all patients in a humane, empathetic and caring manner. Perform dental hygiene treatment to eliminate and/or control local etiologic factors to prevent and control caries, periodontal disease and other oral conditions Control pain and anxiety during treatment through the use of accepted clinical and behavior techniques Provide life support measures to manage medical emergencies should the need arise 5. Evaluation Assess the outcomes of dental hygiene treatment utilizing various indices, instruments, etc. Evaluate the patient’s satisfaction with the care that has been received and the health status that has been achieved. Establish appropriate treatment or referrals based on evaluation data Develop and maintain an appropriate maintenance program for the patient.
COURSE OUTCOMES: Upon completion of DHG 265, the student will be able to: 1. Adhere to the American Dental Hygienists’ Professional Code of Ethics. 2. Adhere to all state and federal rules and regulations governing the practice of dental hygiene. 3. Utilize critical analysis and problem solving skills in the provision of dental hygiene care. 4. Respect the goals, values, beliefs, and preferences of the patient throughout treatment. 5. Utilize infection control protocols for prevention of disease transmission through demonstration of proper sterilization and disinfection methods, barrier techniques and maintenance of asepsis. 6. Perform to clinical competency the following assessment procedures: Vital signs (taking, recording, and evaluating) Thorough medical and dental history evaluation to determine if dental treatment is indicated Extraoral and intraoral examinations Dental and periodontal evaluations and chartings Risk factor assessment Gingival and plaque indices Occlusal evaluations Treatment plans for comprehensive dental hygiene care 7. Perform to clinical competency thorough scaling, root planing, and polishing procedures on indicated patients. 8. Perform appropriate and thorough patient education for each patient. 9. Perform appropriate fluoride procedures for indicated patients. 10. Complete and execute a comprehensive treatment plan for a periodontally involved patient. 11. Perform a nutritional case study for a periodontal patient. 12. Utilize proper dental hygiene care in providing total oral health care for the patient with special needs. 13. Prescribe the appropriate post-operative procedures and instructions for the patient. 14. Adequately document all treatment in the patient’s chart. 15. Utilize the ultrasonic scaler and the air polisher to clinical competency with reference to: Indications Set-up Patient preparation Technique 16. Perform to clinical competency the following expanded functions: Infiltration anesthesia Polishing amalgams DHG 265 CLINIC SYLLABUS 2014
Sealants Impressions Study models Whitening trays 17. Demonstrate professionalism in working with peers, faculty, and patients.
LINKED CORE ABILITIES: 1. Listening skills – following directions regarding patient care 2. Writing skills – proper completion of patient records 3. Problem solving/critical analysis skills – integration of knowledge to adequately assess, diagnose, plan, implement, and evaluate patient treatment
INSTRUCTOR COMMUNICATION: Students are to check Wavenet at least weekly for messages via their e-mail accounts or other message boards that are available. Rather than the instructor making individual phone calls, students will be informed of necessary information via the Internet and their Wavenet accounts.
STUDENT RESPONSIBILITIES: Take ownership and responsibility for one’s learning. Be prepared to participate in learning Put forth effort to learn Ask questions Take responsibility for one’s actions Maintain scholastic honesty
Students must have the understanding that all course material cannot be covered during lecture/laboratory time. Students MUST be willing to review materials learned in lecture to apply techniques correctly during patient treatment.
Show respect for others. Give complete attention and listen while others are talking Avoid arguing with instructor and classmates Avoid confrontations with clinical instructors in front of patients Respect the opinions of others Keep conversations and questions focused on relevant clinical issues Avoid threatening behavior toward students, professors, and patients Use appropriate language
Engage in clinical activities. Arrive early to prepare for patients Actively participate in patient treatment Exhibit positive attitude and interest in the direct care of patients Act as an advocate for the patient’s dental needs. Adhere to the ADHA Code of Ethics Demonstrate accountability for one’s own professional behavior and clinical performance. Respect the privacy of the patient at all times. DHG 265 CLINIC SYLLABUS 2014
Exhibit respect for college property. Use equipment with care Follow all guidelines for equipment use and maintenance; however, ask for guidance if you are unsure Keep your assigned clinical area neat and clean
Show respect for authority. Exhibit cooperation with the professor Avoid comments that show disrespect for the professor and their knowledge Select appropriate times to inquire about academic performance which may be outside the clinical facility Address professors as “Professor”, Mr., Mrs., Ms., or Dr. and not by their first or last name All dentists should be addressed as Dr.
