Working together to achieve the healthiest
life possible for everyone in Ayrshire and Arran
Candidate
information pack
Visit our website: www.nhsaaa.net
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Post Title:
Dental Nurse – Oral Surgery
Job Reference Number:
N/336/15
Closing Date:
05/10/2015
Process for Submitting Application Form:
You can apply using the online application form on the SHOW website –
www.jobs.scot.nhs.uk Alternatively your completed application form can be
returned to Craig.Hannah@aapct.scot.nhs.uk or to the Department of O&HRD,
63A Lister Street, University Hospital Crosshouse, Kilmarnock, KA2 0BE
Please note: if applying using the online application facility on the SHOW
website, the text in the supporting statement section is limited and overlong
statements may be cut off. Please try to limit this section to the length of two
A4 pages.
Section one: Why work in Ayrshire?
Ayrshire is situated in the south-west of Scotland on the Firth of Clyde, and is
characterised by 80 miles of varied coastline, picturesque beaches, rolling green hills
and islands.
Just a 30-minute drive from Glasgow city centre, Ayrshire is an ideal location for
those who want to enjoy city life, with all the benefits of living in a semi-rural area.
Ayr, Irvine and Kilmarnock are the largest towns. However, there are many rural
towns, villages and communities throughout the area should you wish to relocate to
Ayrshire. Whether you decide to locate to Ayrshire or a neighbouring area, you will
find that property prices are more affordable than in other parts of the UK.
Local educational standards are very high at primary and secondary level. However,
private education is also available in the area. See below for more information on
local authority services:
East Ayrshire Council – www.east-ayrshire.gov.uk
North Ayrshire Council – www.north-ayrshire.gov.uk
South Ayrshire Council – www.south-ayrshire.gov.uk
Alternatively, working in Ayrshire provides an easy commute from both Glasgow and
the wider central belt. There is an excellent network of both rail and bus links
throughout Ayrshire to Glasgow and beyond. There are UK and international flights
available from Glasgow Airport, as well as a range of services from Glasgow
Prestwick Airport.
Ayrshire provides a wide range of excellent recreational activities: whether you are
interested in history and heritage, outdoor pursuits, events and festivals, or simply
food and drink, there is something for everyone.
Ayrshire boasts more than 40 quality golf courses, including two Open
Championship courses at Turnberry and Royal Troon.
For more information on the range of recreational activities in Ayrshire, visit
www.visitscotland.com
Section two: NHS Ayrshire & Arran as an employer
NHS Ayrshire & Arran recognises that our staff are vital to delivering our purpose,
values and commitments and to achieving our strategic objectives.
Our purpose
Working together to achieve the healthiest life
possible for everyone in Ayrshire and Arran
Our values
Caring
Safe
Respectful
Our aim is to create an organisation where people want to work and strive to deliver
excellence each day; where staff wellbeing and personal resilience is supported;
where careers are interesting and developed; where staff are encouraged to reach
their full potential; and where staff feel their contribution is recognised and valued.
To do this, we need to attract, develop, support and retain our staff and enhance
their work experience. This will directly contribute to our aspiration to deliver
excellent high quality services to every person every time.
We believe the unique factors that help to define us as an employer are:
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our friendly and supportive environment;
our commitment to staff engagement and effective team working;
our track record in creativity and innovation and our ability to successfully
implement change and redesign;
our track record in supporting our staff’s learning, development and career
aspirations, from an initial comprehensive three-day corporate induction
programme to the availability of a wide range of internal training programmes;
our commitment to supporting flexible working through a wide range of family
friendly policies; and
our commitment to support and improve our staff’s health, safety, wellbeing
and resilience. We do this by implementing our Staff Health, Safety and
Wellbeing Strategy, and in our work towards achieving and maintaining the
Health Working Lives Gold Award. In addition, our Staff Care and
Occupational Health Service provide a range of support and interventions to
our staff.
The organisation has a statutory responsibility to ensure the Staff Governance
Standard is embedded and adhered to as part of the governance framework –
staff, financial, information and clinical governance – in which NHS Boards
operate. The Staff Governance Standard requires all NHS Boards to
demonstrate that staff are:
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well informed;
appropriately trained and developed;
involved in decisions;
treated fairly and consistently, with dignity and respect in an environment
where diversity is valued; and
provided with a continuously improving and safe working environment,
promoting the health and wellbeing of staff, patients and the wider
community.
