Cunningham Chris
Assistant Clinical Director/Specialist in Special Care Dentistry Lothian Public Dental Service Duncan Street Dental Centre Edinburgh.
Br Dent J. 2014 May;216(9):524-5. doi: 10.1038/sj.bdj.2014.379.
The aim of this study was to devise and test a triage protocol to prioritise patients' dental needs in a prison environment. Secondary aims were to include in the triage process oral health promotion and information about accessing prison dental services. Also to work collaboratively with the prison staff to improve referrals to the dental services.
The triage system was devised to have three strands: (1) an oral health assessment conducted by the dental nurse during the induction process for each new prisoner; (2) a simple oral health examination conducted in monthly screening clinics; (3) the prioritisation of referrals from prison landing staff using the prisons computer system PRISM. The triage was evaluated by assessing the first 100 patients' records with regard to the prioritisation of the triage category at the time of the clinical dental examination.
Of the 100 patients triaged 95% were prioritised into the correct triage category. Seventy-two percent of patients were seen in the appropriate timeframe. Referral patterns from prison landing staff were improved along with interdisciplinary working in the prison. All new prisoners were seen within 72 hours of committal and received oral health advice and information on accessing dental services.
This is the first triage system to be introduced into Hydebank Wood Prison, facilitating a targeted approach to dental care. It has improved access to the prison dental services; introduced oral health advice and information into the regular prison healthcare structure; and improved the efficiency of the clinical dental sessions. It is hoped to strategically address problems with waiting times and inequity in service utilisation.
本研究的目的是设计并测试一种分诊方案,以便在监狱环境中对患者的牙科需求进行优先级排序。次要目的包括在分诊过程中纳入口腔健康促进以及关于获取监狱牙科服务的信息。还要与监狱工作人员合作,以改善牙科服务的转诊情况。
分诊系统设计为三个环节:(1)牙科护士在每位新囚犯入狱过程中进行口腔健康评估;(2)在每月的筛查诊所进行简单的口腔健康检查;(3)利用监狱计算机系统PRISM对监狱楼层工作人员的转诊进行优先级排序。通过评估首批100名患者在临床牙科检查时分诊类别的优先级来对分诊进行评估。
在分诊的100名患者中,95%被正确分入相应的分诊类别。72%的患者在适当的时间范围内得到诊治。监狱楼层工作人员的转诊模式得到改善,监狱内的跨学科合作也有所加强。所有新囚犯在入狱72小时内都接受了诊治,并获得了口腔健康建议和获取牙科服务的信息。
这是首次引入海德班克伍德监狱的分诊系统,有助于采取有针对性的牙科护理方法。它改善了监狱牙科服务的可及性;将口腔健康建议和信息纳入了常规监狱医疗保健结构;并提高了临床牙科诊疗的效率。有望从战略上解决等待时间和服务利用不平等的问题。