ATTENDANCE: 1. ATTENDANCE IS MANDATORY since the student has a responsibility to the patient. Students will be required to sign-in upon arrival for each clinical session. For each 5-minute period that a student is late, one-half point will be deducted off the FINAL clinic grade.
2. Students MUST call Mrs. Derouen at 839-1060 to report an absence prior to the start of the clinic session. If there is no message, the student will receive 5 points off the FINAL clinic grade for each appointment session missed. Courtesy calls to Ms. Noelle are strongly encouraged so the patient schedule can be adjusted accordingly. Patients that are in the middle of treatment MUST be cancelled by the student. All other patients will be re-scheduled by Noelle, the office manager.
3. Students should not plan vacations during the semester as the missed days will be considered unexcused and 5 points off the FINAL clinic grade for EACH appointment session will also apply.
4. Clinical sessions are mandatory unless there is a justifiable reason for the absence (personal illness, illness of a child, death in the immediate family, etc.). If the student misses more than 4 clinical sessions, the student will receive an Excessive Absence Form and will be dropped from the dental hygiene curriculum.
5. Personal, medical, and dental appointments, except emergencies, must not be made during scheduled clinical sessions.
GENERAL RULES AND REGULATIONS FOR CLINICAL PROCEDURES:
1. Professionalism MUST be maintained at all times. Personal conversations when patients are present in the clinic WILL NOT BE TOLERATED. Serious or repeated exhibitions of unprofessional behavior will result in the lowering of the clinic grade or failure of DHG 265.
2. The front reception office is OFF LIMITS to all students with the exception of the student rotating through the front office. Patient charts can be obtained from the folder with your name located outside the office door. There is a telephone located in the x-ray viewing room to confirm patient appointments. There is no voice-mail attached to this phone; therefore, all messages for students must go through Noelle’s office. DHG 265 CLINIC SYLLABUS 2014
3. All students should have their units set up and ready to seat patients 15 minutes prior to appointment times. At this time, clinical instructors will take attendance and review patient charts to discuss treatment. NO PATIENTS ARE TO BE SEATED UNTIL THERE IS AN INSTRUCTOR ON THE CLINIC FLOOR.
4. For a medical history check in, students are requested to bring the ENTIRE patient chart and grade sheet for review by the clinical instructor or supervising dentist.
5. Unit clean-up is part of a clinic session and will be included in the clinic grade. If a unit is not clean and is noticed after the session is completed, the grade will be changed accordingly.
6. The Clinic/Office Assistant must report 15 minutes prior to the beginning of the clinic session. The CA will make sure that the clinic and x-ray rooms are prepared for patients. 1% of the Final clinic grade will be based upon the proper completion of the duties. PLEASE DO NOT WAIT TO BE TOLD TO DO YOUR DUTIES.
7. Unless permission is given, no student will leave the clinic floor until everyone is finished. Time must be budgeted wisely as requirements increase each semester. If you finish early, help someone else.
8. All requirements must be completed during the assigned clinic time. No outside clinic appointments will be allowed.
9. Appointment times will be 8:30am and 1:30pm each day. Students will have the option to schedule more than one appointment each clinic session; however, second appointments should be scheduled for reappoints, maintenance or child patients. New patients should be given an entire first appointment to complete as much work as possible. Check out times will be 11:15pm and 4:45pm for all clinic days. This will give the student time to clean up, evaluate x-rays, and talk with clinical instructors. The clinic will close at 12:45PM and 5:45PM SHARP!!
10. Students are requested to take the first 15 minutes (11:30-11:45 and 5:00-5:15) following check-out to complete their patient charts and turn them in for grading. ALL PATIENT CHARTS MUST BE TURNED IN DURING THIS 15-MINUTE TIME PERIOD. The following 15 minutes (11:45-12:00 and 5:15-5:30) are to be used for clinic clean-up. This will ensure that everyone will leave clinic on time. Only those students with instructor permission will be allowed to work past these designated times. This time will also be utilized for instructor/student interaction regarding patient treatment.
11. At check out, each student is to have all instruments as well as a clean mirror and gauze square for the clinical instructor’s use. Please have bracket tray free of debris. Grade sheets should be available for the notation of missed deposits. IF THIS IS NOT FOLLOWED, THE INSTRUCTOR WILL LEAVE THE CLINIC CHAIR (WITHOUT SPEAKING) AND NOT RETURN UNTIL THE AREA IS CLEAN AND READY FOR CHECKOUT! Additional points will be deducted for this infraction.
