Introductions and definitions

Question 1

Define consent

Answer 1

Permission of agreement for an action to be carried out

Question 2

What are the types of consent

Answer 2

Voluntary
Verbal
Informed
Written

Question 3

Describe voluntary consent

Answer 3

Patient decides without a consultation and can refuse or withdraw at any time e.g. opening mouth for examination

Question 4

Describe verbal consent

Answer 4

Pt verbally states they are happy with a procedure, there may be a discussion of risks and benefits and a continuous discussion

Question 5

Describe informed consent

Answer 5

Discussion regarding the risks, benefits and alternatives to treatment and there is a continuous discussion aided by information over a period of time

Question 6

When is verbal consent used

Answer 6

General examinations e.g. BPE

Minor procedures

Question 7

When is written consent required

Answer 7

Larger and more invasive procedures e.g. extractions
IVS/IHS/GA
Peads
Photographic records

Question 8

Define competence

Answer 8

Competency refers to the mental ability and cognitive capabilities required to PERFORM actions needed to put decisions into effect

Question 9

How does competency relate to dentistry

Answer 9

A patient should fully understand the information given regarding their treatment in order to allow them to make a rational decision

Question 10

Who is deemed competent and of capacity?

Answer 10

All adults are deemed competent and having capacity unless otherwise proven

Question 11

What is competency a judgement of

Answer 11

Legal judgement

Question 12

Define capacity

Answer 12

Individual has the ability to use and understand information to make a decision and communicate any decision made

Question 13

What is a capacity a judgement of?

Answer 13

Medical judgement

Question 14

Relevance of capacity in dentistry

Answer 14

The patient should understand their management, comprehend the risks and benefits, retain information and make a decision based on information provided

Question 15

What Legislation is important regarding capacity?

Answer 15

Mental Capacity Act

Question 16

Define confidentiality

Answer 16

Medical confidentiality is a law whereby the practitioner cannot disclose patient information without their consent

Question 17

What legislation is important for confidentality

Answer 17

Data Protection Act 1998 - patients have a right to keep information about themselves confidential

Question 18

Why is confidentiality important

Answer 18

It ensures trust and allows the patient to feel safe during their interaction

Question 19

What instances can confidentiality be breached

Answer 19

• Disclosing information to other healthcare professionals involved in the patient’s care
• As required by law e.g. court order
• In the sake of public interest, protecting the patient or others who are at harm by not doing so e.g. vulnerable adults or child neglect

Question 20

When confidentiality is breached when discussing cases between healthcare professionals, what rules should be followed?

Answer 20

Information should be limited to only necessary information

Patients should be fully aware each time information is passed on to another person

Question 21

What is a complaint?

Answer 21

An expression of dissatisfaction by a patient or a patient’s representative about a dental service or treatment (or experience in the dental practice), whether justified or not

Question 22

What is the main reason complaints arise?

Answer 22

Patients expectations are not met or accounted for

Poor communication

Question 23

What is the importance of effective complaints handling

Answer 23

Improves rapport
Prevents escalation
Prevents future complaints
Reflective learning

Question 24

What are the guidelines for complaint procedures?

Answer 24

• Visible, clearly written and no jargon
• Allow complaints to be addressed in due time and allows a fair investigation
• Confidential
• Has clear outcomes
• Leads to improved service

Question 25

List the steps in complaints handling

Answer 25

1. Acknowledge the complaint by writing, email or telephone (within 24 hours) 2. Inform dental defense union if required 3. RESPOND to the complaint within 10 days (if not make pt aware of different timesscale) 4. Hold staff meeting for peer review, audit and feedback on the complaint

Question 26

How to respond to complaints

Answer 26

``` REACH Recognise Empathise Apologise Compensate Honesty ```

Question 27

Where can the pt be directed to if they are not happy with the outcome of a complaint

Answer 27

- NHS complaints procedure services (CPS) - Patient Advice Liaison Service (PALS) in hospital - Dental Complaints Service (DCS) if private

Question 28

What is an Ombudsman

Answer 28

Representative who investigates complaints

Question 29

What are the GDC guidelines for 'scope of practice'

Answer 29

- Work effectively - Have appropriate support - Delegate and refer patients - Communicate clearly - Manage and lead the team using everyone's skill set

Question 30

What is continuing professional development CPD

Answer 30

Mandatory responsibility for dental professionals to keep their skills and knowledge up to date throughout their careers

Question 31

How many hours of CPD do dentists need

Answer 31

100 verifiable hours within 5 years | Minimum 10 hours verifiable every 2 years

Question 32

What CPD are mandatory

Answer 32

