 Hello everybody, welcome back. So it's practice profile review time. And it is January 24 today. If you have been audited, and you're either taking the quality assurance exam or submitting your portfolio, do not forget to fill out your practice profile. I have this done already, but a lot of people do wait until the last minute so I do offer full practice profile review so what I do is I look through your entire practice profile. I make suggestions on changes you might need to make to successfully pass your audit because if the CDHO does not like your practice profile or if you answer certain things incorrectly they will audit you meaning like audit you again so they will call you. They might do an onsite visit so let me tell you common errors that I've been noticing I've been reviewing profiles from practice profiles for the past couple months now. And this is the common error a couple actually that I've been noticing so if this is you, if you have had this in your practice profile I do suggest changing them. Let me first say I do not suggest being dishonest, obviously so if you're not doing something I'm not telling you to switch it to always, but I'm telling you you need to change it in your practice ASAP. So you can start doing it and you would pass your audit so the first thing you guys is taking vital signs. A lot of dental hygienists are saying they always take vital signs but do you always take vital signs. The CDHO is going to know you're being dishonest if you say always unless you truly do so if you say always, you might get that phone call and they might say to you okay can you explain your vital signs protocols when do you take them why do you take them so that question might surprise you if you don't always take them you might kind of go oh um um when should I be taking them you know so they might wonder why. So the thing is the CDHO wants us to take vital signs on every adult patient meaning blood pressure as well. They want the pulse they want the blood pressure every new patient because we don't know they're healthy until we take the blood pressure. They might tell you they're healthy or if they tell you they haven't seen a doctor in five years well how do they know they're healthy so they want us to take vital signs on every new patient. And at following appointments if their health history warrants it so if they have high blood pressure. They want us to take the blood pressure at every appointment. If they aren't feeling well they want us to take blood pressure if their blood pressure is high at the new patient exam, then we need to refer them to a medical doctor to get it looked at, plus have a note somewhere saying take blood pressure at every appointment because they might be high because they're nervous. If it's really high then there's certain protocols we need to take but that's for another video another story for another day. So really watch the vital signs questions. Okay. If you say always they're really going to ask you do you really take it always as indicated by client condition is more correct. Because it really is truly indicated but it can hurt to take vital signs always by the way you guys that can hurt, but do you really take them the CD HO will know you're lying, and they will ask you about it. Another thing, a lot of dental hygienists asked me, ask me about PSR, and I just realized I should probably zoom in my apologies you guys. A lot of dental hygienists asked me about PSR. I never take PSR. So I would say never or not applicable, but I always do probing so will not always so better answer would be as an indicated by client condition, I do a full mouth probing every year. I never do PSR because I feel like it's a waste of time because you're technically probing everywhere anyway. So a lot of dental hygienists asked me, oh what should I put for that will be honest if you never take it say never. But if you say you never probe, then you're going to get a phone call because you need to be always probing or not always probing but you know by client condition. What I typically see is for oral cancer screening, you do not need to have all of these things for oral cancer screening if you have them all wonderful. The main things are visual and palpation. You should always be doing this on every single client. At the very least you should always be looking inside their mouth for any lumps or bumps or anything that's of a concern. For kids, adults, it doesn't matter. So for example, if you said visual is rarely or never they're going to phone you and say as a dental hygienist you need to be doing this. This is part of our scope of practice. This is our job. If you say, you know, same thing for palpation. I found a lot of dental hygienists will always do visual but they'll never do palpation. It's not that that's wrong but it kind of is because you're missing a lot of areas if you're not touching to check for those lymph nodes. You're not checking inside the mouth with your finger. You need to be checking these things. Not that, you know, you're going to lose your license or something if you're not doing it but they're going to phone you. They're going to give you that phone call. And A, they're going to say to you, you know, why did you feel you shouldn't be doing this? This is within our scope of practice. This is what we should be doing. Have you not been reading our