PERS 1.1.

a Preparing and Maintaining the Clinical Area

1. Clinical area details:

Guidance Notes:
Students should state the procedure to be carried out.
Students should detail the clinical area, the equipment switched on, and the preparation of the area for the
procedure.
Students should state the particular instruments and materials (where relevant) set out, as well as the relevant
patient records
PROCEDURE TO BE CARRIED OUT: Restorative procedure for amalgam filling on the Upper Left
6 misial-occlusal.
TYPE OF PRACTICE: Mixed NHS and Private dental practice.
AGE AND GENDER: 54 years old male.
MEDICAL HISTORY: fit and well, no allergies, no prescribed medications
SOCIAL HISTORY: smoker- 10 cigarettes a day; 2-3 units of alcohol a week
CONSENT: Written signature
MEDICAL RECORDS: Patient medical history was checked and made sure that it was up to date,
the patient’s dental chart, also the radiographs were available on the computer for the dentist.
EQUIPMENT SWITCHED ON: The lights, dental chair, compressor unit, computer, X-ray
machine, suction pump, light cure, amalgamator, autoclave-which was filled with distillated
water and TST place in the firs sickle in the morning without instruments to check sterilization
process and recorded in the dated log book. Ultrasonic bath was filled with enzymatic solution and
degas process was started, water distillation unit and ventilation also switched on.
Patient was provided with protective eyewear and a bib.
PPE for the Dentist- uniform, visor, disposable gloves and mask.
PPE for the nurse (myself)– uniform, closed toe shoes, visor, apron, disposable gloves and mask.
INSTRUMENTS: On the tray prepared disposable tray liner, exam kit- mouth mirror, right-angel
prob, BPE prob, tweezers, disposable 3 in1 tip, spoon excavator, plugger, ball burnisher, amalgam
carver, flat plastic, amalgam carrier with amalgam well, matrix band, wooden wedge, high and
slow handpiece, with relevant burs and aspirating syringe.
MATERIALS: LA cartridge was 2% lidocaine hydrochloride and adrenalin(epinephrine)
1:800000, batch number-B228446AB and expiry date- 06/2020, LA long-35mm needle 25-gauge
thickness, cotton rolls, articulating paper, floss, calcium hydroxide lining, amalgam capsule,
disposable aspiration tip and disposable saliva ejector.
PREPARING OF THE SURGERY: Prior to starting I confirmed the procedure with the dentist.
Washed my hands in compliance with HTM 01-05, place PPE- mask, visor, apron and gloves.
Disinfected all working surfaces: chair, control buttons, bracket table, light handles, light, spittoon,
x-ray, computer, cupboards, amalgamator with viricidal disinfectant in compliance with HTM01-05
and paper towels. Flashed the lines through with distilled water for 30seconds to make sure the
suctions were working, and the tubes were clean. Afterwards removed PPE-gloves, apron, mask,
visor and disposed in the orange clinical waste and applied hand gel.
I discussed with the dentist prior to treatment that if he needs anything. I placed PPE- mask,
visor, apron, gloves followed recommendation of HTM 01-05 and set up for the procedure.
For this appointment I added disposable aspirating tip, disposable saliva ejector, fitted the
disposable 3 in 1tip, applied disposable plastic covert for armrest, light handle, head cover, all
couplets for fast and slow handpiece, 3 in 1and over the aspirator tubes, placed the disposable cup
with mildly antiseptic mouthwash tablet and water provided on the side of the chair. I set a box of
tissues available for the patient. In the clinical area I placed earlier a rigid container with a lid filled
with enzymatic solution available to collect the contaminated instruments at the end of the
procedure.
Then I laid the lined tray with the instruments on the bracket table, connected the fast and slow
handpieces, unassembled syringe, needle, lidocaine 2% LA cartridge.
On the nurse’s side I have the materials that I will be passing on the dentist request to carry out the procedure:
plastic amalgam carrier, amalgam well and amalgam capsule. I also have box of gloves, visor and mask ready.
On the dentist side I made available a box of gloves, visor and mask. I checked the medical history form for the
patient and made sure that it was up to date and available for the dentist on the computer. I also made sure that there
was a patient signed treatment plan for the consent gained for this treatment.
I greeted the patient politely and told him to take a seat. Then I gave the patient protective eyewear and a bib.

