Case Presentation Flashcards
(224 cards)
1
Q
what does SOCRATES stand for
A
site
onset
character
radiating
associating factors
time
exacerbating factors
scale 1-10
2
Q
apart from SOCRATES, what else is it important to ask about pain
A
are they up at night
have they tried any medication and is this working
3
Q
what is symptomatic irreversible pulpitis
A
clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing
can have lingering thermal pain, spontaneous pain and referred pain
4
Q
what is symptomatic apical periodontitis
A
inflammation of apical periodontium producing clinical symptoms including a painful response to biting and/or percussion or palpation
might or might not be associated with an apical radiolucent area
5
Q
what 2 parts of an endodontic diagnosis is needed
A
pulpal and apical
6
Q
what is normal pulp
A
clinical diagnostic category in which the pulp is symptom-free and normally responsive to pulp testing
7
Q
what is reversible pulpitis
A
clinical diagnosis based on subjective and objective findings that the inflammation should resolve and the pulp return to normal
8
Q
what is asymptomatic irreversible pulpitis
A
vital inflamed pulp is incapable of healing
no clinical symptoms but inflammation produced by caries, caries excavation, trauma
9
Q
what is pulp necrosis
A
clinical diagnostic category indicating the death of the dental pulp
pulp usually nonresponsive to pulp testing
10
Q
what is previously treated
A
tooth has been endodontically treated and the canals are obturated with various filling materials other than intracanal medicaments
11
Q
what is previously initiated therapy
A
tooth has been previously treated by partial endodontic therapy
12
Q
what is normal apical tissues
A
periradicular tissues that are not sensitive to percussion or palpation testing
lamina dura intact and PDL uniform
13
Q
what is asymptomatic apical periodontitis
A
inflammation and destruction of apical periodontium that is of pulpal origin
appears as an apical radiolucent area and does not produce clinical symptoms
14
Q
what is acute apical abscess
A
inflammatory reaction to pulpal infection and necrosis characterised by rapid onset spontaneous pain, tenderness of the tooth to pressure, pus formation and swelling of associated tissues
15
Q
what is chronic apical abscess
A
inflammatory reaction to pulpal infection and necrosis characterised by gradual onset, little or no discomfort and the intermittent discharge of pus through an associated sinus tract
16
Q
what is condensing osteitis
A
diffuse radiopaque lesion representing a localised bony reaction to a low grade inflammatory stimulus usually seen at the apex of a tooth
17
Q
origin and insertion of masster
A
O - zygomatic arch
I - angle of mandible
18
Q
origin and insertion of temporalis
A
O - temporal fossa
I - coronoid process
19
Q
origin and insertion of medial pterygoid
A
O - medial surface lateral pterygoid plate
I - zygomatic arch
20
Q
origin and insertion of lateral pterygoid
A
O - base of skull and lateral surface of lateral pterygoid plate
I - condyle surface
21
Q
what is the blood supply to TMJ
A
deep auricular artery
22
Q
what is nerve supply to TMJ
A
auriculotemporal, masseteric, posterior temporal nerve
23
Q
if someone gets pain in the TMJ what bit of it feels pain and why
A
bilaminar zone
articular disc slips forward and bilaminar zone becomes compressed by the condyle
24
Q
what are the causes of TMD
A
myofascial pain
disc displacement
degenerative disease
chronic recurrent dislocation
ankylosis
hyperplasia
neoplasia
infection
25
if the TMJ is clicking what TMJ disease is this indicative of
anterior disc displacement with reduction
26
what is the pathogenesis of TMD
inflammation of muscles
trauma
stress
psychogenic
occlusal abnormalities
27
what is the extra oral examination of TMD
muscles of mastication
joints
jaw movements
facial asymmetry
28
what is the intra-oral examination of TMD
interincisal mouth opening
signs of parafunctional habits
muscles of mastication
29
what are the special investigations used for TMD
OPT
CT
MRI
transcranial view
nuclear imaging
arthrography
ultrasound
30
common clinical features of TMD
intermittent pain
muscle/joint/ear pain
trismus/locking
clicking/popping joint noises
headaches
crepitus (later on)
31
differential diagnosis of TMJ
dental pain
sinusitis
ear pathology
salivary gland pathology
referred neck pain
headache
atypical facial pain
trigeminal neuralgia
angina
condylar fracture
temporal arteritis
32
reversible treatment of TMD
patient education
medication
counselling
physical therapy
splints
bite raising appliance
33
counselling for TMD
reassurance
soft diet
masticate bilaterally
no wide opening
no chewing gum
dont incise food
cut food into small pieces
stop parafunctional habits
support mouth on opening
34
medications used for TMD
NSAIDs
muscle relaxants
tricyclic antidepressants
botox
steroids
35
what types of splint can be used for TMD