During 2013, we consulted with our staff to select the key values and behaviours
which they believed were essential to create a safe, effective and person-centred
working environment which benefits patients, staff and carers. This allowed us to
develop our purpose, values and commitments. We passionately believe in creating
a culture which is open, fair and just.
Section three: Delivering our services
Acute Services
Emergency and elective hospital services are provided by our acute services, which
includes inpatient, outpatient and day case care. There are two district general
hospitals within Ayrshire: University Hospital Ayr and University Hospital
Crosshouse. These hospitals provide a wide range of acute services:
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University Hospital Ayr
University Hospital Ayr provides medical and surgical services on an inpatient,
day case and outpatient basis. It is the main Accident and Emergency service
for South Ayrshire. It provides a number of Ayrshire-wide services including
Vascular Surgery, Ophthalmology and Audiology.
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University Hospital Crosshouse
University Hospital Crosshouse provides medical and surgical services on an
inpatient, day case and outpatient basis. It is the main Accident and
Emergency service for East and North Ayrshire. Inpatient paediatrics, the
Ayrshire Maternity Unit and the main Laboratories for Ayrshire are on the
Crosshouse site.
Community, mental health and learning disabilities services
Following the introduction of Health and Social Care Integration, the operational
delivery for the range of community healthcare services and mental health and
learning disabilities services is through the newly created Health and Social Care
Partnerships and the Integrated Joint Boards:
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East Ayrshire Health and Social Care Partnership
North Ayrshire Health and Social Care Partnership
South Ayrshire Health and Social Care Partnership
Community Services
General medical and dental services are provided throughout Ayrshire and Arran by
general practitioners, dentists, community pharmacies and optometry practices.
Community nurses, health visitors and Allied Health Professionals are all involved in
providing care within our local communities.
Out-of-hours general medical services are provided by Ayrshire Doctors On Call
(ADOC) within the community.
Mental health and learning disability services
Inpatient mental health services, including the Intensive Psychiatric Care Unit, are
largely delivered at Ailsa Hospital in Ayr with further mental health inpatient services
provided at University Hospital Crosshouse
Learning disability services are provided from Arrol Park in Ayr. Elderly mental
health inpatient services are provided from Ayrshire Central Hospital in Irvine, and
East Ayrshire Community Hospital in Cumnock. Community based services are
provided throughout Ayrshire for the range of clinical groups: adults, child and
adolescent, elderly and addiction services.
For more information on the full range of clinical services provided by NHS
Ayrshire & Arran, visit our website www.nhsaaa.net
Section four: Post Details
1. Job Identification
Job Title: Dental Nurse - Oral Surgery
Responsible to: Specialist Dentist in Oral Surgery
Department(s): Primary Care
Directorate: East Ayrshire Integrated Health and Social Care Partnership
Job Reference:
No of Job Holders: 2
Last Update: 29 May 2015
2. Job Purpose
To provide comprehensive clinical support to the clinician, assisting with oral surgery treatment
and providing pre and post treatment advice to patients and to those requiring IV sedation.
To provide care and emotional and physical support to patients throughout oral surgery
procedures.
To maintain Control Of Infection procedures in the dental surgery and local decontamination unit
including surgery fixtures and the decontamination and sterilisation of dental instruments.
To provide reception duties & administrative support to ensure the smooth running of the
service.
3. Dimensions
The provision of oral surgery services in the primary care setting is a new initiative being piloted
as part of the Integrated Care Fund. The pilot will initially be undertaken in North West
Kilmarnock Area Centre and will receive referrals from Oral Maxillo-facial Surgery (OMFS) in the
first instance. As the pilot progresses, there may be potential for GDPs to refer directly to the
oral surgery service.
North West Kilmarnock is one of three hubs for the Public Dental Service in Ayrshire & Arran
and also houses the Dental Outreach Teaching from the Glasgow Dental Hospital at the Teach
and Treat Centre.
Working with the Specialist Dentist in Oral Surgery the post holder will provide clinical and
administrative support for patients requiring oral surgery procedures.