Milestones magazine that talks about how we should be doing this? Have you not been taking courses? Have you not been updating yourself on, you know, procedures that a dental hygienist should be doing? If not, this is, they will suggest courses for you to take because if you're not doing this, they're going to wonder why. Okay, so I see that commonly. The rest of these here I find are pretty straightforward. Number two, how do you usually receive your prescriptions from a dentist for radiographs? If you're working in a dental office, they want it verbal and written at least. If it's only verbal, they're going to call you. They're going to say, well, how can you prove that the dentist did prescribe the radiographs? Because as a dental hygienist, we can't just say, oh, I want to take x-rays on this person. I'm going to do it. We all do it because the dentist trusts our judgment, but we're not allowed to do it depending on where you work, of course. So no, I guess it doesn't really depend because we really shouldn't be doing it. I'm thinking about the states, but this is different. So anyways, so verbal and written is preferred. If you just say verbal, they might call you to ask why they will suggest writing something in the chart. The dentist doesn't have to have to write it. You can write it and say the dentist prescribed two bite wings today because so that's fine. These ones are pretty good. Everybody seems really good with these. The dental hygiene diagnosis and care plan. They want us to say always for these, but it's not really needed per se. If it's as indicated by client condition, that's good. If these are never, they're probably going to call you and ask you why because that's part of our dental hygiene diagnosis and care plan. Everybody's been good with the self explanatory. It's, it's, you know, always or as indicated or never like that's fine. I'm noticing a lot of dental hygienists are not. They don't know what a client specific order is so they say they don't know it should be a yes. So a client specific order is something you should be signing where you work every year where it basically says you're How do I put it into layman's terms you're allowed to scale and root plane you're allowed to clean the teeth on clients, but this is something that should be signed every year. If you guys have questions about this let me know I can send you the link for that. Even if you go to the CDHO website do a search for CDHO and you'll see exactly what I mean. So this should be done as an independent dental hygienist you do not have a client specific order because you're an independent dental hygienist working for yourself. Okay, you're self initiated, but a common misconception is if you are authorized to self initiate which is good, you still need to sign a client specific order it's not mandatory but it's suggested so just say yes. Just sign it as every other dental hygienist signs it in your practice. Next one on everybody's been good with this but how often do you sharpen instruments it should be as required. We sharpen them when they're dull. That's it we don't do it once a day once a week once a month it's when they're dull because we need to upkeep our instruments. So number 13, you should always be educating and these following things but if you're not that's not a bad thing they might talk to you about it, but just kind of things to point out. Let's see you guys these have been good in the, in the reviews that I'm doing like this seems to be fine infection control you should be doing all of this for infection control so that should be always 24 be be honest what do you do I've never seen these reviews with this, the CDHO likes us to barrier everything that can be buried but even I don't barrier everything because personally I feel it's a waste waste to the environment a waste more money that I have to spend that's not needed but of course if I feel there's something where I need to barrier like I can't disinfect it properly, then I barrier it. It's that simple. Number 25 people have been really good with their short answers, but 25 you guys you need to list everything. Meaning how do you purge the lines how often how do you purge them. Yeah, they you need to put down how long, how you purge them it's that simple. You need to put down that you use in an enzyme cleaner what kind put the name down, put the instructions on how you use the enzyme cleaner. If you shock the lines which we all should be doing shock the lines you need to say what you're using how often you do it. What a lot of dental hygienists aren't doing is saying that they're doing the water testing depends on where you live. But you should be testing the water to make sure you're you're purging the enzyme cleaner and the shock is working kind of like sterilization we can all sterilize instruments. But if we don't have indicators in the sterilizer if we don't have sport tests we don't know if it's working or not. This is the same thing you don't want dirty water in your patient's mouth right you wouldn't want it so you need to test depending on what you're using to test it could be once a week it could be once every two months but you need to test them. Okay. 26 everybody's been good with this to just don't forget to mention that you take apart your handpiece for sterilizing. I have a new pro handpiece which you don't take apart