6 STEPS TO HELP PATIENT COMPLIANCE AFTER SURGERY

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6 STEPS TO HELP PATIENT COMPLIANCE AFTER SURGERY

“I can’t smoke what are you kidding me? Yeah right, I can’t stop smoking, I’m dying for a cigarette now so I’m going to smoke!” “the moment I leave here, I’m smoking!” 
If I had a dime for every time somebody said that after explaining to them they shouldn’t do it.  For our patients, compliance with following post-op instructions is just as important  as having a skilled Surgeon.  It’s been shown that most patients don’t follow their doctors prescription instructions1 and if they don’t follow those instructions then I would guess that they don’t follow the rest of the instructions. 

My Suggestions that will aid in the best post-op compliance:

  1. As the patient’s Doctor, I feel its incumbent upon me to personally review the post-op instructions and care with my patients prior to and after treatment.  
  2. Review the most important instructions by the clinical staff, the dental assistant reiterates and mimics the aftercare plan carefully, highlighting the personally tailored instructions based on the treatment rendered and on their health status. Offer copies of these instructions on your website. Consider creating Youtube videos to add to your website.
  3. Instructions administered verbally to an adult escort of all patients receiving intravenous sedation or general anesthesia. Include a written copy of the verbal instructions tailored to the procedure they received. Make them brief and either number them or create bulleted sentences.
  4. In addition, while they are being discharged from the reception/Business area post-op instructions including  specific medication instructions are reviewed again. 
  5. Within 24 hours after discharge from the reception staff call them to determine how the patient is doing and again highlighting proper post-op care. Additionally, it is documented in the record on a form with checks to select on a list of symptoms the patient experiences and fill-in the blank areas.
Results of patient noncompliance can and does cause ill-effects and poor results, in some cases it’s deadly2. The World Health Organization (WHO) reported that 125,000 patients with chronic treatable ailments die yearly in the USA due to improper medication administration. Additionally, this problem spills over into these people needing hospital admission.

Creating visual, verbal and tangible cues will hopefully help to reinforce the important post-op behaviors the patient is to perform. Following the “Tell-Show-Do” method with the oral hygiene instructions and showing the patient the surgical site and explaining the maintenance. There are proven techniques that boost memory4 and may help the patient to do the same.


The Girldoc😉
Post-operative grafting and membrane instruction example


(example)

POSTOPERATIVE GRAFTING/MEMBRANE INSTRUCTIONS 

You should refrain from toothbrushing, flossing and use of other interdental devices at the treated area up to 6 weeks after surgery, or for as long as you are advised by the Dr.. 
Mechanical plaque removal on the teeth adjacent to the graft area should be performed with a q-tip soaked in the antibacterial chlorhexidine rinse (Peridex, Periogard). Care should be taken not to disrupt the sutures. 
An antimicrobial rinse will be given to you which must be used since this replaces mechanical plaque removal at the surgical site. Start using this no sooner than 2 days after the surgery. DO NOT SWISH, vigorous rinsing may disrupt the sutures, instead hold the rinse in your mouth for 5 minutes and expectorate. 
Exposure of the graft material may occur. This should not jeopardize the treatment result, please advise us by calling the office if it does become exposed. 
It is important that you finish all prescribed antibiotics, although the material is acceptable for integrating into the body, it may become infected if antibiotics are not taken or completed. 

«PROVIDER» 
REFERENCES
1https://scopeblog.stanford.edu/2012/04/25/report-shows-over-60-percent-of-americans-dont-follow-doctors-orders-in-taking-prescription-meds/
2 https://www.who.int/chp/knowledge/publications/adherence_report/en/
3 https://www.acpm.org/?MedAdherTT_ClinRef
4 https://zapier.com/blog/better-memory/

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