2. Details of how clinical area managed after procedure:

Guidance Notes:
Students should explain how instruments, sharps, equipment, surfaces were decontaminated and sterilised after the
procedure.
Students should give details of all relevant waste disposal techniques used.
When the procedure was completed, I took the bib and protective eyewear off the patient, then I started the
cleaning process to make the surgery ready for the next appointment. First removed the PPE-mask, gloves and visor
and rub hand gal. Place new PPE-mask, visor and gloves and stared by wiped the eyewear with virucidal
disinfectant spray and paper towel and put the bib in the clinical bin. Detached all the disposable tips, collected the
disposable cup and dispose into the hazardous waste bin in compliance with HTM 07-01. Collected all the
contaminated instruments on the tray from the bracket table, moved them to the clinical area and place in the
container and put the lid on. All sharps disassembled and placed in the sharps bin by the dentist- cartridge, needle,
single use rose head burs and matrix band. All other clinical waste which was not reusable such as cotton rolls,
articulating paper, floss is collected and placed by myself in the clinical waste bin. Placed the use amalgam capsule
in the special amalgam capsule tub. Afterwards changed PPE-gloves, mask, visor and disposed in the clinical waist,
put a new PPE- gloves, visor and mask and disinfected all the surfaces, chair, bracket table, lights, lights handles
and spittoon with virucidel disinfectant in compliance with HTM 01-05. I also ran water through water lines for
30seconds. Remove PPE-mask, gloves, visor, and disposed to the clinical waste bin and washed my hands in
compliance with NICE guidelines CG139. New clean gloves are worn in order to carry the dirty container to the
decontamination room prior to sterilization process. Before starting gloves are removed and disposed in the clinical
waste and applied hand gel, new PPE- mask, visor, plastic apron and a heavy-duty gloves are put on.
Firstly, wiped the handpieces with non-alcoholic wipe and lubricated according to the manufacturer’s
instructions and put on the tray. Scrubbed the instruments in the washing sink at the dirty area, whit a long
handle nylon-bristled brush, under water with non-foaming detergent. Also, unscrewed the amalgam carrier.
Measure the temperature which was under 45C.Fully drained instruments before rinsing with
distillated water in a rinsing sink. Dried the instruments with paper towel . Placed them in the cleaner
basket in a single layer at the correct temperature of under 45C in ultrasonic bath. Which was filled early with
water and enzymatic solution. The timer was set according to the manufacturer’s instructions- 10 to 15 minutes, the
lid closed to prevent aerosol contamination and program started. When finished, basket was lifted and allowed to
drain, then the instruments were put in the rinsed sink and rinsed with distillated water. I also verified the
instruments under the magnifier glass to make sure they were completely clean, without debris or organic waste.
Next step was to laid instruments on the tray with piece of autoclave tap in a single layer. Changed the heavy-duty
gloves with disposable gloves and place instruments in the “N” type autoclave- heated to 134 C, and holds for
3.15min at 2.25 bar pressure. I disposed PPE-gloves, visor, apron, mask in the orange hazardous waste. Washed
hands with water and hand detergent in the washbasin and dried them with paper tissue.
When the autoclave cycle finished, I removed the tray from the autoclave while wearing clean PPE-mask, gloves,
visor in the clean zone in the decontaminated room. Laid them and covered with clean single used cloth. I ensure
that their sterility is maintained until they are required for the next use. When they become cool, dried them using a
single use cloth. Afterwards placed the different instruments in a sealed view pouches and stamped them with
today’s date and the expire date which will be in 12 months’ time. Place the pouched instruments in a clean
container. Removed the PPE-mask, gloves, visor and disposed in the clinical bin. After that the instruments were
place in the drawers in the surgery workplace.

I followed the practice guidelines.

3. Reflective Account:

Guidance Notes:
Students should identify their strengths and weaknesses during the procedure and describe any action they would
take to address weaknesses in the future, if required.
My strength in this appointment was that I was well prepared and had the all the equipment
needed on the Dentist request.
My weakness in this appointment was that I didn’t said “Hi” to the patient. In the future I will
be more polite with the patients.

Surgery Preparation:
Student turned on all equipment required for the procedure:
Student donned appropriate PPE (gloves, mask, eye protection, appropriate clinical dress):
Student cleaned work surface using viricidal disinfectant or detergent solution:
Student flushed through all water lines:
Student applied disposable covers to required areas of the dental surgery e.g. light handles, control panel etc:
Student made all required patient records and radiographs available:
Identify the planned procedure and confirm with the clinician:
Student prepared all instruments, materials and equipment required for the procedure in their order of use:

Clearing Away:
Student removed all sharps safely from the clinical area:
Student disposed of all sharps appropriately:
Student disposed of clinical waste appropriately:
Student disposed of special waste appropriately:
Student transferred dirty instruments to the decontamination zone safely:
Student carried out effective instrument decontamination procedures:
Student carried out effective decontamination procedures on the surgery equipment e.g. work surface, dental cha
Student carried out procedure with consideration for the patient’s condition e.g. latex allergy:

Professionalism:
Student demonstrated professionalism throughout the procedure:
Student demonstrated effective team working throughout the procedure:
Student demonstrated effective clinical decision making throughout the procedure:
Student managed themselves and the clinical environment in line with current standards and guidelines:
I ensure that their sterility is maintained until they are required for the next use.