The reason for this rule is to prepare the student for their clinical board exam where this is a critical component of the exam. Examiners must have clean areas to utilize when checking patients. If the student gets in the habit of having a clean working area now, this will not be a problem when taking the clinical exam. DHG 265 CLINIC SYLLABUS 2014
12. After recording of grades, grade sheets will be located in the front office with Noelle. Please ask her to pull your file and give it to you as students are not allowed to access their own files. STUDENTS MUST REVIEW, INITIAL AND DATE GRADE SHEETS AT A MINIMUM OF ONCE PER WEEK. (Please initial and date all instructor comments on the patient assessment as well as comments on the instrumentation grade sheet). If you feel there is an error, bring it to the clinical instructor’s attention as soon as possible.
13. All clinic requirements, including incomplete grades and records must be completed and turned in by the last day of clinic, April 25, 2013. Any requirements completed after this time WILL NOT BE ACCEPTED FOR CREDIT. REMEMBER, GRADUATION IS NOW AFFECTED BY INCOMPLETE REQUIREMENTS!
CLINICAL ROTATIONS:
There will be one clinical rotation during DHG 265 – Clinical/Office Assistant.
1. The CA will be responsible for all duties indicated on their grade sheets. The CA will also be responsible for making sure that the x-rays rooms are cleaned and disinfected for each new patient.
2. Upon arrival to the clinic, the CA will bring their CA Grade Sheet to a clinical instructor for a signature. The CA will keep their grade sheet during the clinical session to check off the duties that were performed. Once clinic is over, the CA will place the completed grade sheet in the instructor station near the adjunct clinic office.
3. The OA will be responsible for all duties indicated on their grade sheet. The OA will manage the front office with regards to patient greeting, answering the telephone and appointing patients, receiving moneys for patient treatment, preparing patient files, etc.
ASSESSMENT MEASURES:
Clinical Requirements:
1. THE MINIMAL CLINICAL REQUIREMENTS FOR DHG 265 WILL BE THE COMPLETION OF THE FOLLOWING:
3 Moderately involved periodontal patients (Class III) 1 severely involved periodontal patient (Class IV) 3 documented periodontal recare patients that the student has seen from previous semesters A patient in the chair 85% of clinic time: Completion of 90% of the stated clinical/X-ray requirements to an 85% competency level. This will apply to all levels of clinical performance: patient assessment, instrumentation, and x-rays. Should the student not meet the 90% with a grade of 85 or higher, 1 point will be deducted from the category average. For example, if the student did not achieve a grade of 85 or higher for 90% of the Class II instrumentation grades, 1 point would be deducted from that average for each one not achieved. DHG 265 CLINIC SYLLABUS 2014
NOTE: Even though there is not a specified requirement for I’s, I+’s and II’s, all grades will be recorded. Students will be required to treat all assigned I’s - II’s to meet the chairside utilization policy.
If requirements are not met, the following will apply: For each patient class requirement not completed, 2 points will be deducted in the corresponding patient category. 90% of your clinic grades need to be an 85 or higher. If this is not met, 1 point will be deducted from the corresponding patient category for each grade below the 85. ALL GRADES WILL COUNT TOWARDS THE AVERAGE IN EACH CATEGORY.
3. To successfully complete the requirements during DHG 265, it is recommended that each student keep in mind the following time limits for each classification of patient. This is only a guideline to follow. It is understood that some patients will take less time and others will take more. However, it will be the students’ ultimate responsibility to keep track of the time spent on each patient to enable completion of the required quota.
CLASS I & I+ ONE APPOINTMENT (TO INCLUDE SEALANTS) CLASS II ONE–TWO APPOINTMENTS CLASS III THREE-FOUR APPOINTMENTS CLASS IV THREE–FOUR APPOINTMENTS
4. To adequately assess the patient for classification of difficulty, a short screening will be performed prior to the complete intraoral and extraoral examination. Spot probe and explore the patient for pocket depths and deposits to determine the patient classification. This will assist the student in determining if the patient will need vertical bitewing x-rays and also if the patient needs to be switched to a student needing a difficult patient for clinical requirements. All patients will need an instructor check-in unless otherwise noted by the clinical instructor.