bite raising appliances
anterior repositioning splint
36
what does a bite raising appliance do
stabilise occlusion and improve function of masticatory muscles thereby decreasing abnormal activity
37
what is the irreversible treatment of TMD
occlusal adjustment
surgery
38
why does joint clicking occur with disc displacement
lack of coordinated movement between the condyle and articular disc
39
what is the mechanics of disc displacement with reduction
disc initially displaced anteriorly by the condyle during opening until disc reduction occurs
40
signs of disc displacement with reduction
jaw tightness and mandible deviation
41
if disc displacement with reduction is left untreated what can it lead to
osteoarthritis
42
treatment for disc displacement with reduction if it is not painful
no treatment
43
treatment for disc displacement if it is painful
counselling
limit mouth opening
bite raising appliance
surgery occasionally
44
what are the 3 classifications of TMD
joint degeneration
internal derangement
no joint pathology
45
factors of caries
tooth
substrate
bacteria
time
46
how does bacteria attach to the enamel
due to saliva which acts as a primer
47
what does enamel caries do to enamel structure
enlarges gaps between rods
48
how does the stephan curve work when you already have white spot lesions
active lesions have a very low drop and persist for longer period
inactive lesions have slight reduction but doesnt stay there
no lesions will never reach pH of 5.5 and will have quick resolution
49
what acid is produced by microorganisms to cause caries
lactic acid
50
why are active sites (enamel lesions) more susceptible to a drop in pH
because the bacteria thrives here so the sites are more virulent for producing acid
51
if you see grey enamel what does this mean
there is no longer dentine supporting the enamel as the caries has extended
52
when is fluoroapatite formed
during demineralisation and remineralisation
53
what does streptococcus mutans need to produce acid
sucrose
54
what minerals remineralise enamel
phosphate
calcium
fluoride
55
what are the 7 elements of caries risk
clinical evidence
dietary habits
social history
fluoride use
plaque control
saliva
medical history
56
what is given to patients to assess their diet and how long do they use it for
four day diet diary
at least one day over the weekend
57
what are the 8 elements of preventive programme
radiographs
toothbrushing instruction
strength of F in toothpaste
F varnish
F supplementation
diet advice
fissure sealants
sugar free medicine
58
name some safe snacks
milk/water
fruit
savoury sandwiches
crackers and cheese
breadsticks
crisps
59
what are the steps of caries progression
adhesion
survival and growth
biofilm formation
complex plaque
acid
caries
60
what is the proportion of streptococcus mutans linked to
high sugar diet
61
what are the characteristics of strep mutans
glycolytic systems
EPS/sucrose metabolism
attachment mechanisms
greater acidogenicity
ecological competitiveness at low pH
genomic characteristics
62
what does the Stephan curve show
the fall in pH below the critical level of pH 5.5 at which demineralisation of enamel occurs, following intake of food and drink, and how long it takes to get back to neutral pH
63
microorganism present with endodontic infections
enterococcous faecalis
64
virulence factors of enterococcous faecalis
endotoxins
adhesins
collagenases
hyaluronidase
immune evasion
65
what percentage of adults have asthma
2-5%
66
what is the cellular response of asthma
allergen triggers IgE production
B and T cell interaction
degranulation of mast cells
narrowing of airway, oedema and mucous secretion
67
what is asthma
airway narrowing due to:
bronchial smooth muscle constriction
bronchial mucosal oedema
excessive mucous secretion into the airway lumen
68
what is air flow related to
radius of the bronchus to the power of 8
69
what are the symptoms of asthma
cough
wheeze
shortness of breath
diurnal variation
difficulty breathing out
70
when is asthma worse
overnight and early morning
71
what tracks airway resistance in asthma
peak expiratory flow rate (PEFR)
72
how do you compare the PEFR measurements for asthma
compare morning with morning etc
73
what are the triggers for asthma
unknown
infections
environmental - dust
cold air
atopy
74
what is the acute biphasic response of asthma
early response with acute asthma attack
attack later on again if corticosteroids are not used
75
what are the core asthma drugs
LA and SA beta adrenergic agonists
low and high dose corticosteroids
adjuvant therapy (biologics, prednisolone)
76
what are the stages of asthma therapy (in terms of what inhalers are used related to severity)
mild intermittent
regular preventer
initial add on
persistent poor control
continuous or frequent oral steroids
77
my patient is on salbutamol and beclomethasone/foromoterol, what stage of asthma therapy are they on
initial add on therapy
78
what type of drug is salbutamol
