Scientific journal
European Journal of Natural History
ISSN 2073-4972

THE DENTAL HYGIENIST LOAD CALCULATION

Kalininskaya A.A. 1 Ildarov R.B. 2
1 «The Treatment and Prevention Organization» FSHM ЦНИИОИ Minzdravsotzdevelopment of Russia Moscow
2 OOO «Comfort – Dent»
1. Alimsky A.V. On the Planning and Regulatory, and Qualitative Indices in the Pediatric Dentistry // Dentistry. – 1999. – Vol. 78. – № 1. – Р. 63–68.
2. Ashuev Zh.A., Kulakov A.A. The Early Rehabilitation Justification of the Patients with the Partial or Complete Teeth Loss, at the Dental Implants Use in the Experiment. – 2007. – С. 59.
3. Shipova V.M. The Fundamentals of Valuation Work in the Public Health Care // The Textbook. – 1998. – Р. 320.

The forms of work and the results of the work quota setting of the dentist hygienist have been presented in the paper.

According to the WHO and the various authors’ data, the dental diseases prevalence among the children population is being reached up 75–95 %, among the adult one – 100 %. So, the challenges, having associated with the teeth and the mouth cavity diseases, are being come in the first place, in the age groups of the population, who is older, than 35 years old.

Its citizens’ dental health is constantly being deteriorated, having increased the medical, the social, and the economic damage.

The stomatology development intensive way with the predominant focus on the increase in the clinical and the medical work volume is not quite able to be solved the main challenge – the population dental morbidity reducing. The medical technologies care and the further improvement treatment, and the earlier prevention of the dental diseases is one of the challenges in the further dental care improving (e.g. A.V. Alimsky, 1999, Z.A. Ashuev, 2007).

So, the development and the further implementation of the individual programs of the hygienist education, the population education and the implementation of the measures for the dental disease prevention is the dental hygienist’s work main purpose. Thus, the development and the further implementation of the individual programs, the basic hygienic prevention of the dental diseases is the dental hygienist’s main objective. So, during the process of the research, the three main groups of the basic activities, having realized and carried out by the dental hygienist, have already been identified by us: the treatment, the prevention, and the training ones.

• The Treatment and Preventive Measures: the anti – inflammatory treatment: the applications, the gum bands, the films, and etc.; the physiotherapy treatment: the gums hydro – massage, the depoferez, the vacuum therapy, and etc.; the immature fissures filling by the temporary filling materials; the fissures sealing (e.g. the invasive and the non – invasive methods), all the fluorination methods; the patients’ prophylactic medical clinical examination and the rehabilitation with the decompensated form of the caries, with the diseases of the oral cavity mucosa and the periodontal; the hygienic preparation just before the surgery operation for the periodontal disease, the implantations and the rehabilitation measures implementation in the post – operative period; the teeth whitening; the teeth hyperesthesia treatment; the occlusion test, the preliminary contacts identification, the selective teeth lapping.

• The Preventive Measures: the patient‘s examination survey with the certain hygienic indices definition; the mouth cavity irrigation (e.g. the ablution) by the antiseptic solutions; the local application or the injection anesthesia conducting; the deposits removal of the dental tartar and the soft incrustation or the dental deposit; the dental cervices and the sites available of the teeth roots grinding and the polishing after the dental tartar deposits removing; the hygienic indices control definition; the fluorinated content drugs and the preparations use to be improved the remineralization processes of the enamel and the dentin, in the form of the gels, the lacquers, and the rinses, the deep fluoridation.

• The Education Activities and the Training Measures: the studies conducting with the patient by the mouth of cavity individual hygiene method, and the healthy lifestyle.

The dental hygienist work time expenditures have been determined, by means of the methodological approaches, having developed in the Scientific Research Institute of Social Hygiene, Health Economics and Management after N.A. Semashko. The position normative has been designed, in accordance with the steps, having recommended by V.M. Shipova (1998).

So, the primary information has been collected, by means of the observation sheet of the photo – chronometer observations, the conducting of which are preceded the works classifier development – «The Dictionary of Activities Types and Labor Operations of the Dental Hygienist».

