CIC Flashcards
(28 cards)
What are the 5 moments for hand hygiene
- Before patient contact
- After patient contact
- Before aseptic task
- After body fluid contact
- After contact with patient surroundings
9 GDC standards
Put patients’ interests first
Communicate effectively with patients
Obtain valid consent
Maintain and protect patients’ information
Have a clear and effective complaints procedure
Work with colleagues in a way that is in patients’ best interests
Maintain, develop and work within your professional knowledge and skills
Raise concerns if patients are at risk
Make sure your personal behaviour maintains patients’ confidence in you and the dental profession
What is the Dentist Act 1984
-set up the current constitution of
the GDC for the regulation of dentistry
-involved in the registration and control of persons practising dentistry’
Function of the GDC - the 1 main overlying one. Then 5 functions
-PROTECTION OF PATIENTS
1) The Regulation of Dentistry (ensuring public confidence in profession)
2) Quality Assurance of Dental Education
3) Registration Role (recognised training pathway)
4) Setting Standards of Dental Practice and Behaviour (sets out what patients expect from professionals)
5) Keeping up to date (life-long learning) - CPD
Conditions that. must be fulfilled for consent
-communicate, understand, retain and evaluate information
-able to 1) comprehend and retain info, 2) believe info given, and 3) able to weigh the info to make a choice
-be able to have capacity and competence to understand treatment options, benefits/ risks
(Next of kin can’t consent, but should be involved in discussions)
Understand:
-all risks/ benefits/ tx options given to the patient
-Alternative options to the treatment suggested
-Any substantial risks must be indicated [1]
-What may happen if the procedures suggested were NOT undertaken
-What / the procedure involves [1]
-Benefits
Who the parental responsibility of a child lies with
Parents if married at time of birth
Mother if not married at time of birth unless Father on birth certificate or they marry or he gains responsibility via court order
Legal guardian
Local authority if in care
5 principles of capacity under the Mental capacity act
- Assume capacity unless established they lack it [don’t assume they don’t have capacity]
- Don’t treat person as unable to make decision unless all practicable steps to help them make the decision have been undertaken and failed
- Person is not unable to make decisions simply because they make an unwise decision [Refusal ≠ lack capacity]
- Any act done or decision made on behalf of someone lacking capacity has to be in their best interests
- Any act done or decision made should be the least restrictive of the person’s rights and freedom of action
examples of never events (dental and general medical related)
Wrong Site Surgery (wrong tooth extracted)
Wrong sided nerve block
Wrong Implant or Prosthesis
Retained foreign object post-procedure
Overdose of insulin due to abbreviations or incorrect device
Falls from poorly restricted windows
Transfusion or transplantation of ABO incompatible blood components or organs Misplaced naso or oro-gastric tubes
Scalding of patients
Wrong route of drug administration
The key steps of CPR
- Check for danger
- Check responsiveness: tap their side, shake shoulders, ‘can you hear me’
- Shout for help
- Airway: tilt head back and chin lift. Keep tilted to open airways and check for obstruction. Vomit should be aspirated or flicked out
- Breathing: oxygen mask placed over nose and mouth to see any fogging. Place hand on chest to check for rising. Check for up to 10s. Put face up to theirs to feel and look down chest for breathing
- Circulation – check carotid pulse only if competent
- Get someone to call 999 if in dental hospital or out anywhere, or 2222 if in hospital: ‘adult in cardiac arrest, ask for adult cardiac arrest team, location’
- Get someone else to get the defibrillator (level 5 or 3 of dental hospital)n
- Chest compressions: 30, 5-6 cm deep (1/3 of chest depth), 100-120 bpm. Hands in centre of chest
- Two rescue breaths using bag-valve mask. 1 person holds it over the face to create a good seal, keeping airway open. You squeeze it until chest rises and gently release. If mouth to mouth, pinch nose while doing so.
- Recommence compressions and continue 30:2 cycle.