The Specialist Dentist in Oral Surgery will also be involved in training General Dental
Practitioners in basic oral surgery techniques. The dentist undergoing training will have the
option of bringing their own dental nurse so the post holder may have a role in mentoring these
individuals.
Some of these patients may require their dental treatment carried out under inhalation/IV
sedation.
IV Sedation duties - The post holder will be required to provide additional clinical support to the
clinician during IV sedation sessions. This includes pre procedure health checks, clinical
monitoring of the patient throughout the procedure and preparation of IV sedation drugs for use
by the clinician.
4. Organisational Position
Associate Medical
Director (Primary
Care)
Clinical Director
(Public Dental
Services)
Dental
Services
Manager
Dental
Practice
Advisor
Specialist in
Oral Surgery
Dental Nurse
– Oral Surgery
Consultant in
Dental Public
Health
OMFS
5. Role of Department
Primary Care hosts Dental Services in Ayrshire & Arran including the General Dental Services
(GDS), Public Dental Service (PDS) and Hospital Dental Service. The PDS headed by a clinical
director and the GDS, under the clinical leadership of Dental Practice Advisor (DPA). The
specialist dentist will be line managed by the DPA. The nurse managed by the specialist dentist.
Due to the pilot setting being in North West Kilmarnock a good working relationship with the
PDS will have to be established.
6. Key Result Areas
Clinical Duties
The post holder will assist the clinician in the provision of oral surgery treatment in accordance
with the Standards of the General Dental Council & NHS Ayrshire and Arran organisational
policies.
Anticipate the requirements for the dental procedure and provide chair side assistance including
aspiration of the oral cavity & handling & preparation of dental instruments & materials safely in
accordance with manufacturer’s instructions. This will involve the manipulation of fine tools and
dental materials, with a need for a high level of accuracy.
Maintain support & care for the patient at all times during oral surgery treatment including pre
and post operatively ensuring that any relevant instructions are provided.
Assist the clinician in the provision of dental treatment and sedation for anxious patients under
sedation under supervision.
Assist the clinician in the production of radiographs as defined in IR(ME)R Regulations and local
working procedures. All dental nurses can carry out basic operator duties e.g. processing.
Radiography trained dental nurses may act as operator and carry out dental exposures under
written guidance from a practitioner i.e. the dentist.
Decontamination
Cleaning & preparation of dental surgery prior to and following treatment in accordance with the
organisation's Control of Infection & Health & Safety Policies.
Cleaning and maintenance of dental equipment including chair, spittoon, suction hoses and
filters etc.
Comply with HFS decontamination guidelines to ensure that all dental waterlines are disinfected
daily to prevent Bio-film build up.
Ensure all contaminated dental instruments are decontaminated (cleaned, disinfected and
sterilised) and properly maintained and stored. This may involve delivery of instruments to a
Local Decontamination Unit (LDU) for processing.
Reception and Administration
Undertake reception/escorting of patients attending for dental treatment whilst communicating in
a caring manner to reassure the patient.
Ensure valid consent, medical history, proof of exemption, adults with incapacity certificate has
been obtained for the patient.
Maintain patient records, dental chartings, filing system and input of data onto computer
software system in accordance with Data Protection and Patient Confidentiality Policy.
Completion of GP17 (dental payment forms) for auditing purposes including discretionary fees.
Maintain stock control and ordering of supplies from dental companies, area supplies and
pharmacy including drugs for emergency drug kits.
Dealing with patient complaints and/or escalating to appropriate clinician or manager.
7a. Equipment and Machinery
Care and Maintenance of Equipment
Maintain high standards of cleanliness and infection control procedures in all clinical and
decontamination areas in accordance with NHS Ayrshire and Arran Control of Infection and
Health and Safety policies.
Daily care and maintenance of all dental equipment including:
Cleaning and disinfection of surgery work surfaces and dental equipment at the start and finish
of each day and between each patient. This includes dental chair, bracket table, spittoon,
aspirator, operating light etc.
Daily cleaning and disinfection of spittoon and aspirator suction hoses including filters.
Daily cleaning and disinfection of dental waterlines.
Daily use of equipment including:
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Dental chair/unit/operating light
Aspirator
Dental instrumentation
X-ray developing machine
Use of portable wheelchair platform and bariatric bench
Equipment used for intravenous sedation:
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Blood pressure monitor/ sphygmomanometer – to record patient blood pressure pre and
post operatively.
