Health Care Skills Rating
  Dental Hygienis Skills Checklist
   NAME  
   Email-Id
   DATE    
I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Instructions:

This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

 
Proficiency Scale: 1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

  
Rating Stars (Click)
Assessment/Patient Care- General 1
2
3
4
Patient Privacy,Practice Act/HIPPA
OSHA
Review of Comprehensive Medical and Dental History
Identify Contraindications to and/or Modifications to Treatment Modalities
Identify Medical Risk Patients
Identify Patients Demonstrating Dental Anxiety
Prevention of Medical Emergencies in the Dental Office
Obtain/ Assess Vital Signs (BP, Pulse, Respiratory, and Temp)
Identify/Report Neglect or Abuse
Infection Control Protocol/Bloodborne Pathogens/MSDS
Identify Basic Dental Anatomy and Root Morphology
Basic Knowledge of Head and Neck Anatomy
Identify and Assess Oral Head and Neck Pathology
Identify Oral Manifestations of Systemic Diseases
Identify and Record Evidence of Oral/Head/Neck Pathology
Identify Restorative Dental Materials Identify and Classify Types Occlusion
Documentation Identify and Record Signs and Symptoms of Periodontal Disease
Identify and Classify Stages of Periodontal Disease
Perform Conventional Dental Radiography (Intra- Oral/Extra- Oral/Panoramic)
Perform Dental Photography (Intra- Oral/Extra-Oral)
Identify Radiographic Evidence of Disease Process (Caries, Periodontal Disease, and Pathology)
Medical Emergency in Dental Office/CPR/AED
Patient/Caregiver Education on Oral Disease Process
Patient/Caregiver Education on Dental and Dental Hygiene Procedures
Patient/Caregiver Education on Dental Products
Patient/Caregiver Education on Home Plaque Removal
Rating Stars (Click)
Assessment/Patient Care- Devices and Equipment 1
2
3
4
Classification of Dental Carious Lesions
Development of Dental Hygiene Process of Care(Including Assessment, Treatment Planning, and Appointment Sequencing)
Rating Stars (Click)
Assessment/Patient Care- Computerized Documentation 1
2
3
4
Intra-Oral//Extra-Oral Photography
Digital Radiology (Intra- Oral/Extra- Oral/Panoramic)
Hard Tissue Charting
Periodontal Charting
Clinical Narrative Charting
Scheduling of Appointments
Computerized Documentation (cont.)
Use of CDA Coding of Dental Procedures for
Third Party Coverage Generation of Correspondence to Patients, Third Parties and Other Professionals
Patient Experience
Special Needs Patient (MHMR/PhysicalDisability)
Fearful Patient (anxiety/phobia)
Hospital/Nursing Home Patient
Bedridden Patient
Patient Undergoing Chemotherapy/Radiation Therapy
Pregnant Patient
The Aging Patient
Immuno-compromised Patient
Organ Transplant Patient
Implant Patient
Methamphetamine Patient (Meth Mouth)
Conscious Oral Sedation Patient
IV Sedation Patient
General Sedation Patient
Pulmonary Distress
Respiratory Arrest
Rating Stars (Click)
Assessment/Patient Care- Patient Experience 1
2
3
4
Hyperventilation
Asthma
Apnea
Diabetes
Insulin Shock
Diabetic Coma
Hyperglycemia
Hypoglycemia
Ketoacidosis
Seizure
Epilepsy
Hypothyroidism
Hyperthyroidism
Joint Replacement
Transient Ischemic Attack(TIA)
Stroke
Congenital Heart Defect/Heart Murmur
Heart Valve Replacement
Congestive Heart Failure
General Tachycardia
Arrythmias
Hypertension
Angina Pectoris
Myocardial Infarction
Anaphylaxis
Syncope
Vertigo
Rating Stars (Click)
Age Group Experience- Age Groups 1
2
3
4
Birth to 30 Days
30 days to 1 Year
1 - 3 Years
3 - 5 Years
5 - 12 Years
12 - 18 Years
18 - 39 Years
40 - 65 Years
above 65 Years
Rating Stars (Click)
Medications/Therapeutic Interventions- General 1
2
3
4
Identify the Need for Medical Consultation Prior to Dental Treatment
Identify the Need for Prophylactic Premedication Prior to Dental Treatment
Identify Drug Categories
Identify Common Oral Manifestations of all Drug Categories
Categories/ Signs of Adverse Drug Reactions
Clinical Manifestations of Adverse Reactions
Basic Classes of Local Anesthetic Agents
Adverse Effects of Local Anesthetics
Identify Generic Name of Local Anesthetics
Identify Drugs Listed on Medical History that are Commonly Used to treat: Cardiovascular Disease, Seizures, Diabetes, Asthma, Psychosis, Organ transplants, Thyroid Conditions, Immunocompromised Patients and Pulmonary Disease.
Identify Medications that can Cause Xerostomia
Identify Medications that can Cause Gingival Hyperplasia
Writing Prescriptions Not Applicable Explain Directions for a Written Prescription
Recognize Need and Protocol for Placement of Local Chemotherapeutic Agents in Periodontal Pockets
Identify Need for Appropriate Antibiotics to Treat Dental Related Infection
Identify Need for PrescriptionStrength/Dosage/Fluoride/Remineralization Agent Regimen
Identify Need for Home Fluoride/Remineralization Agent Regimen
Distinguish Type of Fluoride/Product Indicated According to the Patient's Needs
Recognize adverse reactions to Nitrous Oxide Conscious Sedation Not Applicable
Rating Stars (Click)
Procedures/Equipment- General 1
2
3
4
Ergonomics
Manual BPCuff and Sphygmomanometer/Electronic BP Device/PulseOximeter
Operate Pulse Oximeter
Perform Extraoral/ Intraoral Cancer Screening
Hard Tissue Charting
Periodontal Assessment and Recording