beta adrenergic agonist
79
what are the actions of beta adrenergic agonists
relax bronchial smooth muscle (reduce bronchoconstriction and resting bronchial tone)
80
when do you start taking corticosteroids for asthma
if you are using a SA beta agonist more than 3 times a week use a low dose
move onto high dose if symptoms indicate need for it
81
my patient has mild asthma, what does this mean
what if she had moderate asthma what drug would she be taking as well
she only uses low dose steroid inhaler and short acting beta agonist
long acting beta agonist for moderate therapy
82
what should a dentist know about asthma
that the patient has asthma
the severity of the patients asthma
the triggers for the patients asthma and how to avoid these
know how to assess and treat a patient during an acute asthma attack
83
action of beclomethasone
anti-inflammatory reducing the swelling and irritation in the lungs
reduces the release of inflammatory mediators (histamines, leukotrienes, cytokines) by acting on specific receptors within the cell resulting in altered gene expression
84
side effects of beclomethasone
headache
ORAL CANDIDIASIS
pneumonia
ALTERED TASE
voice alteration
85
how do you reduce the risk of candidiasis with oral steroid use
spacer devices
rinsing the mouth with water after inhalation
antifungal oral suspension or gel to treat
86
what type of drug is formoterol fumarate
long acting bronchodilators
87
what is a drug that formoterol interacts with to produce hypokalaemia that is commonly given in dentistry
fluconazole
88
side effects for formoterol
dizziness
muscle cramps
nausea
altered taste
89
side effects for salbutamol
muscle cramps
90
what is the effect of using beclomethasone and formoterol together
make breathing easier by providing relief from symptoms such as shortness of breath, wheezing and cough
prevent symptoms of asthma
91
common side effect of fostair
oral candida
headache
hoarseness
92
what is benign paroxysmal positional vertigo
sensation of spinning with certain head movements as a result of a problem in the inner ear
93
triggers of BPPV
ear conditions
tilting head up or down
lying down
getting up
94
medication used for BPPV in severe cases
vestibular suppressant medication - meclizine
95
procedures for severe BPPV
semi-circular canal occlusion
96
therapy for BPPV
repositioning manoeuvres
97
specialists to consult for BPPV
GP
otolaryngologist
neurologist
98
what is going on in the ear with BPPV
crystals from the otolith organs (which are gravity sensitive) become dislodged and move into the semi-circular canals in the vestibular labyrinth so now the semi-circular canals are sensitive to head position changes making you dizzy
99
how quick do SA beta agonists work and how long do they last for
2-3 minutes
lasts 4-6 hours
100
how quick do LA beta agonists work and how long do they last for
1-2 hours
lasts 12-15 hours
101
fostair is a compound preparation made of 2 drugs, what type of therapy is this used for
maintenance and reliever therapy
102
what type of hypersensitivity reaction is asthma
type 1 - exaggerated IgE mediated immune response
103
what type of hypersensitivity reaction is a metal allergy
type 4 - delayed hypersensitivity (takes longer for it to show)
overreaction of T helper cells (cell-mediated response)
104
how does type 4 hypersensitivity reactions work
CD4 cells recognise foreign antigens
macrophages secrete IL-12 stimulating the proliferation of more CD4 cells and CD8 cells
CD8 cells destroy target cells while macrophages form giant cells
gives excessive cytokine production and tissue damage, inflammation
105
how does a type 1 hypersensitivity reaction work
during exposure to allergen the immune system recognises antigen as foreign
antigen presenting cells process the allergen and present it to T helper cells
T helper cells activate B cells leading to IgE antibodies specific to allergen
allergen binds to IgE antibodies already attached to mast cells and basophils which releases histamine
106
how does sensodyne claim to work
builds a protective layer over sensitive areas of your teeth
helps to reduce sensitivity by shielding the nerve endings from external stimuli
107
fluoride content of sensodyne
1450ppmF
108
what can smoking do to your mouth
staining
periodontal disease
loss of teeth
oral cancer
halitosis
109
what is pack years in relation to smoking
unit for measuring the amount a person has smoked over a long period of time
110
how do you work out a pack year
multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked
111
what is a pack year defined as
twenty cigarettes smoked every day for one year
112
effect of alcohol on oral health
xerostomia
halitosis
oral cancer
caries
erosion
113
what smoking cessation services are available
quit your way
pharmacy services
114
safe units of alcohol
14 per week
115
what causes an amalgam tattoo
