Revision Session Flashcards
What is the NHS constitution
Establishes the principles and values of NHS England
- Comprehensive service available to all
- Access is based on clinical needs
- Aspires to highest standards
- Patient is at heart
- Works across boundaries
- Value for money
- Accountable to public, communities and patients
NHS core values
Working toget her for p[atients
Respect and dignity
Commitment to quality and care
Compassion
Improving lives
Everyone counts
What is the duty of candour
Covers all providers registered with CQC
Statutory duty of candour applies to organisations rather than individuals
BUT
You have professional duty to be honest and open with patients
Notifiable patient safety incidents -
Incidents where something unexpected has happened in the care of a patient and appears to have resulted in:
Death
Impairment
- of sensory / motor / intellectual function
- has lasted for 28 days continuously
Changes to the structure of the body
Prolonged pain / psychological harm (28 days +)
Shortening of their life expectancy
The patient requires treatment by a healthcare professional in order to prevent death, or the adverse outcomes listed
Complaints handling
GDC principle 5
Their concerns or complaints to be acknowledged listened to and dealt with promptly
Make it easy for a pt to complain
- visible
- accessible
- simple language
- easy to follow steps
- provides information on organisations / where to raise concerns
NICE guidelines
Oral cancer referrals
Laryngeal
- hoarseness / throat pain
Oral
- oral ulceration / abnormal bleeding
- regional lymphadenopathy
Thyroid
- nodule within gland or as a diffuse thyroid swelling
- regional lymphadenopathy
Urgent referral for
- lip / oral cavity lump
- oral cavity red / white patch
Suspected cancer pathway
- neck lump
- hoarseness
- ulceration oral cavity
- thyroid lump
RIDDOR
Reporting of Injuries, diseases, and dangerous occurrences
- typically completed by practice manager
- if someone dies / has been injured due to work related accident
- not all accidents need to be reported
Consent and mental capacity
GDC principle 3
Mental capacity act 2005
- a person must be assumed to have capacity unless it is established that the person lack capacity
- a person is not to be treated as unable to make a decision unless all practicable steps to help the person to do so have been taken without success
When a person is considered to lack capacity to consent:
Consult with
- anyone named by person
- carer / interest in welfare of pt
- lasting power of attorney
- deputy appointed to person by court
Information governance
GDPR and data protection
Data protection act 2018 (relates to info used to identify an individual or their personal details)
UKs GDPR outlines 6 principles that everyone who handles personal data must adhere to
- Used fairly, lawfully and transparently
- Used for specified explicit purposes
- Used in a way that adequate, relevant and limited to whats necessary
- Accurate / up to date
- Kept for no longer than necessary
- Handled in a way that ensures appropriate security / access / loss / destruction / damage
Clinical audit
Reviews current practice and compares this to expected published standards
Audit is a tool
Improves the quality and efficiency of patient care:
1. Helps identify areas of practice that need improving
2. Identifies and reinforces areas of good practice
Eg, legal responsibility on practices to establish and maintain audits for dental radiology
Direct access to
Including POMS
H&T
Dental h&t can carry out full scope of practice without prescription and without the pt having to see dentist first. Only exception is for tooth whitening which must be carried out on prescription from a dentist.
Direct access to
Including POMS
Dental nurse
Can participate in preventative programmes without the patient having to see a dentist first
Direct access to
Including POMS
Orthodontic therapist
Can carry out index of orthodontic treatment Need (IOTN) screening without the pt having to see a dentist first
Direct access to
Including POMS
Clinical dental technicians
Can for the provision and maintenance of full dentures only
Direct access to
Including POMS
Dental technician
Can repair dentures only
Patient information for direct access
Clear information is vital
Make sure the practice publicity is clear about:
- what treatments are available via direct access
- The arrangement for booking an appt with h&t
- what will happen if pt needs tx which h&t cannot provide
POM
Patient specific directive OR Patient group directive
- LA (lidocaine, articaine, prilocaine)
- duraphat 2260ppm / 2.26% fluoride varnish
- duraphat toothpaste 2800ppm/5000ppm
- emergency drugs
Tooth whitening
Not covered under direct access
Cosmetic product safety amendment regulations 2012
- products containing / releasing between 0.1%-6% hydrogen peroxide can only be sold to dental practitioners
- can only be made available to pt following an exam
- the first episode of tx being provided by a dentist or h&t under supervision of a dentist (within same dental setting)
Botulinum toxin (Botox)
Not covered under direct access
Not in the practice of dentistry so does no appear in the scope of practice document
Injectable dermal fillers
- classified as medical devices and do do not require a prescription
H&t who chose to provide these tx must be sure that they are trained competent and indemnified to do so
HTM01-05
HTM - healthcare technical memoranda
= comprehensive guide a dguidance
= standards policy and up to date best practice
HTM01 = decontamination
HTM 01 - 05 = intended to be used or referred to by all members of a dental team providing primary care dental services
Cleaning of instruments
- cleaning using a washer disinfector
- manual combined with ultrasonic cleaning
- manual
Occurs before sterilisation
Sterilisation
- type N and B are most commonly used in practice
- testing is crucial to ensure optimal performance
- outcomes from testing needs to be recorded in a log book
- failure to meet any test requirements = autoclave should be withdrawn from use
GDC
Uk regulator of dental professionals
Protect dental patients safety and maintain public confidence in the dental professions
Register
Set standards
Investigate
Quality assurance
GDC - fitness to practice
Serious / repeated clinical mistakes
Failure to meet pt needs
Inappropriate professional indemnity insurance
Cross infection issues
Breach of pt confidentiality
Criminal offence / fraud / theft / dishonesty
Poor health that affects treatment
=
Remove from register
Take no action
Issue a reprimand
Place conditions
Suspend registration
9 principles registered dental professionals must adhere to
- Put pt interest first
- Communicate effectively with pt
- Obtain valid consent
- Maintain and protect pt info
- Have a clear and effective complaints procedure
- Work with colleagues in a way that is in pt best interest
- Maintain develop and work within knowledge and skills
- Raise concerns if pt at risk
- Ensure personal behaviour maintains pt confidence in you and dental profession
Dental nurse scope of practice
Provide clinical and other support to registrants and pt
Orthotic therapist scope of practice
Carry out certain parts of orthodontic treatments under prescription from a dentist
Can apply fluoride and complete plaque scores under prescription
DO NO modify orthodontic treatment / complete lab work
Dental hygienist scope of practice
Help maintain oral health by preventing and treating periodontal disease
Can carry out tooth whitening and conscious sedation under prescription
DO NO restore teeth
Dental therapist scope of practice
Carry out certain dental treatments direct to pt or under a prescription from a dentist
Can carry out tooth whitening and conscious sedation under prescription
Dental technician scope of practice
Make dental devices to a prescription from a dentist or clinical technician
Repair dentures direct to members of the public
DO NOT provide treatment / give advice to pt
Clinical dental technician scope of practice
Provide complete dentures direct to pt (edentulous) and other dental devices on prescription from a dentist
Qualified dental technicians can develop additional clinical skills including teeth whitening
Dentist scope of practice
Can carry out all items in scope of practice
Can develop additional skills in providing implants and non surgical cosmetic injectables
Enhanced CPD scheme
What is it and how long for
CPC is compulsory
Dental H&T = 75hrs/5yrs
Not meeting minimum CPD requirements can put your registration at risk
IR(ME)R
Ionising Radiation (medical exposures) Regulations
Ionising radiation =
Radiation with enough energy to charge or ionise an atom
Diagnostic radiation
- xray is electromagnetic
- source = energetic e-
- causes ionisation
- high frequency / short wavelength
