PMHP

Question 1

Domestic abuse station, how would i go about speaking to the patient and enquiring?

Answer 1

AVDR

ASK
- ask about abuse and when it occurs
- ‘is everything ok at home?’
- do you feel safe?
- bruises on neck / soft areas etc

VALIDATE
- take blame away from victim
- show sympathy and that they dont deserve to be hurt
- say you are concerned for their safety

DOCUMENT
- specific and detailed
- use the patients own words
- name, location and witnesses
- describe injuries / photograph if needed

REFER
- only on patients wishes, its their problem to solve
- use domestic abuse pamphlet

Question 2

How might one handle a complaint made to me on behalf of a colleague?

Answer 2

Take the concerns seriously and answer questions as able

Acknowledge the patients anger / emotion
- do not accept blame

Try to offer practical help
- offer to take over treatment
- offer investigation with colleague
- offer the patient to go through the formal complaints procedure at reception
- recement crown / do procedure again for them

Question 3

If i receive a complaint letter, how might I handle it?

Answer 3

Acknowledge complaint and provide patient with practice complaint procedure
- inform dental organisation that i require advice
- inform pt of timescales and stages involved
- acknowledge the patient in writing as soon as you receive it
- deal with all points raised in the complaint
- offer practical solution where applicable

Step 1 - frontline resolution
- offer on the spot apology, explanation etc
- record and note what has gone on

Step 2 - investigation
- frontline resolution not possible / not what complainer wants
- more complex or high risk
- 20 days to give definitive response following investigation of points

Step 3 - independent external review with Scottish ombudsman

Question 4

How might one break bad news of SCC?

(SPIKES)

Answer 4

SETTING
- sit at same level as pt
- make sure they’re comfortable

PERCEPTIONS
- ensure pty is aware of what you are about to discuss
- ‘do you know purpose of your biopsy’ etc.

INFORMATION
- inform patient that i have results of biopsy
- ask if they’d like me to go through them

KNOWLEDGE
- warning shot first - I’m sorry it’s bad news
- give knowledge of the test - abnormalities in the cells of biopsy meaning you have oral cancer
- big pause here or patient may wish to know more information

EMPATHY
- deeply sorry to break this to you, it’s never easy
- any questions that come to mind?

SUMMARY
- repeat news
- summarise plan going forward
- make anything positive if possible - early diagnosis / at least we caught it now etc.

Question 5

Give smoking cessation advice

Answer 5

ASK
- how long
- how many a day
- triggers / why smoke?

ADVISE
- smoking is large oral cancer risk
- large risk factor for gum disease
- general health harm - cardiovascular etc

ASSESS MOTIVATION
- would you be willing to try and quit
- would you like a referral
- do you have any motivations that would help?

ASSIST
- local stop smoking services improves quitting likelihood by 4 times
- best evidenced based treatment is nicotine replacement therapy

REFER
- quit your way
- local GP
- cantstopsmoking

Question 6

Nurse sharps injury - BBV risk assessment request - how go about it?

Answer 6

Explain nature of injury sustained by nurse to patient
- risks are to nurse / injured not the patient

Explain risks of BBV transmission
- HIV 1:300

Explain standard procedure
- requirement of blood sample from the patient and this is universal for all patients not just yourself
- make it clear no pressure on pt to agree

Undertake MH review
- infectious diseases diagnosis
- IV drug user
- unprotected sex regularly / sex with another man
- sex with someone outside of uk
- blood transfusion in a country not on list
- dental treatment from country not listed above
- from a country not listed above
- tatto/piercing not regulated artist / in a country not listed above etc

Yes to any = high risk