amalgam particles embedded in soft tissues corrode over time and macrophages take up exogenous particles leading to staining of fibres
116
when is a 6PPC done and why
3 months after treatment
to allow time for the gingivae to heal and clinical reattachment
117
what does BPE 0 mean
probing <3.5mm
black band visible
<3mm pocket
no BOP
no calculus
118
what does BPE 1 mean
probing <3.5mm
black band visible
<3mm pocket
BOP present
no calculus
119
what does BPE 2 mean
probing <3.5mm
black band visible
<3mm pocket
BOP maybe
definitely calculus
120
what does BPE 3 mean
probing 3.5-5.5mm
partially visible black band
4-5mm pockets
BOP possible
calculus possible
121
what does BPE 4 mean
probing >5.5mm
no black band
>6mm pockets
BOP possible
calculus possible
122
treatment for BPE 0
OHI
123
treatment for BPE 1
OHI
124
treatment for BPE 2
OHI and remove calculus and plaque retentive factors
125
treatment for BPE 3
OHI
radiographs
decide if periodontitis or not
PMPR
126
treatment for BPE 4
OHI
PMPR
127
if you have BPE code 3 when do you do a 6ppc if you are following the BSP guidelines
after treatment
128
what reattaches after periodontal treatment
long junctional epithelium
129
what are ramfjords teeth
16
21
24
36
41
44
130
what is marginal bleeding a reflection of
how well the patient can carry out effective plaque control DAILY
131
what is modified plaque a reflection of
how well the patient is performing plaque removal
132
going by ramjords scores what is an engaged patient
<35% bleeding
<30% plaque
OR
greater than 50% improvement in both
133
properties of chlorhexidine
absorption to oral surfaces
long substantivity
fairly broad antimicrobial spectrum
interferes with taste
stains
134
why do we use 6PPC
to monitor the periodontal condition of the teeth of someone with periodontitis
135
what does generalised periodontitis mean
affecting >30% of teeth
136
what does stage 3 periodontitis mean
mid third of root
137
what does grade A periodontitis mean
slow rate of progression
(<0.5)
138
what does currently unstable mean with periodontitis
PPD >5mm
or
PPD >4mm and BOP
139
if someone was stable with periodontitis what does this look like
BOP <10%
PPD <4mm
no BOP at 4mm sites
140
what is step 1 of S3 guidelines
explain disease
OHI
reduce risk factors
interdental cleaning
PMPR of clinical crown
141
what is step 2 of S3 guidelines
reinforce OH
risk factor control
subgingival PMPR
142
what is step 3 of S3 guidelines
MANAGE NON-RESPONDING SITES
moderate pockets (4-5mm) = subgingival instrumentation
deep pockets (>6mm) = consider alternative causes
consider referral for surgery
143
what is step 4 of S3 guidelines
targeted PMPR
supportive care
reinforce OHI and risk factor control
144
what rate of diagnostically acceptable radiographs is seen as an acceptable amount for IRMER17
95%
145
regarding IMRER17 who is the employer
someone other than an employee who carries out or engages others to carry out medical exposure
if NHS practice then it is NHS
if private then it is practice owner
146
who is the operator in IRMER17
anyone who is entitled by the employer to carry out a practical aspect
147
who is the practitioner in IRMER17
registered healthcare professional entitled by employer to take responsibility for an individual exposure
148
who is the referrer in IRMER17
registered healthcare professional who is responsible for referring individuals to the practitioner for specific exposures to be undertaken in accordance with the employers recommendations
149
responsibility of the referrer in IRMER
providing sufficient medical data to practitioner to enable justification
150
responsibility of the practitioner in IRMER
justification of each exam
ensure doses ALARP
comply with employers procedures
151
responsibilities of the operator in IRMER
select equipment and methods to limit dose
follow employers procedures
not perform exam unless authorised as justified
152
what is justified, optimised, limited
J - more good then harm
O - ALARP
limited - individual radiation dose limits
153
what sets the guideline radiation dose levels for patients undergoing examinations
diagnostic reference levels
154
diagnostic reference levels of intraorals for adults
1.7mGy
155
how do amalgam overhangs occur
when a matrix band is not properly adapted
156
how do you remove amalgam overhands
at the time with carver
flame bur
ultrasonic scaler
curettes
diamond bur
finishing bur
157
what is a common side effect of amalgam overhangs
periodontal disease
amalgam tattoo
158
why do buccal cusp fractures occur on MOD amalgam premolars
anatomical vulnerability - absence of both marginal ridges weakens the tooth by 60%
MOD compromises tooth structure
amalgam does not bond - stress concentration
159
what diet advice would you give a patient
reduce sugar intakes/only at meal times
if snacking stick to non-cariogenic snacks
dont use excess sugar (in tea etc)
try to have less than 3 sugar intakes per day
be wary of acidic drinks/food
160
what would you use to extract retained roots
