www.itee.uq.edu.au/~pig/dentist/layout.jpg
Observations
General description:
Dentist A is working in a single workplace on his own. Occasionally a supervisor will come to help or check work being carried out, or an assistant will provide help ( for example, flossing a patient's mouth ) or equipment required.
www.itee.uq.edu.au/~pig/dentist/layout.jpg
Initially, the dental student will go collect the patient from the waiting room. At the same time they collect the patient's chart from the receptionist. They lead the patient into the surgery and sit them down at the chair, put their bag/coat to the side, etc.
The general procedure at this point is for the dentist to first adjust the patient's chair to suit the patient, ie, head height, etc. Usually at this point the patient is quizzed about their teeth and/or the record is checked. After this, the dentist puts their face mask on and cleans their hands thoroughly. They then put gloves on and adjust the chair into the lying position ( the student uses their feet to do this ), and seat themselves behind the patient's head.
Once the student has completed the procedure, they must be signed off by a supervisor. For any unfamiliar or uncertain work, the supervisor is also called over to check proceedings. Once signed off, the patient is led back to the waiting room and their records left with the receptionist.
Cleanliness:
Students and staff must wash and dry their hands thoroughly to become clean. While clean they may touch anything that has been sterilised or cleaned with methylated spirits or other cleaners. To touch 'dirty' areas, such as the patient's mouth, they must wear gloves. Once a patient has been touched wearing gloves, the gloves must be removed before touching other clean items or items that will not be cleaned later. The reason is not specifically to keep the patient from being exposed to other germs, but to stop the patient's germs from being exposed to others.
Currently for data entry to take place during a procedure, the dental student uses a pen wrapped in glad wrap to write on a dental record. At the end of the procedure, the glad wrap is thrown away, and the information on the record is transcribe to the official patient record. The paper is then thrown away. This ensures that pen and paper used during a procedure do not pose a contamination risk.
At the end of each patient visit, all surfaces are cleaned twice with antibacterial liquids [?]. Equipment is then either cleaned on the spot ( for items not placed in the patient's mouth ) or sent to the autoclave for sterilization.
Foci of Attention:
The work observed was very focussed. Several occasions were observed where finding the right instrument or necessary piece of equipment disrupted the work. The proximity of the patient to the dentist is extremely close and is well within the personal space of both the patient and the dentist.
www.itee.uq.edu.au/~pig/dentist/attention1.jpg
There are very long periods of still work. Fine focus and fine motor control are required for a dentist to perform a procedure well. However, at the same time, the patient must also remain very still with their mouth open for extremely long periods - upto 45 minutes. One of the attention breaks noticed was the need for obtaining instruments. The dentist ( both students and the instructor ) would "touch, touch, touch, grab" to find the correct instrument. The instruments look very similar and there are a lot of them. Many procedures have a limited time period due to setting amalgam and the like which causes the dentist to be quick with picking up and putting down tools.
www.itee.uq.edu.au/~pig/dentist/attention2.jpg
Equipment:
The dentist has a large workbench which contains the necessary instruments, tools and consumable items for their procedures.
www.itee.uq.edu.au/~pig/dentist/Margotsketch.jpg
Instruments are sterilised in an autoclave while tools which do not go in a patient's mouth are cleaned at the end of each procedure using alcohol based products. The supervisor has a cup containing a sickle probe and mirror for their personal use during procedures.
It was noted that older tools can slow work down. This is because they may have lost their accuracy or may be stiffer or clumsier to operate.
Another observation was that gloves would be changed many times during a procedure. [how many on average?]
Equipment used to help infection control, such as tweezers to pick up items, seemed clumsy to use and slowed the dentist's work down as well as broke their concentration.
Patient comfort:
Patient records:
Patient/Dentist interaction:
Chair observations
Dentist/Assistant/Supervisor communication:
Possible designs:
www.itee.uq.edu.au/~pig/dentist/ircamera.jpg
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