- Defibrillator when it arrives. Switch it on with pads attached to save time. Only stop CPR when attaching pads. 1 at right side of chest below collar bone, 1 on left side of ribcage. Needed within 4 mins of cardiac arrest. Stand 1 metre clear when advising shock
- Only stop CPR when patient recovers, crash team arrive and tell you to stop, too exhausted
- Put in recovery position if recovers.
Recovery position
Right hand on floor on right side of head. Left knee raised. Left hand over right cheek. Roll over to right side (or vice versa)
What to do if someone is choking
- Ask if they are choking and check they can talk
- Get them to cough. If no noise, colour change, see-saw breathing then…
- Call cardiac arrest team
- Give 5 back blows between shoulder blades. Make sure the patient is up right and leaning slightly forward
- Then give 5 abdominal thrusts. Clasp hands just below rib cage, pull in and up
- 5:5 blows and thrusts
- If collapses perform basic life support: get them to lie down, call for help, CPR etc.
Can cause internal damage to organs so need to be checked over afterwards
How CPR differ for children 1yo - puberty
More likely to have respiratory arrest followed by cardiac arrest.
Ribs less likely to break as cartilaginous
5 rescue breaths first. Use a smaller bag-valve mask.
Then 15 compressions. 4-5cm
2 rescue breaths: 15 compressions
How CPR differs for baby
For checking responsiveness, tap their side or pinch their ear. Should cry or squirm
For opening airways, head tilt is very slight, make face parallel to ground
Use 2 thumbs to do chest compressions
Can carry them down the corridor while doing CPR to find help
What to do if needle stick injury
-stop what you are doing
-Take off glove
-Wash with soap and water, encourage bleeding
-plaster
-Record the patient source
-Inform patient what is happened
-Report injury on datix and inform head nurse (never event)
-Risk assessment carried out by someone else- including status of transmissible diseases of pt
-Record in incident book
-Bloods need taken from both parties (hep B, C, HIV)
-Visit occupational health and identiy any risks
-Attend a follow up appointment
How to don and doff PPE
-On= apron, mask, visor, wash hands, gloves
-Taking off= gloves, apron, visor, mask, wash hands (20s)
Dental equipment that contain latex
-Gloves, latex dam, GP points, some prophylaxis cups, mixing bowls, orthodontic elastics, suction tips, bite blocks, amalgam carriers, IV tubing, emergency resus masks, BP cuffs, bungs in IV drugs, protective eyewear, elastic bands, and pens.
Temperature for decontamination
134- 137 degrees
Decontamination Guidelines
HTM01-05
Decontamination process for dental instruments
-Washer-disinfector: at 93 degrees for 45 mins to get rid of proteins and debris (uses Alkaline and thermadent)
-If broken then manual scrub with soft brush at 40 degrees and ultrasonic bath for 20 mins
-Inspect instruments for debris under the light. Put back in up to 3 times
-2 types of autoclave depending on the instrument:
1. Vaccum- XLA, endo, handpieces. Packed in bags. 134 degree. 30-40 mins
2. Non-vaccum- perio, cons, exam kits. 20 mins. 134 degrees. No drying time
How often are autoclaves drained, serviced, and how long are audits kept for
- every day
- 3 months (or they can come at any time)
- 3 years
How often are 1) sharps bins and 2) clinical waste bins emptied.
1) when 3/4 full or 1x year
2) when 3/4 full or 1x daily
What is CQC
Care quality commission - ensure better care by monitoring how providers comply to standards, issue fines/ warnings if below standards, promotes improved services, protects patients who’s rights are restricted by the Mental Health act, regular reviews of services, seek opinions of those who use the services, governs IRMER
Who can access clinical records. What law governs this. What does this law also enforce
-health professionals involved in treating the patient
-the patient
-an insurance company paying for the tx
-a court of the police (only when needed for investigation in a particular crime)
-1988 Data protection act - also date must be held securely, obtained fairly for a particular purpose, patients should be be able to access it if requested, should be adequate/ not excessive
How long are clinical records kept for
-11 years after conclusion of tx
-Children= until the age of 25, or 11 years since the conclusion of tx (whichever is longer)
