nhs education for scotland portal - gms h&s day 1-all pps · 2017. 3. 7. · quality education...

07/03/2017

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Quality Education for a Healthier Scotland

Managing Health & Safety in a Dental EnvironmentUnit Code - H8P9 35

Stacy O’DonoghueClaire Marshall

June James


Contact DetailsStacy O’DonoghueDental Tutor

NHS Education for Scotland2 Central Quay

89 Hydepark StreetGlasgowG3 8BW

Work: 0141 531 2603

Email: [email protected](Mondays and Wednesdays)


Contact DetailsJune JamesDental Tutor



Work: 0141 5312657

Email: [email protected](Wednesdays, Thursdays and alternate Fridays)


Contact DetailsClaire MarshallDental Tutor



Work: 0141 5312646

Email: [email protected](Monday-Thursday)


Unit Purpose

This unit is designed to meet the range of skills required of learners who are obligated to manage Health & Safety in a

dental environment. The unit will provide learners with knowledge of the current policies and legislation relating to

Health & Safety, including infection control, in a dental environment.


Learning Outcomes

On completion of the unit, candidates will be able to:

� Develop and maintain individual and organisational competence in Health & Safety.

� Determine and implement Health & Safety risk control measures.

� Monitor, review and audit the Health & Safety policy and Infection Control policy.

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Course Outline

Day 1� Administration� Introduction to Unit H8P9 35

� Legislation and Guidance� Hazards, safe systems and

risk assessments� CPD requirements

� Audit and SEA� Infection Control

Day 2� Roles and Responsibilities � Quality Assurance and Quality

Improvement� Policy/Regulatory Framework

� Reflective Practice


Unit Assessment Method

• All outcomes assessed by completion of one report.

• 1500 - 2000 words.

• Completion of 3 risk assessments and 3 audits (in as appendices).

• Completion of Competence Sheet signed by GDC Registrant.

• Report submission by 3rd May 2017


Outcome One -Developing

• Outline individual and organisational responsibilities under the Management of Health and Safety at Work regulations.

• Analyse functions, activities and tasks within the dental environment in order to develop and implement risk assessments.

• Monitor and review procedures in order to identify deficiencies.

• Implement improvements to policy and procedures.


This section of the report should include the current practices that you and your colleagues within your workplace adhere to. You should identify 3 areas for improvement within the workplace regarding Health & Safety and Infection Control and carry out risk assessments for each of these. Suggestions for improvements should be implemented.

• Arial font, size 12, and double spacing should be used.

• States the sources of references.

• Word Count should be approx. 750 words.


Outcome Two -Implementing

• Implement risk control measures.

• Evaluate the effectiveness of risk control systems.

• Suggest improvements to policy and procedures.

• Act in accordance with legislation and GDC policy and guidance.


This section of the report should include how you implement the risk control measures from your own assessment of the deficits and if they made a difference to your workplace. Think about the potential improvements that could be made to how your workplace carries out certain procedures or any adaptation to policies.




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Outcome Three -Monitoring

• Evaluate their own role and the roles of key people in their organization or workplace.

• Explain the key principles of quality assurance and quality improvement.

• Carry out an internal audit of health & safety and infection control procedures and provide examples of managing three operational procedures in relation to health and safety and infection control. An explanation of the legislation, policies and any guidance, which relates to these must be included.


This section requires the candidate to provide an evaluation and review of the risk assessments. This includes evaluation of the effectiveness of the risk control measures applied and reflection on your own/others practice. Three separate audits should be carried out to show effectiveness/ineffectiveness of the changes made and the candidate should discuss the reasons for this.





Reflective Writing• Reflective writing is evidence of reflective thinking. In an

academic context, reflective thinking usually involves:

• 1. Reviewing something (usually an event, i.e. something that happened, but it can be an idea or object)

• 2. Analysing the event or idea (thinking in depth and from different perspectives, and trying to explain, often with reference to a model or theory from your subject)

• 3. Consider what the event or idea means for you and your ongoing progress as a learner and/or practising professional


Reflective WritingStructure for reflective writing: description, interpretation and outcome

1. Description� What happened? � What is being examined?

2. Interpretation� What were you thinking?� What were you feeling?

3. Outcome � What have I learned from this?� What does this mean for my future?

Reflection is an exploration and explanation of events and not just a description of them.


Referencing• Referencing enable your readers to look up the exact sources that you have cited in your piece of

work therefore you need to give accurate information including:

• The name or title of the item• The type of item

• Who produced it• The date it was produced

• Where you found it

• Identify as much information as possible , by placing these elements in the right order and relevant format the reader will be able to locate the source you used.

• Everything you have cited in the text of your work, for example journal articles, web pages, podcasts etc. should be listed in alphabetical order at the end.


Referencing in the TextIf the author’s name occurs naturally in the sentence put the year the work was published in brackets:

� “In a recent study Hughes (2002) asserted that….”

