Abstract
AimsA quality improvement project was conducted in a General Dental Practice environment. The aim was to reduce the rate of Acute Alveolar Osteitis, which was locally found to be at 19.4%.MethodsA range of quality improvement tools were utilised to determine and measure potential interventions, and the results from the initial Plan-Do-Study-Act cycle utilising perioperative 0.2% Chlorhexidine as a preventative method are presented.ResultsThe use of perioperative 0.2% Chlorhexidine mouthwash showed an absolute risk reduction of 6.2%.DiscussionGeneralisation from the results is highly dependent on local factors, although the favourable reduction in acute alveolar osteitis and cost savings found supported the project.ConclusionsThis project highlights the strengths of Quality Improvement methodologies in implementing and assessing changes to improve service provision and patient outcomes.
Highlights
The Dental Teaching Unit, Port Talbot Resource Centre (DTU) is located in South Wales, and provides in-hours access (IHA) sessions for NHS Direct, as well as providing routine care and treatment for the local area
Acute Alveolar Osteitis (AAO) is a relatively common postextraction complication, which sees a failure of healing characterised by the loss of the clot from the socket, superficial infection and acute pain and discomfort that is often described as worse than the previous toothache.[1]
The “Model for Improvement” was selected as the most appropriate quality improvement framework for this project.[5]. This facilitated a progressive environment with changes being central to the overall aim. This stands in contrast to clinical audit (CA), where recent evidence has undermined the validity of using CA as the impetus of improvement with one study estimating only 5% of audits led to any change in practice.[6,7]
Summary
The Dental Teaching Unit, Port Talbot Resource Centre (DTU) is located in South Wales, and provides in-hours access (IHA) sessions for NHS Direct, as well as providing routine care and treatment for the local area. Both patient groups present with an overall high dental treatment need and varying levels of dental neglect. Acute Alveolar Osteitis (AAO) is a relatively common postextraction complication, which sees a failure of healing characterised by the loss of the clot from the socket, superficial infection and acute pain and discomfort that is often described as worse than the previous toothache.[1]. As some IHA patients will utilise NHS Direct again, rather than contacting the practice for follow-up care, the rate of AAO is feasibly higher than this observation indicates
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