5. All students will complete the patients that they start unless an instructor authorizes a switch.
6. Patients should not be dismissed without first consulting a clinical instructor.
Capstone Clinical Competency:
1. During Spring semester, each student will be required to demonstrate patient treatment competency on a Class III/IV patient. This means the student will perform all patient treatment following check-in without any instructor intervention. Upon final checkout, the student must achieve an 85% on both patient assessment and instrumention to demonstrate competency. If this is not achieved, the student will continue to work under instructor guidance until it is determined that the student is ready for another competency evaluation.
2. Students who did not complete their Class II Capstone Competency during Fall semester must complete this, as well, by the end of the semester to qualify for graduation. DHG 265 CLINIC SYLLABUS 2014
X-ray Requirements:
The following is the radiology requirement for this semester. X-rays will comprise 15% of the total final clinical grade. A CLINICAL FACULTY MEMBER WILL DISTRIBUTE ALL FILM TO STUDENTS AS WELL AS SIGNING THE X-RAY ROSTER.
BWX – 6 FMX – 3 PAN – 1
X-ray Retake Policy:
# of Retakes allowed for each type of film: Bitewings 1 FMX 3
NOTE: RETAKE X-RAYS MUST BE COMPLETED UNDER THE GUIDANCE OF A CLINICAL INSTRUCTOR TO CORRECT THE PROBLEM AND ALLEVIATE FURTHER RETAKES.
Grading of Radiographs: The student is allowed 3 retakes per FMX and 1 retake per BWX. When grading the retakes, the instructor will automatically deduct 1 point for the film being a retake. The retake will then be graded accordingly following the point system on the grade sheet. Retakes above the allowed number will carry an additional 5 point reduction for EACH film. These films will only be retaken for patient benefit to assure the series is diagnosable should it be sent to a local dentist. ALL RETAKE POINTS WILL BE DEDUCTED FROM THE GRADE FOR THAT SET OF RADIOGRAPHS, RESULTING IN A LOWER FINAL GRADE.
Each student must have a clinical hygiene faculty member sign the grade sheet for retake evaluation. If there is NO dentist signature in that space, 10 points will be taken off the final X-Ray grade for that series.
X-rays must be evaluated by the student within one week and then turned in for a grade. The x-rays will be graded by Dr. Miller. Once they have been graded and the grades recorded, they will be returned to the student. Each student must meet with either Dr. Miller, Ms. Sawyer, or Ms. Derouen to review the instructor comments. Both the instructor and the student must initial their x-ray grades sheets to signify that all comments have been read and reviewed.
Following the review with the faculty member, the student will then record a brief “Radiographic Interpretation” on the Record of Treatment section of the patient chart.
Example: 1-7-13 RI: Generalized horizontal bone loss, extensive calculus, decay noted on #12, 22, and 31.
If requirements are not met, the following will apply: 2 points will be deducted from the x-ray average for each requirement not completed. DHG 265 CLINIC SYLLABUS 2014
90% of your x-ray grades need to be an 85 or higher. If this is not met, 1 point will be deducted from the corresponding patient category for each grade below the 85.
Expanded Function Requirement:
NOTE: These are ANNUAL requirements and must be completed by the end of Spring semester, 2013. It is recommended that each student complete these requirements as soon as possible to ensure completion prior to graduation.
3 Infiltration anesthesia’s (Must be completed on 3 separate patients under strict instructor guidance) 6 sealants 2 amalgam polishings 2 impressions on a clinic patient 1 study model – orthodontic trim 2 whitening trays
1. Expanded functions are to be recorded in the proper section on the top portion of the Patient Assessment Evaluation form. PLEASE PUT THE NUMBER OF SEALANTS AND IMPRESSIONS that were completed. If the patient was here for a cleaning, the patient must be completed to receive credit for the expanded functions.
The student will be graded on expanded functions under the corresponding section on the grade sheet with a grade of Pass/Fail. The student may perform as many expanded duties as necessary to attain the above quota with all passing grades.
NOTE: If the above requirements are not met, 2 points will be deducted from the FINAL clinic grade for each incomplete item.
