Professional Standards of a Dental Nurse

Objectives

▪ Have an awareness of how patients are protected from your actions

▪ Recognise how to keep records safe
▪ Define whistleblowing

Introduction

This section looks at the GDC standards and other regulatory bodies which apply to
you as a dental nurse.
Topics;

▪ Consent ▪ Complaints ▪ Indemnity

▪ Confidentiality ▪ Grievances and ▪ Training

whistleblowing
▪ Record keeping and ▪ Safeguarding ▪ CPD
data protection

Consent
Consent is the act of giving permission for someone to do something.
Points include:
▪ Decisions must be made by the person themselves. Staff, friends or family
must not influenced decisions (voluntary).
▪ A person must be given all of the benefits and risks, what treatment will
involve, and if there are alternative treatments available (informed).

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 ▪ A patient has the right to withdraw consent at any time. They can ask for
treatment to be stopped during a procedure or refuse treatment altogether
(the risks of which must be explained). Steps should be taken to ensure
consent remains valid over a course of treatment (valid).
▪ The person must understand the information provided (have the ability or
‘capacity’) using it to make an informed decision. A patient may lack capacity
if they are a child (that has not been deemed Gillick competent) or if they are
proven not to have capacity under the Mental Capacity Act (2005) which
prevents them;
- Understanding information
- Remembering information
- Weighing up information
- Communicating their decision
Useful links:
http://www.gdc-uk.org/Pages/default.aspx
http://www.cqc.org.uk/
https://www.gov.uk/government/collections/mental-capacity-act-making-decisions

Confidentiality
A set of rules that limits access/ places restrictions on information. Examples of
personal data that must be kept confidential include the patients name, address and
date of birth (all things that could identify a person against their wishes). Examples of
sensitive data includes information such as; political beliefs, mental health status and
criminal records. Steps are taken within the dental practice to ensure this information
is kept safe. These fall under the Data Protection Act 2018 and the Caldecott Principals
should be applied.

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Record Keeping and Data Protection
▪ Patients have a legal right of access to their records (Access to Health Records
Act).
▪ Data Protection Act 2018; all dentists must register if keeping computer
records (This version of the act supersedes the 1998 act.)
▪ GDPR - Since 2018 the General Data Protection Regulation (GDPR) has been
applicable across the EU. In the UK, it is incorporated into the Data Protection
Act 2018, strengthening the Data Protection Act 1998.
▪ Consumer Protection Act; Patient records must be retained for 11 years (or
until age of 25 – whichever is longer). All drugs and materials used on patient
must also be recorded.
▪ As a dental Nurse you are expected to use passwords for computers and
destroy paperwork no longer needed in the correct way (shredding).

Useful links:
https://www.gov.uk/data-protection/the-data-protection-act
http://www.medicalprotection.org/uk/resources/factsheets/england/england-
factsheets/uk-eng-access-to-health-records
https://www.gov.uk/make-a-freedom-of-information-request

Complaints
An expression of dissatisfaction by a person or their representative, about a service or
treatment (whether justified or not).
Types include;
▪ Customer service
▪ Clinical complaint
▪ Internal/ external complaint
▪ Child complaint/vulnerable adult (safeguarding)
A dental service provider has a duty to respond, investigate (informing patients of the
results) and take appropriate actions to ensure mistakes are not repeated. A

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complaint may be given in writing or verbally- however both should be treated the
same. A policy must be on display in the practice for both internal and external
complaints procedures.

As a dental nurse you are expected to take accurate notes- if a patient makes a
complaint about treatment it may be used as evidence during investigation.

Grievance and Whistleblowing

The GDC states that ‘If you believe that patients might be at risk because of your
health, behaviour or professional performance, or that of a colleague, or because of
any aspect of the clinical environment, you should take action’.

