PMHP Flashcards
At population level, name 3 methods of fluoride delivery
Water flouridation
Flouridated salt
School milk
School water fluoridation
Name 6 components of clinical governance
Clinical effectiveness
Risk management
Education and training
Clinical audit
Openness
Research and development
What are the stages of an audit?
Identify problem/issue
Set criteria and standards
Observe practice/data collection
Compare performance with criteria and standards
What two things should be done after an audit cycle?
Implement changes
Repeat the audit
You see two nurses wearing uniform in public, what two concerns does this raise?
Infection control
Practice and profession reputation
You decide to give staff working in your practice a learning session on PPE. Name 6 learning outcomes from this session
* Wear PPE at all times when dealing with procedures
* Wear PPE when cleaning up
* Change PPE between patients
* Correct disposal of PPE after useage and soiling
* During decontamination; protect eyes, hands and clothing with the use of PPE
* Protect patients eyes and clothing
How would you check staff are following instructions regarding the use of PPE?
Clinical audit
Regular inspection by supervisor
What is PICO?
Population
Intervention
Comparison
Outcome
What two things could show that a study was random?
Randomised control trial
Computer generated assignment
Why is cleaning an important prerequisite before disinfection and sterilising?
Removes gross debris
Removes restorative material
Restores function
Aids disinfection
Why is it important to test the washer disinfector and steriliser?
To ensure the machines are clean
To ensure they are working as expected
Medicaolegal requirement
What are the 5 cycles of the washer disinfector and explain
Flush - sprays water at instruments
Wash - uses detergent and power of water
Rinse - removes detergent
Disinfection - uses steam
Dry - Dries instruments
What are the 3 categories of sterilisers?
S, B, N
Why shouldnt instruments be dried with paper towel?
Small pieces can come off and stick. Use non-linting towel
Why should a type B steriliser be used?
B = best
Active air removal
What is clinical governance?
Systematic approach to maintaining and improving the standard of patient care in a health system
What are the dimensions of healthcare/clinical governance?
Patient centred, safe, effective, efficient, equitable, timely
What are three divisions of NHS scotland dental services?
Primary care = General practice and public dental services
Secondary care = hospital services
How many hours of CPD should be completed in each cycle?
100 hours in any 5 year cycle with no fewer than ten hours in any two year cycle
What are the core CPD topic requirements and how many hours are advised?
Medical emergencies 10 hours
Radiology 5 hours
Decontamination 5 hours
List the 9 GDC standards
- Put patients interests first
- Communicate effectively with patients
- Obtain valid consent
- Protect patient information
- Have a clear and easy complaints procedure
- Work with colleagues in patients best interest
- Maintain, develop and work within own skills
- Raise concerns if patients are at risk
- Behave professionally and maintain patient confidence in you and the profession
Name 6 members of the dental team registered with the GDC
Dentist
Dental nurse
Hygienist
Therapist
Technician
Clinical technician
Orthodontic therapist
What chemicals are used to clean a blood spill?
Sodium hypochlorite or sodium dichloroisocyanurate >10,000ppm
How long are chemicals for a blood spill applied?
3-5 minutes
Give waste streams and an example for each
Black - domestic waste
Orange - Low risk ie PPE
Sharps box - sharps
Red hazardous - amalgam
Yellow hazardous - teeth
What document is a GDP required to keep for waste disposal. How long for? What should be on it?
Consignment note
Kept for 3 years
Description, destination, quantity, origin, and transport
What are the four principles of waste disposal?
- Segregation
- Storage
- Disposal
- Document
List the chain of infection
Infectious agent - reservoir - portal of exit - mode of transmission - portal of entry - susceptible host
What is the sinner circle?
Time, temperature, chemical, energy
Name 10 SICPs
- Cough etiquitte
- Hand hygiene
- Equipment management
- Waste disposal
- Fluid management
- Linen management
- Environmental control
- Sharps exposure
- PPE
- Patient placement
What are the 4 pillars of ethics?
- Non maleficence
- Beneficence
- Justice
- Pt autonomy
What is negligence?
The omission to do something which a resonable practitioner would do, or doing something that a reasonable practitioner would not do
How long should patient notes be kept for?
Minimum of 3 years
Ideally 11 years or until the age of 25 for children
What should notes be?
Confidential
Accurate
Legible
Complete
Retrievable
Current
Retained
Who is on the GDC board?
What are the 7 stages of significant event analysis?
- Identify event
- Collect information
- Set meeting to discuss
- Meet and analyse
- Implement changes and monitor
- Write up SEA
- Seek external feedback
What factors make consent valid?
Recent
Specific
Remains appropriate
What type of study provides the highest level of evidence?
Systematic review of randomised control tials. Cochrane review
List 4 aspects of systematic review of RCTs
Randomised
Controlled
Blinded
Inclusion/exclusion criteria
Give 3 study designs
Cohort - prospective
Case control - retrospective
Case study - one patient
What is incidence?
The number of new cases over a specific time
What is prevalence?
Number of cases at a time
What is SIMD
Scottish index of multiple deprevation
A tool for identifying areas of povery and inequality across Scotland
Give 5 factors influencing deprevation
Unemployment
Income
Education
Crime
Access to health care
Environment
Housing
What are some signs and symptoms of Alzheimers?
Memory, comprehension, cognition, emotional instability, communication skills, aggression, confusion
What are some signs and symptoms of Parkinsons?
Resting tremor
Mask like face
Rigidity
Slow movement
Bradykinesia
What complications are there for dental treatment for patients with dementia or Parkinsons?
Consent
Poor OH
Poor denture care
Pain unrecognised
Tremor
Communication
What are the principles of the adults with incapacity act 2000?
- Treatment must benefit patient
- Minimal necessary intervention
- Account for patients past wishes
- Consult with relavent others
- Encourage residual capacity
What is capacity?
Pt can understand the treatment
Pt is informed
Pt can retain the information
Pt can communicate their choice
Who can consent under the AWI 2000?
Welfare power of attorney or welfare guardianship
What are the advantages of a split mouth study design?
Both control and intervention exposed to same environment
What are the disadvantages of a split mouth study design?
Patient cannot be blinded
What is confidence interval?
Representation of study findings to real world population. Worked out using effect size and sample size relative to the true population. 95% likelihood of repeat results
What is the decontamination cycle?
Cleaning - disinfection - (disposal) - packaging - sterilisation - transport - storage - use
Give 4 legislations for decontamination
Consumer protection act
Health and safety at work act 2014
NHS (GDC) Scotland Regulation act
Medical devices directive
Give 5 common reasons for handpiece faults
- Air pressure
- Incorrect bur
- Incorrect use
- Poor cleaning
- Poor lubrication