Chairside Utilization Policy:
Students are required to have a patient in the chair at all times; however, cancellations and broken appointments will occur. Therefore, 90% of the assigned clinical time should have a patient in the chair which will leave 6 sessions for cancellations. Excessive open appointments keep the student from meeting the required number of chairside hours that is set by the program’s accrediting agency. NOTE: If a patient is more than ½ hour late for any appointment, please document the amount of time late on the treatment record. This is an important factor in determining a patient’s future willingness to meet the needs of our students. Requirements for this semester are MINIMUM quotas that must be accomplished by the student to achieve competent skills and progress in the dental hygiene curriculum. These requirements have been based on the amount of chairside and x-ray time that has been assigned to each student. Students should strive to complete these requirements early in the semester to avoid loss of points from the final grade.
Patient procurement is a large responsibility that the student assumes upon entering the program. Emphasis should be placed on the procurement of difficult cases to develop technical skills of the student. It is recommended that each student maintain a back-up list of patients that could be called on short notice if a cancellation occurs. As always, the faculty will do their part in making contacts in the community for students to call for appointments. However, IT IS THE STUDENT’S ULTIMATE DHG 265 CLINIC SYLLABUS 2014
RESPONSIBILITY TO MAKE SURE THAT EACH APPOINTMENT IS FILLED AS WELL AS MEETING THE CLINICAL REQUIREMENTS.
Patient Communication:
Students will be responsible for calling their patients to review the medical history AT LEAST 3-4 DAYS prior to the appointment. For the first visit, the student MUST ask the patient for the following information:
Medications being taken (have the medications already referenced from the Computer Drug Program prior to the patient’s appointment-this will be checked by the instructors). Information for drugs will be obtained from the Computer Drug reference and then WRITTEN DOWN ON THE MEDICATION ID FORM (PLEASE PRINT LEGIBLY). Medical problems that would alter dental treatment
Medical problems that would require pre-medication (refer to clinic manual) If the patient’s physician does not feel that pre-medication is necessary, a Physicians’ Consult Form must be signed by the physician PRIOR TO TREATMENT.
FINAL GRADE DETERMINATION:
Grading Scale Weights or percentages assigned to patient difficulty 95.100 A Class I & I+ 10% 88.94 B Class II 20% 78-87 C Class III 30% 70.77 D Class IV 40% 0.69 F
Final Grade Breakdown: Each clinical patient grade has two components: Patient Assessment and Instrumentation. The Instrumentation grade includes scaling, polishing, and professional judgment.
For each patient in DHG 265, the Instrumentation grade percentages are as follows:
Patient Assessment 30% Instrumentation 50% X-Ray 14% Professional Judgment 5% CA/OA 1% TOTAL 100%
Points off in the scaling and polishing categories are as follows:
Patient Sub-Cal Supra-Cal Plaque, Stain, Classification Debris I -10 I+ -6 -6 -10 II -6 -6 -10 III -6 -6 -10 IV -6 -6 -10 DHG 265 CLINIC SYLLABUS 2014
INCOMPLETE GRADE POLICY:
1. As this is the last semester in the dental hygiene curriculum, NO incomplete grades will be issued. If the student does not complete the designated requirements (to include any requirements from the previous semester) before the end of the semester, the student will not graduate and will have to repeat the course the next time that it is offered. THIS WILL BE ON A SPACE AVAILABLE BASIS ONLY!
NOTE: TO PASS THIS COURSE AND GRADUATE, THE FINAL AVERAGE MUST BE 78% OR HIGHER!! DHG 265 CLINIC SYLLABUS 2014
STUDENT SYLLABUS AGREEMENT
I, ______, have received the course syllabus for DHG 265 Clinical Dental Hygiene IV from Ms. Alice Derouen. The syllabus has been explained to me, and I have had all of my questions answered by the instructor. I understand that it is my responsibility to keep the syllabus in my possession for future reference. I will take the initiative and maintain the necessary degree of persistence to obtain any future questions to be answered by the instructor.
I also understand that additional assistance may be obtained from the instructor during posted office hours or by scheduling a personal appointment; however, it is my responsibility to seek such assistance. I further understand that my instructor may recommend that I schedule an appointment with her or seek assistance from the SSTC (Student Success and Technology Center).
I fully understand the potential for both passing and failing this course, and that I must obtain a cumulative grade of at least a grade of “C” or higher. This means I must achieve a 78% or higher for this course to obtain the grade of “C” to successfully complete the course.
I have been given ample time to review this information and are therefore signing my name that I fully agree to the guidelines specified in this syllabus.
STUDENT NAME PRINTED:______
STUDENT SIGNATURE:______
DATE:______
This document is to be signed and returned to the course instructor by the end of the first lecture period.