Introductions and definitions Flashcards
Define consent
Permission of agreement for an action to be carried out
What are the types of consent
Voluntary
Verbal
Informed
Written
Describe voluntary consent
Patient decides without a consultation and can refuse or withdraw at any time e.g. opening mouth for examination
Describe verbal consent
Pt verbally states they are happy with a procedure, there may be a discussion of risks and benefits and a continuous discussion
Describe informed consent
Discussion regarding the risks, benefits and alternatives to treatment and there is a continuous discussion aided by information over a period of time
When is verbal consent used
General examinations e.g. BPE
Minor procedures
When is written consent required
Larger and more invasive procedures e.g. extractions
IVS/IHS/GA
Peads
Photographic records
Define competence
Competency refers to the mental ability and cognitive capabilities required to PERFORM actions needed to put decisions into effect
How does competency relate to dentistry
A patient should fully understand the information given regarding their treatment in order to allow them to make a rational decision
Who is deemed competent and of capacity?
All adults are deemed competent and having capacity unless otherwise proven
What is competency a judgement of
Legal judgement
Define capacity
Individual has the ability to use and understand information to make a decision and communicate any decision made
What is a capacity a judgement of?
Medical judgement
Relevance of capacity in dentistry
The patient should understand their management, comprehend the risks and benefits, retain information and make a decision based on information provided
What Legislation is important regarding capacity?
Mental Capacity Act
Define confidentiality
Medical confidentiality is a law whereby the practitioner cannot disclose patient information without their consent
What legislation is important for confidentality
Data Protection Act 1998 - patients have a right to keep information about themselves confidential
Why is confidentiality important
It ensures trust and allows the patient to feel safe during their interaction
What instances can confidentiality be breached
- Disclosing information to other healthcare professionals involved in the patient’s care
- As required by law e.g. court order
- In the sake of public interest, protecting the patient or others who are at harm by not doing so e.g. vulnerable adults or child neglect
When confidentiality is breached when discussing cases between healthcare professionals, what rules should be followed?
Information should be limited to only necessary information
Patients should be fully aware each time information is passed on to another person
What is a complaint?
An expression of dissatisfaction by a patient or a patient’s representative about a dental service or treatment (or experience in the dental practice), whether justified or not
What is the main reason complaints arise?
Patients expectations are not met or accounted for
Poor communication
What is the importance of effective complaints handling
Improves rapport
Prevents escalation
Prevents future complaints
Reflective learning
What are the guidelines for complaint procedures?
- Visible, clearly written and no jargon
- Allow complaints to be addressed in due time and allows a fair investigation
- Confidential
- Has clear outcomes
- Leads to improved service
List the steps in complaints handling
- Acknowledge the complaint by writing, email or telephone (within 24 hours)
- Inform dental defense union if required
- RESPOND to the complaint within 10 days (if not make pt aware of different timesscale)
- Hold staff meeting for peer review, audit and feedback on the complaint
How to respond to complaints
REACH Recognise Empathise Apologise Compensate Honesty
Where can the pt be directed to if they are not happy with the outcome of a complaint
- NHS complaints procedure services (CPS)
- Patient Advice Liaison Service (PALS) in hospital
- Dental Complaints Service (DCS) if private
What is an Ombudsman
Representative who investigates complaints
What are the GDC guidelines for ‘scope of practice’
- Work effectively
- Have appropriate support
- Delegate and refer patients
- Communicate clearly
- Manage and lead the team using everyone’s skill set
What is continuing professional development CPD
Mandatory responsibility for dental professionals to keep their skills and knowledge up to date throughout their careers
How many hours of CPD do dentists need
100 verifiable hours within 5 years
Minimum 10 hours verifiable every 2 years
What CPD are mandatory
Medical emergency (10 hours) Infection control (5 hours) Radiography and protection (5 hours)
What are other CPD examples
Law and ethics Dental materials Photography Business Complaint handling
What do you document for CPD log?
A plan (personal development plan)
Hours completed
Evidence for completion
What is a clinical audit
Measuring a clinical outcome or process against the standards set on the principles of evidence based practice
What are the aims of clinical audits
Highlight clinical areas requiring improvement
Implement change to improve patient care and outcomes
What is required in a clinical audit?
- Aims and objectives
- Summary and methodology
- Timetable
- Detailed educational source materials
What is a peer review
Groups of dentists and dental care professionals review and evaluate aspects of practice
What are the aims of peer review
Increased quality of care and safety
Identify areas for change
Share experiences
What categories of dentistry may be subject to peer review
Clinical care
Administrative care
What are the essentials for peer reviews
- identify topics and research them before the meets
- Topic must be relevant to improving patient care
- The peer review must demonstrate how changes can be achieved
What is the reason for raising concerns
Provides the opportunity to open a discussion with the aim of acting in the patient’s best interests - it is not a complaint of malpractice
When may a concern be raised in dentistry -
- Health, behaviour or professional performance of a colleague does not put pt interests first
- Any aspects of the environment where tx is provided does not put pt interests first
- Someone asks you do so something against your duty to putting pt interests first
Who do you raise concerns with?
Initially in house with senior colleagues, lead person for raising concerns or employer
For advice - defense organisations and professional associations
More severe cases or no improvement - CQC or GDC
What is the process of raising concerns
- Keep a log on series of events e.g. emails, time, dates
- Familiarise yourself with the practice policy on raising concerns
- Approach raising concerns lead, practice manager or employer
- Try to solve in practice/hospital or escalate
- Contact defence union at any time for informal advice
When should concerns be raised with the GDC?
- It is not practical to deal with on a local level
- The local solution has not solved the issue
- Serious problem has occurred e.g. violence or illegal practice
Who is relevant in terms of safeguarding
Children and vulnerable adults
Define a vulnerable adult
Person above 18 who is or may be in need or community care services by reason of a mental or other disability, age or illness; and is unable to care for themselves or protect themselves from harm of exploitation
Who should be contacted in terms of safeguarding
- Safeguarding lead
- Senior colleague
- Social services or the police
- Defence organisations after the immediate situation has been dealt with
What are the types of abuse
- Sexual
- Emotional
- Physical
- Verbal
- Neglect
- Financial
How may neglect or abuse be identified by a dentist
- Frequent caries
- Plaque stagnation
- Frequent trauma that has late presentation or story does not correlate to injuries
- Unclean clothing
- Poor attender
- Bruising, bite marks, ,eye injuries, burns
Define decontamination
Process where reusable items are rendered safe for further handling and use, and involves multiple steps including cleaning, disinfection, inspection and sterilisation
Define disinfection
Process by which the number of viable harmful micro-organisms are reduced in an area by the use of chemicals (disinfectants) or heats
What aspects of the dental surgery are subject to disinfection?
Areas that cannot be sterilised e.g. the dental chair, floors, lights
Define sterilisation
Process by which an object is rendered free from ALL viable harmful microorganisms, including viruses, bacteria and spores.
What objects in the dental surgery require sterilisation?
Reusable items that are used intraorally on patients