� “A recent study (Hughes, 2002) shows that…”

� Two authors “Hughes and Browning (2002) suggested that…”

� More than two authors “Hughes et al (2003) argued that……”

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Referencing in the TextIf you quote an author directly in the text: use quotation marks, give

the author’s name, year of publication and the page number:

According to Hughes (2002:53) staff development programmes “…should be informed by the future directi on and culture of the institution”

The …. at the beginning of the quote means I have left out some of that sentence.

The full quote is on page 53 of the text.


Referencing a Website

When referring to a website in the text avoid the urge to include the URL.

The URL should be included in the references page.

All that is needed in the text is enough information to find it on the references page such as author and date or source. eg: University of Surrey (no date)


Forming an Appendix

An appendix (one item) OR appendices (more than one item) is information that is NOT ESSENTIAL to explain your findings in the essay or report that you have written. However, this information may support

your analysis and validate your conclusions.Appendices are not included in your word count.

https://youtu.be/oqWjRr9MCTE



Outcome 1

Develop and maintain individual and organisational competence in Health

and Safety


Outcome 1

• Legislation and related statutory requirements

• Common hazards • Risk assessments (RA)• Significant event Analysis (SEA)

• Audit

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Relevant Legislation and Guidance

• Health and Safety at Work Act

• Management of Health and Safety at Work Regulations

• Control of Substances Hazardous to Health (COSHH)

• Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995

• Working Time Regulations

• Equality Act (2010)


Health and Safety at Work Act

• The Health and Safety at Work Act (HSWA) 1974 controls workplace health, safety and welfare. The purpose of the act is to prevent injury or illness because of a workplace or a workplace activity

• Employers and employees have a “duty of care” to protect the health and safety of others at the workplace


Health and Safety at Work Act Employer

Responsible for providing safe work environment, providing safe equipment and training

Employee Obey health and safety policy, use equipment safely and wear provided PPE.

Be aware of others safety. Good role model, report any issues

A written policyis required when there are more than 5 employees. It should include: a

statement of intention to provide a safe workplace, details of how this would be achieved and the persons responsible

Inspectorshave the right to inspect the practice at any time


(COSHH)Control of Substances Hazardous of Health

Regulations


(RIDDOR)Reporting of Injuries,

Diseases and Dangerous Occurrences Regulations 2013


Working Time Regulations

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Equality Act


Risk Assessment


Group work

Why do we risk assess?

Discuss and feedback to group


Risk Assessment termsHazard –� Potential source of injury, ill health or disease� Hazards are obvious eg. sharps injury, others are not, eg.

exposure to radiation

Risk –� The possibility that the hazard will cause ill health or injury� eg. The risk associated with a sharps injury is determined by

the exposure to the patients’ blood or body fluid

Exposure –� Risk to health increases with the severity and exposure to the

hazard. eg. exposure to any form of radiation can be dangerous


Group work

Discuss the potential risks you may encounter within your own dental environment


What are the hazards?

Who might be harmed and how?

What are you already doing? Do you need to do anything else to control this risk?

Action by who?

Action by when?

Completed

Slips and trips Staff and visitors may be injured if they trip over objects or slip on spillages.

General good housekeeping is carried out.

All areas well lit, including stairs.

No trailing leads or cables.

Staff keep work areas clear, eg. No boxes left in walkways, deliveries stored immediately.

Better housekeeping in staff kitchen needed, egon spills.

Arrange for loose carpet tile on second floor to be repaired/replaced.

All staff, supervisor to monitorManager

From now onxx/xx/xx

xx/xx/xxxx/xx/xx

HSE Sample Risk Assessment

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Quality Education for a Healthier Scotland Quality Education for a Healthier Scotland

Group work

Complete a risk assessment related to working within your own specialist dental department


Significant Event Analysis

SEA


What is SEA ?

"It is an event thought by anyone in the dental team to be significant in the care of patients

or the conduct of the practice."


Why do we use SEA ?• Highlight a significant incident and how it contribute to

the practice.• Identify what the dental team do well / there is

room for improvement • Discuss an event and each individuals role in it.• Identify training needs / necessary changes.• Enhance patient safety.


A Successful SEA

• Identify the event• Collect information• Discuss event• Implement changes

• Monitor progress• Submit the report

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Report Format

• What happened?

• Why did it happen?

• What has been learned?

• What has been changed?


Audit


Audit

• What is an Audit?

• Why is it important?


Conducting an Audit

• Needs careful planning

• What are you trying to achieve?

• What data should be collected?

• How can the data be collected?

• Are there resources available?

• Does it have the potential to result in change?


