Ergonomically Yours: A Call to Action for All Dental Professionals

Transcription

1 Ergonomically Yours: A Call to Action for All Dental Professionals 1. Navy Department of Defense Ergonomics Policy It all started with a memo in the Navy's Department of Defense: February 4, Overview. Ergonomics. What are the Consequences of Poor Ergonomics?. Instruments, Equipment, Magnification. Application of Ergonomic Principles to Dental Practice 3. What is Ergonomics? 4. Natural Spinal Curves Cervical and Lumbar are more mobile and can be easily influenced 5. Forward-head posture. Leads to muscular imbalances. Contributes to rounded shoulder position. May lead to rotator cuff impingement 6. Postural awareness Tilt seat angle 15 degrees - hips higher than knees Sit close to patient knees under patient chair Place both feet firmly on floor Your back should contact the lumbar support of chair note: pivot from hips, not waist 7. Posturedontics, LLC Phone: Bethany Valachi, MS, PT 8. Ergonomics is not new! 9. Ergonomic Design Goals Eliminate unnecessary tasks, steps & effort Reduce potential for injury Minimize mental/physical fatigue Increase satisfaction, comfort, morale and fulfillment of the clinician Colleen Rutledge, RDH Page 1

2 10. Consequences of Poor Design. Discomfort ~ Chronic Pain. Accidents ~ Injuries. Fatigue ~ Increased Errors. Work-Related Musculoskeletal Disorders (WMSDs) - Low back pain - Tendonitis - Epicondylitis - Bursitis - Carpal tunnel syndrome 11. Work-related Musculoskeletal Disorders in Dentistry 12. Reasons for Early Retirement Among Dentists. Musculoskeletal Disorders (29.5%). Cardiovascular Disease (21.2%). Neurotic Symptoms (16.5%). Tumors (7.6%). Diseases of the Nervous System (6.1 %) 13. WMSD Symptoms Among Dentists, Assistants & Hygienists 14. What Factors Contribute to WMSDs?. Repetitive motions (e.g., scaling, polishing) 15. Contributing Factors 16. OSHA Ergonomics Standard. Draft ergonomics standard released in Feb 99. Final rule issued in late Repealed by Congress & President in Renewed efforts underway to "re-invent" a version more palatable to new administration & industry 17. OSHA Ergonomics Standard Based on six elements:. Management leadership. Employee participation. Hazard identification. Job hazard analysis Training. Medical management. Program evaluation. Applicable to manufacturing and manual handling operations; workplaces where WMSDs are reported Colleen Rutledge, RDH Page 2

3 18. ANSI Z-365 Control of Cumulative Trauma Disorders. Voluntary standard to address work-related musculoskeletal disorders. Developed by committee of government, labor, business, industry and science representatives (including ADA). Draft approved by the Accredited Standards Committee in May 98. Public comments under review 19. Applying Ergonomics Principles to Dental Environment. Instruments. Work Stations. Work Practices. Equipment 20. Instrument design. Overall shape and size. Handle shape and size Weight Balance Maneuverability. Easy to use Easy to maintain 21. Goals of Instrument Design What to look for in a hand instrument:. Hollow or resin handles. Rounded handles. Friction grip. Use an assortment of different size handles 22. Ergonomic handles 23. Carbon Steel vs Stainless Significantly harder Forms a better edge when sharpened Retains sharpness longer 24. Sharpening Systems 25. CET Honing Channel Sharpening Stone 26. Ergonomic Choices 27. Which probe would you prefer? Color Vue, PerioPal, Florida Probe, Dental Rat Colleen Rutledge, RDH Page 3

4 28. What to look for in a handpiece Lightweight and ergonomic design~ Cordless Rules! 29. Ergonomic benefits of Ultrasonics VS. Hand Scaling 30. Anne Guignon RDH, MPH ~ 31. Syringes and Dispensers Look for:. Adequate lumen size. Easy to clean. Knurled handles (no finger cut-outs). Easy activation and placement 32. Magnification Helps decrease eye strain and low back pain Essential in ergonomics and promotes healthy posture Prolongs the career of the clinician Most companies offer free no obligation trial period 33. Types of magnification. Through the lens OR Flip Ups RANGE: 1.7 X, 2.5 X, 3.5 X and 4.5 X. Hygienist usually prefer 2.5 X 34. Illumination Headset OR Mounted to the frame of the glasses 35. Hygienetown survey: Which loupes are better? 36. Biggest obstacle to using loupes? Benefits of magnification 37. Treatment room layout 38. Integrating technology 39. Patient Chair 40. Potential Strategies:. Position patient so that operator's elbows are elevated no more than 30 degrees.. Adjust patient chair when accessing different quadrants. Alternate between standing and sitting 41. Work Practices 42. Scheduling Strategies. Increase treatment time. Alternate heavy and light calculus patients. Alternate difficult endo, surgery. Vary procedures within the same appointment Colleen Rutledge, RDH Page 4

5 . Shorten patient's recare interval. Delegate a separate day for difficult procedures and big cases. Delegate a separate day to non-surgical periodontal therapy 43. "Stress at the Desk" Monitor screen Keyboards Pens Wrist / Palm support Chair Phone / Headset 44. Monitors. Flat screen takes up less room. Viewing distance is inches. Increase text size on screen whenever possible. Top of monitor at or slightly below eye level (15-20 degrees) 45. Keyboards Use adjustable keyboard tray Elbows close to body with forearms parallel to the floor Wrists should not bend up, down or sideways "Alternative" keyboards available Wrist/palm pads encourage neutral position when in the "resting position. Do not keep wrists on pad while typing Mouse pads with support at wrist offer much needed support for wrist 46. For more information: search word: computer stations 47. Prosthetics Labs 48. ERGONOMICS SUMMARY Good ergonomics DOES improve comfort, health, morale, and productivity of the entire dental team Colleen Rutledge, RDH Page 5