EXAMPLES OF WATER FLUORIDATION PDSA CYCLES

“P” = PLAN

“What is your family’s drinking water source?”

AIM

• Determine if drinking water has a safe and adequate amount of fluoride.

• MEASUREMENT: DEPENDS ON SOURCE

• Well: DHEC measure level• Municipal:

http://apps.nccd.cdc.gov/MWF/Index.asp• Purchased: Provider supplies level

“D” = DO• 1. Pick target % for posing topic question to family• 2. Select study patient ages and cycle time length • 3. Educate staff • 4. Sign in office staff flags candidate visit• 5. Nurse rooms patient and notes flag• 6 Nurse audits record: no previous discussion• 7. Nurse asks topic question• 8. Nurse determines Fl content (slide 3)• 9. Provider comments on Fl level• 10. Provider makes water/fl recommendation• 11. Family leaves

“S” = STUDY

1. Tabulate # of qualifying routine exams done during study period

2. Tabulate # of exams where steps 6-9 were completed 3. Calculate % completed for each step 4. Discuss with staff and decide

countermeasures to improve % on next cycle

• Decide on new plan to improve oral fluoride use: EXAMPLES TO CONSIDER:• Place picture of tooth on all qualified charts to

remind staff of PDSA cycle • Inquire about water filtration devices• Do out of home bottled water use assessment• Calculate estimated fluoride burden from all

sources (e.g. diet, toothpaste, water, fl treatments)

“A” = ACT

Reminder! Ask the PDSA question