luxator
elevator
root forceps
161
management of an OAC
if small then encourage clot and suture closed
if large then refer for buccal advancement flap
162
what are the principles of cavity design and preparation
identify and remove carious enamel
remove enamel to identify maximal extent of lesion at ADJ and smooth the enamel margins
remove peripheral caries in dentine from ADJ then circumferentially deeper
only then remove deep caries over the pulp
outline form modification
internal design modification
163
how does saltwater help healing tissues after an extraction
creates an environment hostile to bacteria to prevent infection and other post-extraction complications
increases the pH making it a more alkaline environment
promotes gingival fibroblast migration to regulate wound repair
164
what are the advantages of hot salty mouthwash after an extraction
reduced bacterial growth
soothing effect
improved blood circulation (warmth)
gentle cleansing
reduced swelling
165
what are the parts of composite resin
filler particles
resin
camphorquinone
low weight dimethacrylates
silane coupling agent
166
what monomer is used in composite
BIS-GMA
167
what do monomers do in composite
undergoes free radical addition polymerisation
is a difunctional molecule which has C=C bonds to facilitate crosslinking
168
what is the effect of adding filler particles to composite
improved mechanical properties
lower thermal expansion
lower polymerisation shrinkage
less heat of polymerisation
improved aesthetics
169
advantages of using light cure
extended working time
less finishing time
immediate finishing
less waste
higher filler levels
less porosity
170
what is depth of cure
depth at which material hardness is about 80% that of the cured surface
171
problem with materials that are light cured
light/material mismatch
premature polymerisation
optimistic depth of cure
recommended setting times too short
polymerisation shrinkage
172
what rise of temperature is accepted as a potentially irreversible traumatising to the pulp
5.5 degrees
173
strength of composite
350MPa
174
youngs modulus of composite
12GPa
175
how do you bond to enamel
acid etch
176
how do you bond to dentine
dentine bonding agent
177
bond strength of composite
40MPa
178
what are the advantages of a composite onlay to a direct composite
better mechanical performance
significant reduction in polymerisation shrinkage
maximise marginal integrity
ideal proximal contacts
excellent anatomic morphology
optimal aesthetics
179
what is the advantage of a composite onlay over a porcelain onlay
not as abrasive
transfer of masticatory forces are considerably less
greater capacity to absorb compressive loading forces
180
how is bond strength of indirect restorations increased
etching with hydrofluoric acid
sandblasting
181
disadvantages of indirect composite onlays
ABSORBS STAINS
increased cost and time
requires two appointments
fabrication of temporary restoration
low potential for repair
182
uses of onlays
tooth wear
FRACTURED CUSPS
restoration of root treated teeth
replace failed directs
minor bridge retainers
183
what should the internal preparations of a tooth be for an onlay
no undercuts
rounded internal line angles
shoulder or chamfer margins
4-6 degree tapered walls
margins not on occlusal contact points
184
what was the appointment like for onlay prep
prepare the tooth
impression with PVS and lab putty
bite registration
lower impression
make temporary with protemp and cement with temp bond
check occlusion
185
what was the appointment like for onlay cementation
remove temporary
try in onlay
cement with dual cure composite and DBA
check occlusion
finish if need to
186
what cement is used to cement composite onlays
dual cure composite and DBA
187
when are onlays considered
when there is no or little intracoronal shape to the preparation and retention is poor
188
what is retention provided by for onlays
adhesive cement but should also incorporate conventional tooth preparation for retention
189
how are indirect composites cured and what does this do for them
cured by heat, pressure and intense light
improves strength, reduces wear
reduction in polymerisation shrinkage
190
what is the bond for dual cure composite resin cements
micromechanical and C=C bond
191
why do you want to use a dual cure cement for composite onlays
light penetration is poor
although they are dual cure, if they are not light cured the mechanical properties decrease by 25%
192
what sensibility tests are available
EPT
ethyl chloride
TTP
193
what are the problems with sensibility testing
stimulate nerve fibres
does not indicate blood supply state
periradicular inflammation can occur before necrosis
hard testing multirooted teeth
194
what is the process of mechanical debridement of the root canal
preparation of tooth
access cavity preparation
creating straight line access
initial negotiation
coronal flaring
working length determination