The Structure of the Dental Hygienist’s Working Time Expenditures. All the specialist’s activities we, in accordance with the SRI SGiOZ after N.A. Semashko, have divided into 2 main groups:

а) The Production one, which is included the main and the basic activities (e.g. the survey, the patients’ examination, the medical treatment, the prophylactic manipulations, the mouth cavity hygiene health education and the etc.), the work with the documentation (e.g. the getting acquainted with the medical records, the filling primary medical care documentation in the primary medical treatment, and the repeated visits, the references, the certificates, the directions completion and etc.);

b) The Non – production one.

The activities types not directly related to the patients are included the following: the support activities (SA) (e.g. the gown dressing, the redressing; the hands washing; the workplace preparation and its cleaning; the equipment inspection; the sterile table covering; the medicines and the dental equipment preparing; the disinfection and the pre-sterilized treatment tools, tips carrying out; the transitions into the central sterilization department; the nurses’ work supervision), the service talks, the personal time needed, the other activities types; the idle time.

The structure of the dental hygienist’s working time expenditures has been presented below.

In the structure of the specialist’s working time the maximum share is made the main activity (e.g. 64 %), further the auxiliary work is followed (e.g. 21,7 %), the work with the documentation (e.g. 7 %), the service talks, and the personal time necessary to 2,6 %, the other activities 1,4 %. Since the time it was idle, due to being late for the work, it was excluded just from the calculation. In the expenditures structure of the most of the work, the maximum percent are made up the medical manipulations and the mouth of cavity hygiene education (e.g. respectively, 35,3 and 17 %).

Having characterized the specialist’s time expenditures structure, as a whole, we can say, that the working time is being used rationally and efficiently by the dental hygienist.

Table 1

The Structure of the Dental Hygienist’s Working Time Expenditures (in % of the total)

The Elements of Activities:

The Expenditures structure (%)

I. The Main Activities:

64,7

– talk with the patient

5,0

– examination

2,5

– medical checkup and diagnosis

4,9

– medical treatment and prophylaxis

35,3

– mouth of cavity hygiene education

17,0

II. The Auxiliary Activities:

21,7

– gown dressing, redressing

1,9

– hands washing

2,5

– working place preparation and its cleaning

6,4

– equipment inspection

0,8

– sterile table covering

0,8

– medicines and dental equipment preparation

1,54

– disinfection and pre–sterilized treatment tools, tips carrying out

5,36

– transition into the central sterilization department

2,4

III. The Work with Documentation:

7,0

– introduction to the medical records and the research results review

0,3

– entry into the medical records (e.g. the initial visit)

3,8

– entry into the medical records (e.g. еру follow-up visit)

1,9

– other types of the work with documentation

1,0

IV. The Service Talks:

2,6

– talk with the medical staff

2,6

V. Other Activities:

1,4

– reading of the literature

1,4

VI. The Private Time Necessary:

2,6

– short break, food intake

2,6

Total:

100,0

Table 2

The Dental Hygienist’s Time Expenditures, Not Related to the Direct Medioprophylactic

Care for the Patients Provision

The Activities Type:

The Actually Spent Time (min)

The Time, Taken for the Calculations (min)

Service Talks

42

100

Other activities

55

55

Personal time necessary

87

100

Idle time

62

-

Auxiliary activities

846

846

Total:

1,092

1,100

Some correction of the labor expenditures has been made by the experts, so the personal time has been regulated by the rate of 10 minutes per day, as it is taken its place in the other sectors and the branches of the national economy. Thus, the time has been added for the service talks, and the idle possible time has been excluded.

So, the average estimated time for the 1 patient’s service by the dental hygienist has been made up 40 minutes. It should be emphasized, that the specialist conducts the admission in the adult dental polyclinic, where he accepts both, as the adults’ patients, well as the children ones, that is he works on the family lines.

And it has been conditioned the mixed reception doing, as the activities types structure, their execution frequency, as well as the temporary costs on them.

The load calculation (e.g. the service) of the dental hygienist. The live standard workload of the dental hygienist will be made up 1,5 visit per hour (e.g. 60 min: 40 min).

Сonclusion

The dental hygienists will allow to be improved the quality of the primary medical and sanitary care provision, which has a positive impact on the dental health of the population.

The work is submitted to the International Scientific Conference «Present-day problems of science and education», Russia, (Moscow), February, 26-28, 2013, came to the editorial office on 23.01.2013.