Self-assessment is an essential component of learning and developing decision-making and critical thinking skills for dental assisting. Dental assistants must think critically and develop problem-solving strategies during their formal education to ensure quality ongoing development of knowledge and skill related to dental science, assisting and patient care.
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Clinical Reflection Guidelines
1st State The Lesson/Tip
2nd Explain the Experience
3rd Give the Lesson
Example Clinical Reflection:
Tip: Always review the Pt’s medical history and ask the DRANC questions that has been pounded in our heads since the beginning of the Fall semester!
Experience: The new patient was seated. The patient was being seen for dental pain. I reviewed the medical history confirming the information that was provided by the patient.
The dentist arrived to meet the patient and noted that the patient was taking an anticoagulant called Eliquis. The dentist further probed why he was taking Eliquis. The patient proceeded to tell the dentist that he had prosthetic heart valve placed 5 months ago! The dentist informed the patient if dental treatment was necessary today, he will need to take an antibiotic to prevent infective endocarditis.
If I had asked the patient why he was taking Eliquis – along with all his other medications (I didn’t want to appear like I didn’t know – when I surely did not!), this would have informed me that the patient had some kind of heart problem. The next step, I would have confirmed that the patient had a heart valve replaced. This information would have been relayed to the dentist.
Lesson: When reviewing health histories, I will be sure to confirm the medications patients are taking then ask why! Often patients don’t list the condition which is why we need to ask why they are taking medications.
According the American Heart Association (2017), there are five cardiac recommendations for prophylactic antibiotics, which cardiac valve replacement is one of the five. These conditions call for an antibiotic prior to any dental treatment that may cause bleeding to prevent infective endocarditis which is an infection of the tissue that lines the inside of the heart known as endocardium.
If I had taken a few moments to ask more questions about the patient’s medications, I could have better prepped the dentist. I learned from the dentist, we could have started the patient on antibiotics right away so we didn’t have to delay in the patients care.
American Heart Association. Antibiotic Prophylaxis 2017 Update. Retrieved from https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/06/aae_antibiotic-prophylaxis-2017update.pdf