barbara e. dixon b.d.s., m.sc., d.p.d.s., p.g.cert.ed.. access has many advantages, however it has...

Barbara E. Dixon

B.D.S., M.Sc., D.P.D.S., P.G.Cert.Ed..

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*Direct Access has

many advantages,

however it has

opened up many

questions that as yet

have no answers

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• What are the rules?

• What are the pitfalls?

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I.C.R.P.

I.R.R. 1999

I.R.M.E. 2000

Radiological Standards in Primary Dental Healthcare

Selection Criteria for Dental Radiographers

Guidance notes for Dental Practitioners

On the safe use of x-ray Equipment

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• Justification

• Optimisation

• Limitation

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• Concerned principally with the

safety of workers and general

public

• Address equipment aspect of

patient safety

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• Concerned with patient safety • Define Legal Person-

• Employer-

• Practitioner -

• Operator.

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NO RADIOGRAPH SHOULD

BE TAKEN WITHOUT A FULL

EXAMINATION AND HISTORY

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Providing the person requesting the

radiograph complies with the mandates of

I.R.M.E. and has successfully completed

the extended duties course in Radiography,

the are deemed competent to request the

appropriate radiograph

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Do the regulations and

guidelines allow Therapists

and Hygienists to prescribe

radiographs ?

Referrers

The Referrer must be a registered

healthcare professional (a person who

is a member of a profession regulated

by a body mentioned in section 25(3)

of the National Health Service Reform

and Health Care Professions Act 2002).

Decisions on who is entitled to act as a

referrer should be taken at local level

Practitioners • The Practitioner must be a registered healthcare professional (i.e.

a person who is a member of a profession regulated by a body

mentioned in section 25(3) of the National Health Service Reform

and Health Care Professions Act 2002).

• The practitioner must be entitled by the Employer and may be

based on the type of medical exposure/radiotherapy treatment

and on specific circumstances.

• It may be appropriate to agree that certain non-medical health

professionals can act as a practitioner for diagnostic/radiotherapy

procedures depending upon the complexity of the

examination/treatment.

• The primary responsibility of the practitioner is to justify medical

exposures

Operators • The operator does not have to be a registered

healthcare professional but is required to be

adequately trained for their scope of practice as

detailed in Schedule 2 of the Regulations.

• The definition of operator is stated in IR(ME)R as

‘any person who is entitled, in accordance with

the Employer’s procedures, to carry out practical

aspects of radiography

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• the referrer is normally a dental

practitioner

• from January 2001 it is not

permissible for a DCP to act as a

referrer

Additional skills which dental therapists could develop include:-

• administering inhalational sedation

• varying the detail of a prescription but not the direction of a

prescription

• prescribing radiographs

• carrying out tooth whitening to the prescription of a dentist

• removing sutures after the wound has been checked by a dentist

Dental therapists do not carry out a patient’s initial

diagnosis or take overall responsibility for planning a

patient’s treatment.

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The Ionising Radiation (Medical Exposure) Regulations 2000 or IR(ME)R

recognise some professions as operators (i.e. as being able to take

radiographs) and some as prescribers. Dental hygienists and dental

therapists are recognised as operators but not as prescribers.

The GDC considers that prescribing radiographs is an appropriate additional

skill for hygienists and therapists but, at present, the dentist remains the

only member of the dental team who can prescribe radiographs.

THE JURY IS STILL OUT!