apical preparation
195
what impression material is used when taking impressions for indirect restorations
addition cured silicone - polyvinylsiloxane
196
what body of PVS is used for impressions of crown prep etc
light body on the tooth and then heavy body/lab putty in the tray
197
what is the single stage technique of impressions for indirects
light body used around the teeth and heavy body in tray will push material into hard to get areas around the teeth
198
what is the ISO standard of surface replication for an elastomer
grooves of 20um replicated
199
what is the shark fin test testing and what would you see with a good result
flow under pressure
big fin
200
how do you optimise mucosal support for upper partial acrylic dentures
using connector over centre of palate
201
what gives direct retention for an upper acrylic partial denture
good fit
cohesion
wrought clasps
202
how much gingivae should be left clear of the denture base if you are making a partial acrylic denture
3mm of clearance
203
what makes up debris left on dentures
salivary proteins and bacteria
oral debris
calculus
204
what are the effects of poor denture hygiene
caries
periodontal disease
denture stomatitis
halitosis
pain
205
what can be used for mechanical denture cleaning
soap and soft brush
ultrasonics
206
what can be used for chemical cleaning of acrylic dentures
alkaline peroxides (the tablets)
fairy liquid
milton steriliser
toothpaste - abrasive
207
what is the hygiene advice for denture wearers
brush dentures daily
soak dentures daily
leave out at night
visit dentist regularly
208
how do you get used to new dentures
practice speaking out loud (reading)
learn to eat with them in
practice adjusting your denture (in and out of mouth)
wear them for as long as you can during the day
209
what is clinical governance
systematic approach to maintaining and improving the quality of patient care within a health system
210
what are the dimensions of healthcare quality
person-centred
safe
effective
efficient
equitable
timely
211
how do you promote implementation of research in clinical practice
critical appraisal of literature
development of clinical guidelines and protocols
implementation strategies
212
what is the aim of clinical guidelines
provide recommendations for the treatment and care of individuals
be used to develop standards for clinical audit
be used in education and training of health professionals
help patients to make informed decisions
improve communication between patient and health professional
213
what is the aim of SDCEP
support dental teams throughout Scotland by providing guidance developed by the profession for the profession on topics identified as priorities for dentistry in Scotland
214
what are the SDCEP recommendations based on
current legislation/professional regulations
group consensus after critical evaluation of evidence
group consensus after considering expert opinion
215
what are the key clinical governance activities
CPD
evidence based practice
openness on poor performance and practice
risk management
clinical audit
peer review
Critical incident review
research project
quality improvement projects
216
what should CPD do
provide NHS staff opportunity to continuously update skills and knowledge
result in delivery of modern, effective and high quality care
identify training needs across professions to aid clinical team-working
217
what is the mandatory CPD
100hrs within 5yr cycle at least 10hrs across 2 consecutive yrs
218
what are the highly recommended areas to do CPD for
MEDICAL EMERGENCIES
DISINFECTION AND DECONTAMINATION
RADIOGRAPHY AND RADIATION PROTECTION
legal and ethical issues
complaints handling
oral cancer
safeguarding children and young people
219
what is clinical audit
a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and implementation of change
ENSURE WHAT SHOULD BE DONE IS BEING DONE AND IF IT NOT IT PROVIDES A FRAMEWORK TO ENABLE IMPROVEMENTS
220
steps of clinical audit
select topic
set agreed standards and decide on data requirements
observe practice and collect data
analyse data and determine any deviation from standards
identify any areas of change required
make necessary changes
repeat audit process and determine whether improvements have occurred
221
what is the audit cycle
identify problem or issue
set criteria and standards
observe practice/data collection
compare performance with criteria and standards
implement change
222
what are the educational strengths of an audit
encourages learning about new techniques and treatments
modifies attitudes and management of clinical conditions
indicate gaps in knowledge and/or skills
223
what is the process of enhanced significant event analysis for critical incident review
set up a meeting to discuss events
meet and undertake a structured analysis
implement changes and monitor progress
write up report
seek external comment/feedback
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