``` Medical emergency (10 hours) Infection control (5 hours) Radiography and protection (5 hours) ```

Question 33

What are other CPD examples

Answer 33

``` Law and ethics Dental materials Photography Business Complaint handling ```

Question 34

What do you document for CPD log?

Answer 34

A plan (personal development plan) Hours completed Evidence for completion

Question 35

What is a clinical audit

Answer 35

Measuring a clinical outcome or process against the standards set on the principles of evidence based practice

Question 36

What are the aims of clinical audits

Answer 36

Highlight clinical areas requiring improvement | Implement change to improve patient care and outcomes

Question 37

What is required in a clinical audit?

Answer 37

- Aims and objectives - Summary and methodology - Timetable - Detailed educational source materials

Question 38

What is a peer review

Answer 38

Groups of dentists and dental care professionals review and evaluate aspects of practice

Question 39

What are the aims of peer review

Answer 39

Increased quality of care and safety Identify areas for change Share experiences

Question 40

What categories of dentistry may be subject to peer review

Answer 40

Clinical care | Administrative care

Question 41

What are the essentials for peer reviews

Answer 41

- identify topics and research them before the meets - Topic must be relevant to improving patient care - The peer review must demonstrate how changes can be achieved

Question 42

What is the reason for raising concerns

Answer 42

Provides the opportunity to open a discussion with the aim of acting in the patient's best interests - it is not a complaint of malpractice

Question 43

When may a concern be raised in dentistry -

Answer 43

- Health, behaviour or professional performance of a colleague does not put pt interests first - Any aspects of the environment where tx is provided does not put pt interests first - Someone asks you do so something against your duty to putting pt interests first

Question 44

Who do you raise concerns with?

Answer 44

Initially in house with senior colleagues, lead person for raising concerns or employer For advice - defense organisations and professional associations More severe cases or no improvement - CQC or GDC

Question 45

What is the process of raising concerns

Answer 45

- Keep a log on series of events e.g. emails, time, dates - Familiarise yourself with the practice policy on raising concerns - Approach raising concerns lead, practice manager or employer - Try to solve in practice/hospital or escalate - Contact defence union at any time for informal advice

Question 46

When should concerns be raised with the GDC?

Answer 46

- It is not practical to deal with on a local level - The local solution has not solved the issue - Serious problem has occurred e.g. violence or illegal practice

Question 47

Who is relevant in terms of safeguarding

Answer 47

Children and vulnerable adults

Question 48

Define a vulnerable adult

Answer 48

Person above 18 who is or may be in need or community care services by reason of a mental or other disability, age or illness; and is unable to care for themselves or protect themselves from harm of exploitation

Question 49

Who should be contacted in terms of safeguarding

Answer 49

- Safeguarding lead - Senior colleague - Social services or the police - Defence organisations after the immediate situation has been dealt with

Question 50

What are the types of abuse

Answer 50

- Sexual - Emotional - Physical - Verbal - Neglect - Financial

Question 51

How may neglect or abuse be identified by a dentist

Answer 51

- Frequent caries - Plaque stagnation - Frequent trauma that has late presentation or story does not correlate to injuries - Unclean clothing - Poor attender - Bruising, bite marks, ,eye injuries, burns

Question 52

Define decontamination

Answer 52

Process where reusable items are rendered safe for further handling and use, and involves multiple steps including cleaning, disinfection, inspection and sterilisation

Question 53

Define disinfection

Answer 53

Process by which the number of viable harmful micro-organisms are reduced in an area by the use of chemicals (disinfectants) or heats

Question 54

What aspects of the dental surgery are subject to disinfection?

Answer 54

Areas that cannot be sterilised e.g. the dental chair, floors, lights

Question 55

Define sterilisation

Answer 55

Process by which an object is rendered free from ALL viable harmful microorganisms, including viruses, bacteria and spores.

Question 56

What objects in the dental surgery require sterilisation?

Answer 56

Reusable items that are used intraorally on patients