Your duty as a dental nurse is to:

▪ Raise any concerns you have which override any personal/ professional
loyalties.
▪ Try and raise concerns locally first. Grievances are concerns, problems or
complaints that employees raise with their employer. Raising a concern is
different from making a complaint; when someone makes a complaint, they
may be expected to prove their case. When you raise a concern, you should
not be expected to prove the malpractice you are concerned about.
▪ Contact the GDC (or other external organisation) if you can’t, or if you have
already raised a concern locally and nothing has been done about it. This is
known as ‘whistleblowing’.

Safeguarding
Safeguarding is the act of protecting vulnerable people from harm (from sexual,
physical, neglect or emotional abuse).

Vulnerable people are categorised as;

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 ▪ Children; Under 18’s are assumed to lack mental capacity and must prove they
have capacity to be treated as an adult (Gillick competency). Laws such as the
Children’s Rights Act protect their individual needs.
▪ Adults; Assumed to have capacity unless it is proven otherwise (covered by the
Mental Capacity Act 2005). Examples of patients that may lack capacity include
those with brain injuries or that have suffered a stroke.

To reduce the risk of patients being harmed there are a number of practice policies in
place to meet safeguarding laws. Acts relating to safeguarding include:
▪ Rehabilitation of Offenders Act 1974
▪ Children’s Act 1989
▪ Human Rights Act 1998
▪ United Nation Convention on the Rights of a Child
▪ Education Act 2002
▪ Sexual Offences Act 2003
▪ Children’s Act 2004
▪ Safeguarding Vulnerable Groups Act 2006
▪ Safeguarding Children and Safer Recruitment in Education - Every Child
Matters 2007
The CQC focus on patient safety and one requirement is for staff to undergo a DBS
check (to ensure staff are safe to work with vulnerable people).
http://www.cpdt.org.uk/

Indemnity
Until recently this has been an ethical issue (suggestion only). It allows patients to
claim compensation if there is sufficient reason. This has now become mandatory for
all DCPs and GDPs. As a result, GDC registration will not be permitted without it. Since
August 2015, new registrants must prove they have sufficient indemnity. It is advisable
that this is made on a personal basis, as you may not know if an employer’s indemnity:
▪ Cover automatically runs over form year to year

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 ▪ Covers you at a basic level only
▪ Has even been implemented

Dental nurses are advised to look at joining the British Association of Dental Nurses:
http://badn.org.uk/
http://badn.org.uk/badn-statement-on-indemnity
http://www.dentallaw.co.uk/

Training
In-house (covers specific aspects local to your practice as well as national guidelines,
carried out by work colleagues):
▪ Induction - Should occur in the first week of employment and include things
like where the fire exits are located.
▪ Training log - A record of your training, shows compliance
▪ Staff handbook - Sets out expectations
▪ Meetings - Used to update procedures and inform of any changes
▪ Policies and Procedures - Lays out expectations
▪ Performance reviews - A chance to give an individual feedback
External (covers underpinning knowledge, skills and theory in formal settings):
▪ ADDN - NVQ
▪ NDDN - NEBDN

Both achieve the same status; registered dental nurse. Please refer to week 1 to look
over your course guidelines. Alternatively if you wish to learn more, please visit:
http://nebdn.org/
http://www.cityandguilds.com/qualifications-and-apprenticeships/health-and-
social-care/dental-nursing/4234-dental-nursing#tab=information

CPD
Continuing professional development is needed to maintain your status as a
registered professional. This is only required after registering with the GDC (and

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external training complete). A copy should be given to your workplace, however
maintaining these are your responsibility.
Dental nurses must undertake 50 hours of verifiable CPD for each 5 year cycle.
CPD activity should be relevant to your field(s) of practice and should relate to GDC
development outcomes(s).

The GDC have identified topics that are highly recommended:

▪ Medical emergencies - at least 10 hours in each CPD cycle
▪ Disinfection and decontamination - at least 5 hours in each CPD cycle
▪ Radiography and radiation protection - at least 5 hours in each CPD cycle

Recommended topics:
▪ Legal and ethical issues
▪ Complaints handling
▪ Oral cancer: early detection
▪ Safeguarding children and young people
▪ Safeguarding vulnerable adults

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