Selecting a Topic

Make sure it is important and relevant to your practice

Health and Safety&

Infection Control


Aims and Objectives

Aims• Will define the overall purpose of the audit• Have to be specific- H&S and IC

Objectives• Are the specific outcomes you are seeking from

the audit• Achievable and realistic

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Criteria and Standards

Criteria• Factors that will be measuredi.e PPE - are all staff wear suitable PPE

Standards• Having a benchmark to compare against

• Defined by the number of times the criteria is met


Important factors to conside r

• Is the data retrospective or prospective• Sample size• Relevant data• Start and finish dates• Confidentiality• Design the data collection tool


What now?

• Proposed recommendations made

• Actions plans are produced

• Budget limitations/ timescale/ staffing

• Agree on review dates



Outcome 2

Determine and implement H&S Decontamination risk control measures


Learning outcomes –

• Identify modes of infection and cross infection

• Describe the Standard Infection Control Precautions (SICP’s)

• Define and evaluate the process of effective decontamination measures

• Discuss and implement risk control measures, Health Safety at Work Act and GDC guidelines

• Suggest improvements to policy and procedures

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Groupwork –

Discuss –• What is your role with regards to

decontamination?• Is the process fully effective?• Are there any areas that could be

improved?• Fully compliant?


Management and Responsibilities –In Your Practice

Title Who Responsibilities

Management e.g. Practice Principal •Ensures compliance with law

•Staff training

•Correct installation of equipment

•Documentation & Testing

User e.g. Practice Principal or Practice

Manager

•Day to day management of LDU

•Ensures equipment fit for purpose

•Staff training

Operator e.g. Dental Nurse, LDU Operative •Operation of LDU equipment

•Logging equipment readings

•Replenishing consumables

•Simple housekeeping


Risk control measures


Groupwork –

Discuss –

What risk control measures are there in relation to decontamination?


Risk control measures

*Compliance with legislation and guidance *

• SICP’s• Safe handling of sharps and disposal of waste• Flushing dental units• Training• Audit and risk assessments• Equipment testing


Considerations……

• Decontamination life cycle – minimum acceptable standards to be achieved at all stages

• Consideration given to –o Management of the processeso Workflowo Activity at each stageo Facilities and equipmento Validation maintenance and testingo Operation policies and procedureso Training of decontamination staff

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GROUPWORK –

What stops good practice??

Discuss in groups and list at least five reasons for this


What stops good

practice??

• Too busy

• Not enough time

• Cost implications

• Patient wasn’t ‘High Risk’

• Lack of knowledge

• No training given

• Poor motivation

• Bad habits


Safe systems of work in the dental environment


Standard Infection Control Precautions (SICP’s)

•Hand Hygiene•Personal Protective Equipment (PPE)•Occupational Exposure Management•Manage of Blood and Body Fluid Spillage•Manage Care Equipment•Control of the Environment•Safe Handling of Waste (including Sharps)•Safe Management of Linen•Patient Placement•Respiratory Hygiene / Cough Etiquette


The Special Waste Amendment (Scotland) Regulations 2004


Healthcare Waste Legal Requirements

� Safe storage� Trained staff� Waste disposal policy� Contract with Licensed Collector � Transfer notes - keep 2 years� Duty of Care

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Health and Safety (Sharp Instruments in Health) Regulations 2013


Safe Management of Sharps

• SAFE practice• Prompt disposal• Responsibility• Re-sheathing• Safe systems• Containers


Scottish Dental Clinical Effectiveness Programme Practice Support Manual

Managing Decontamination in Dental Practice (MDDP)


SDCEP

Decontamination Guidance


GDC CPD

• Disinfection and Decontamination

• Core Topic

• At least 5 hours in every 5 year cycle


Risk Assessment and Audit Suggestions

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Hand HygieneKey Points-

• Perform between every patient (at least)

• Plain non-antimicrobial liquid soap (washing)• Alcohol based hand rub

(hand hygiene) • Surgical scrub/rub• Remove watches, bracelets and rings• No decanting products


Why, What and How long?

Hand washing Hand rub Surgical scrub/rub

Render hands physically clean

Remove or destroy transient microbes

Remove transients and reduce residents

Non-antimicrobial liquid soap

Alcohol based hand rubs (ABHR)*

Antiseptic solution or alcohol based hand rub (ABHR)*

At least 15 seconds 20-30 seconds 2-3 minutes

*Licensed for that purpose


‘bare’ below the elbows!!


Personal Protective Equipment


Decontamination

Key (essential) Requirements:

• Transport boxes (identify dirty/clean)• Compliant LDU (facilities, equipment, process)• Dirty to clean workflow• Washer Disinfector(s) • Operation, loading and care of decontamination equipment• Management (testing, training, paperwork)• Sterile/Sterilised – ALL instruments

Never wrap instruments for non-vacuum sterilisers


Local Decontamination Unit (LDU)

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Discuss…..

� Any deficiencies in your decontamination processes

� Risk assessment� Audit ideas and potential for implementing

change� How can you achieve this?


nhs education for scotland portal - gms h&s day 1-all pps · 2017. 3. 7. · quality education...

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