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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-47Strategies Towards Reducing the Percentage of Adult Patients Experiencing DentalAnxiety during Dental Extractions at Klinik Pergigian (KP) BahauSagaya Alysha D1, Sarah Athirah R1, Thivya M4, Ammar H1, Marlene M1, Husna Najihah N2, Arif HaziqZ3, Zamrina MN11Klinik Pergigian Bahau, Negeri Sembilan2Klinik Pergigian Bandar Seri Jempol, Negeri Sembilan3Klinik Pergigian Palong 4,5,6, Negeri Sembilan4Klinik Pergigian Palong 7,8, Negeri SembilanSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Dental extraction, a routine procedure, is often linked to anxiety. A verification study (8/2023) found that54.4% of patients experienced dental anxiety during extraction. Severe anxiety leads to neglect of dentalcare, impacting quality of life.KEY MEASURES FOR IMPROVEMENT:Improvement was measured through Percentage of Adult Patients Experiencing Dental Anxiety duringDental Extractions using the Modified Dental Anxiety Scale - Dental Extraction Procedure(MDAS-DEP), with a standard of <20% set by the Klinik Pergigian Bahau (KP Bahau) Plan of Action2023.PROCESS OF GATHERING INFORMATION:A quality improvement study conducted in KP Bahau over four monthly cycles. The MDAS-DEP scale,dental records, and questionnaires were used for data collection. The study involved medically andmentally fit adult patients needing extractions under local anaesthesia (LA).ANALYSIS AND INTERPRETATION:54.4% of adult patients experienced dental anxiety during extraction procedures during pre-remedialstudy. Contributing factors were fear of needles (33.7%), afraid of sharp instruments (26.9%), absence ofdistraction (14.2%), unpleasant environment (13.4%), language barrier (11.8%), poor LA administrationtechnique (63.6%), and unclear standard operating procedure (SOP) (54.4%).STRATEGIES FOR CHANGE:Patient-oriented remedial measures included black-out goggles, stress balls, calming music, air fresheners,discrete instrument arrangement, iced cotton swabs (ice sticks in cycle 3), and a multilingualpost-extraction care leaflet. An updated SOP, continuous dental education on the SOP, and an auditchecklist for extractions were also established.EFFECT OF CHANGE:In Cycle 1, dental anxiety during extraction decreased to 30.8%, then to 15.8% (Cycle 2), but rose to21.2% (Cycle 3). After remedial measures, it fell to 16.7% (Cycle 4). Using ice sticks (RM 20/100)instead of topical anaesthesia (RM 45/bottle) saved up to RM 196/month. Cycle 5 is now beingimplemented across all KPs in Jempol.THE NEXT STEP:This study aims to expand to state and national levels to achieve the gold standard of care.152 | Page