a UNIT PREPARATION PROFICIENCY PERFORMANCE EXAM ~ Competency: Prepare Unit Competency: Follow infection control guidelines Competency: Assess own performance for quality and improvement : Heather Vanolwoi lt Clinic 1 80% needed Nam * Failure of starred item/critical errors results in automatic failure of proficiency. Instructor: | Jiat_ 2 Acceptable 1 Needs Improvement 0 Unacceptable I. Preparation Criteria: A 1 U Explain rationale for asepsis/infection control to instructor® |__(2 Flushes sink faucet for 2 minutes @ 1 0 Puts on mask, safety glasses, clinic coat, washes hands, @ puts on gloves*: Z I_Operatory Set Up 7 Wipe down dental chairs, counters, dental unit, water bottle with 1 0 appropriate disinfectant/ let sit for 10min f Fills water reservoir / turns on master switches: 1 0 Flushes water lines for 30 seconds 1 0 Applies disposable barriers/head rest cover ) 1 0 "Removes gloves, washes hands* e} Ill. Cassette/Handpiece Set Up Criteria: f A T U Completes yellow card/ Retrieves cassette/handpiece from ey) 1 0 dispensary/places on dental cart Wash hands/puts on gloves* (2 ‘Sets up counter with disposable items / instrument cassette (2 4 0 ‘Assembles handpiece-checks for function (2) 2 0 ‘Assembles air/water syringe tip, suction tip & checks for @ 1 0 function £ Positions chair for ease of entrance 2 4 0 Uses over gloves to access non-sterile” @ IV. Self Assessment ‘Completed Z és No. ‘Student completes self assessment Discusses assessment with instructor* 30 100_% 30 Instructor Comments: Unit Prep