but you take off the shield so I would mention that. If you have a motor you need to be sterilizing the motor it is now mandatory. Your boss is going to have to buy a ton of motors but this is what needs to be done. Okay, a lot of dental hygienists are forgetting this. You need to dry with a lint free cloth you can get them from the dollar store you don't have to get them from a dental supply company they're going to charge you 20 bucks for a cloth literally go to the dollar store buy a pack of four for a dollar. So yeah, it works. I mentioned a lint free cloth that I say they want you to lubricate handpieces mentioned all of that. 27 everybody's been really good with this I feel like they have been copy and pasting from the CDHO of what to do. That's fine copy and paste that do a search for CDHO recall of improperly process instruments you will find the full thing there copy and paste that's been fine. The CDHO has been accepting that. Okay this they no longer want us to use cold soak I hope you guys say never use because if you do use it still they will be calling you to say change that ASAP. We always need indicators you guys so you should know depending on what sterilizer you have it would depend on if it's daily or every load. If you need help with this I can help you with this this is part of my practice profile review so I make sure that what you have is good for what you need. Okay, I know it's very confusing to you but it's easy to me because that's what I do so let me help you so it's less stressful. I'm listing all the sterilization monitoring tests so basically all of this you need to explain it in here so say how long you quarantine the instruments if you're using a class five indicator in every pouch or every cassette or whatever they don't have to be quarantined. But if you're not they have to be quarantined depending on what type of sport test and incubator you have summer 12 hours summer 24 hours apparently now summer only a couple hours I have a 24 hour one. So my instruments need to be quarantined every 24 hours. So you will need to know that so make sure write down everything you guys you have 2000 letters you can do this. And that's all I have for keeping it should be always for everything but be honest of course yes always for these ones. How long the client records are retained everybody's good with that it's you know 10 years or 10 years past the age of what they would turn 18. So this is where if you work for two offices you would fill out your practice profile for your main office where you work and then list key differences and number 35. The CD the CD HO does look at this but they're not really concerned about it they want you to know for your main office that you know what you're doing. But of course that you're aware for the other offices to that you also need to know what you're doing does that make sense. So a lot of people ask me what to do for number 35 this is just any additional info you feel like you couldn't add into those checkmarks, especially if you work for more than one office. This is pretty good self explanatory, you do need to know the location of your oxygen supply, you need to know how to use it you need to hold a current CPR. And you guys I apologize. What I just said about this one, which is fine too, but it's not 35 that you would put in your offices like your differences, it would actually be down here but if you did it in 35 they're not going to mark you wrong for it. You know, because that's a short answer to right so it's totally fine. But if you're an independent mobile hygienist, because a lot of people have been asking me, I don't know if you need oxygen on site. If you're a mobile hygienist, I don't necessarily want oxygen in my car. Hello, explosion. No, thank you. But I did ask the CDHO if I do need one and they still haven't gone back to me this was literally in September. So my guess is I don't need one but I will follow up with you guys on that because I don't feel comfortable having oxygen in my car, but hey if you need one you need one but like I said, so you guys I hope that helps your practice profile just kind of the common errors that I do see or questions. If you need help I'll leave the link for you guys on. If you want me to review your practice profile to make sure you do have everything by no means is it a guarantee of a successful audit, but sometimes we all just want somebody to review and who knows what they're doing. I've been through the audit process I've been through all of them including the onsite audit where they actually came to my office to go through everything so I can help you with that too if you need it. I've had the CDHO phone call I've gone through all of that so I speak from experience and I've passed all of them, you know so. And this is why I like to help people because I know it's so stressful so I'll leave the link for you guys on the bottom. I hope you like the video please take time to click like if you don't mind and subscribe because I do upload a lot of videos per week. I'm all about dental so I love to help you guys. So thank you for watching and if you are going to submit your practice profile review to me do it soon it's January 24. And you have until the 31st I'm spending the whole week just reviewing practice profiles pretty much, but send it to me soon you guys okay. Thank you. Have a good day.