PMHP

Question 1

What is the acronym for handling domestic abuse?

Answer 1

AVDR
Ask
Validate
Document
Refer

Question 2

What should you ask in domestic abuse cases?

Answer 2

Private setting - without family
Use non-judgemental language
Is everything OK at home?
I’ve noticed you have some bruises on your neck, is everything OK?, you dont seem your usual self
Do you feel safe

Question 3

How can you validate someone in a domestic abuse case?

Answer 3

Take blame away from the victim
You don’t deserve to be hurt no matter what happened
I am concerned about your safety
Still do this even if pt denies abuse
Help to realise the seriousness of situation

Question 4

How can you document a domestic abuse case?

Answer 4

Be specific and detailed
Use pts own words
Name, location, witnesses that pt mentioned
Describe injuries in as much detail as possible - photographs if able

Question 5

How do you refer a domestic abuse case?

Answer 5

Scottish Domestic Abuse Helpline
Even if they dont seem keen - they may go away and think about it
Do not attempt to deal with issue yourself - pt needs to take action not you

Question 6

What is ARR?

Answer 6

The difference in risk between groups

Question 7

What is RR?

Answer 7

The ratio of the risk in each group

Question 8

What is NNT?

Answer 8

The number of pts you would need to treat to prevent one pt from developing the risk

Question 9

What is a 95% CI?

Answer 9

95 times out of 100 the CI will contain the true value in the entire population - can be determined for both ARR and RR

Question 10

What is a null hypothesis?

Answer 10

Claim that the effect being studied does not exist

Question 11

What do the CI need to overlap to prove the intervention and control risk are the same?

Answer 11

ARR - overlaps 0
RR - overlaps 1

Question 12

How can you comment on a CI range?

Answer 12

A narrow range means the study is more representative of the true population

Question 13

What are the types of studies?

Answer 13

RCT - prospective
Cohort study - prospective
Case-control - respective
Cross-sectional - one single point of time

Question 14

What are the criteria for a good RCT?

Answer 14

Blinding
Inclusion/exclusion criteria
Randomisation
Control

Question 15

What should the setting be like when breaking bad news?

Answer 15

Sitting down at same level
Try to make them as comfortable as possible
Ensure pt knows what appt is for

Question 17

What info should you give a pt when breaking bad news?

Answer 17

Inform you want to discuss prognosis of tooth - ask them if they want to discuss
Give warning shot
Give them knowledge that you know
Let it sink in and let them dictate pace of conversation
Give them chance to ask questions
Repeat news and summarise what you’ve told them and what plan is
Give immediate options and permanent options
Offer follow up appt and phone number

Question 18

How should you start a conversation with a nurse who has been doing bad things?

Answer 18

Introduce yourself
Do you have a minute to talk?
Find facts of a situation - what, where, how
Ask for their account
Allow the nurse to reply to the accusation

Question 19

How can you explain to a nurse what they were doing is wrong?

Answer 19

Explain why it looks bad
Quote GDC standards
I know it may have been misjudged but unfortunately it’s unacceptable to do this
Not providing the public with confidence in you

Question 20

What options can you give to a nurse who has done something wrong?

Answer 20

What’s in the pts best interest
If there is a social media post - delete
Apologise to pt - practice can contact pt to ideally attend for a formal apology
Inform nurse that this shouldn’t happen again
Ask if they would be willing to undertake training on this matter, if problem repeats get advice from someone more senior - defence union, VT trainer
Document conversation

Question 21

What are the steps to responding to a complaint?

Answer 21

Take concerns seriously - answer questions
Acknowledge anger and apologise that they feel this way
Offer practical help
Make an apology, explain how it happened and express remorse
Ensure amends
If satisfactory then complaint closed

Question 22

What is the NHS complaints procedure?

Answer 22

Acknowledge complaint and provide pt with practice complaint procedure
Inform dental defence if you need advice
Inform pt of timescales and stages involved
Acknowledge complaint in writing, by email or by telephone as soon as you receive it
Early resolution 5 working days - straightforward issues
Investigation 20 working days - complex or high risk issues
Independent external review ombudsman for issues that have not been resolved

Question 23

What are the steps of smoking cessation?

Answer 23

Ask
Advise
Assess
Assist
Refer

Question 24

What should you ask in smoking cessation?

Answer 24

Do you smoke
What do you smoke
How long
How many a day
Would you be interested in trying to quit

Question 25

What should you advise about smoking

Answer 25

General health problems - cancers - heart, lung, heart disease, stroke, COPD Oral health problems - risk of tooth loss, reduced ability to heal, staining, gum disease, oral cancer Four times more likely to quit with help

Question 27

How can you assess smoking cessation?

Answer 27

Ask about motivations to quit Have you tried to quit in the past What worked in the past and what didn’t

Question 28

How can you assist in smoking cessation?

Answer 28

Would you like help from the local stop smoking services Evidence based advice - NRT can help with: - champix medication - patches - e-cigarettes

Question 29

What info can you give to pts on e-cigarettes?

Answer 29

New - dont fully know side effects Respiratory effects of fluid in lungs Likely less harmful than tobacco Dont vape around children Maintains habit and culture of smoking

Question 30

How can you refer to smoking cessation?

Answer 30

Pharmacy GP Self referral to quit your way or visit NHS24 staff are trained Offer written material Arrange follow up

Question 31

How should you explain BBV risk to the nurse then the pt

Answer 31

Risk of transmission of a BBV eg HIV, low risk 1:300 To pt - risk is to the nurse and not the pt

Question 32

How can you explain the standard procedure for managing sharps injuries which is applied to all pts?

Answer 32

Requirement for a source blood sample and clarify that this is a universal process applied to all pts Sensitively request to the pt that they get a blood sample Make it clear that there is no pressure to agree

Question 33

How should you review a medical history for a BBV blood test?

Answer 33

Have your ever been diagnosed with HIV, HepB, HepC Have you ever injected drugs, had sex with someone who has Had sex with another man Had sex with someone outside the UK Had a blood transfusion Received dental tx in another country From another country Had a tattoo/piercing done by an unlicensed artist in the UK/artist outside the UK Yes to any of these indicate high risk

Question 34

How can you confirm consent for a pt for BBV blood tests?

Answer 34

Establish that pt understands options Give opportunities to ask questions Confirm pts decision - giving bloods Yes or No