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Pulse oximeter – to continuously monitor patient heart rate and oxygen levels throughout
the procedure.
Equipment used for inhalational sedation:
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Inhalational sedation machine – delivers sedation gases to patient.
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Scavenging machine – removes exhaled gases from patient.
Handling and disposing of hazardous substances/waste including sharps, clinical waste,
mercury, x-rays, x-ray chemicals, dental and cleaning materials in accordance with
organisational Health and Safety procedures.
Safe handling and transporting of used medical devices within clinics.
7b. Systems
Use of a computerised appointment system on Carestream Clinical Plus or similar dental
software system
Maintaining confidential patient information, dental chartings and treatment plans on
Carestream Clinical Plus dental software system.
Management of an appointment system.
PECOS –responsible for ordering of supplies on electronic stock ordering system stock
ordering/rotation and completion of non-stock requisitions, stock requisitions and pharmacy
orders on a monthly basis.
Datix – reporting of patient complaints /incidents / adverse events in accordance with Health
and Safety guidelines and escalating to appropriate person.
Reporting of faulty equipment
Telecommunication, security and alarm systems.
8. Assignment and Review of Work
The post holder will be assigned their duties by the Specialist Dentist in Oral Surgery.
Workload is generated from daily patient activity.
Review of work is measured against set objectives as agreed with line manager at Personal
Development & Performance Review meetings.
9. Decisions and Judgements
The post holder is expected to work autonomously within clinics without the immediate
supervision of a line manager.
The post holder acts as the second appropriately trained person during Intravenous
Sedation treatment as stated in GDC guidelines.
The post holder must record and understand observations pre-operatively of patients who are to
undergo intravenous sedation. Monitor the patient during the recovery period. Recognise when
the patient is safe for discharge according to clinical criteria and confirm this with the sedationist.
Use personal initiative to manage the appointment book, ensure that the length of appointment
is suitable to enable satisfactory completion of treatment, ensure that overall clinical time
is maximised and that other constraints are kept to a minimum.
Ability to adapt to changing circumstances during any procedure or to daily plans e.g.
change of treatment plan, patients cancelling or failing to attend appointments resulting in
re-scheduling appointments,
Analysis of impending surgical procedure and provision of appropriate instrumentation e.g.
setting out instruments for specific procedure plus any others which may be required due
to unexpected change of treatment plan .
Use of personal initiative to anticipate likely materials demands and maintain adequate stocks of
essential supplies for clinics.
The post holder must plan optimal use of clinical sessions and activity using their knowledge and
experience of the impact of the patient’s medical condition, social circumstances, psychological
condition and disability on the provision of clinical dental treatment.
The post holder must recognise where improvements can be made in the delivery of dental care
for patients and patients attending for IV sedation and propose changes to protocols and practices
10. Most Challenging/Difficult Parts of the Job
Ability to work well within a multi-surgery clinic: providing close clinical & administrative support
to the oral surgeon while simultaneously maintaining a professional and caring manner towards
patients, some of whom are very challenging and difficult to treat.
Ability to empathise with patients while at the same time being able to apply clinical detachment
in order to carry out sometimes unpleasant but still necessary treatment.
11. Communications and Relationships
The post holder is required to communicate effectively with a wide range of patients, their
families and carers, with other dental staff within the Public Dental Service and General Dental
Service, with hospital staff, other NHS staff and other partners as required. Discretion,
diplomacy, courtesy and confidentiality to be used at all times, when dealing with patients,
parents carers and other members of staff, health professionals and the general public
INTERNAL
 Line Manager/Dental team members
 PDS Dental Nurse Team Leader for repairs
 IT department - computer advice/queries/
 Purchasing/stores - enquiries and ordering
 Other healthcare professionals -, referrals and information gathering and in an advisory
capacity
 Staff Representative – Information and advice
 Training departments – Continuous Professional Development, mandatory staff training
 Employee Relations – Information and advice
EXTERNAL
 Patients and carers contact by telephone and mail regarding queries/referrals
/appointments
 Other healthcare professionals (nursing homes), referrals and information gathering and
arranging visits
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Social Work Dept. –when dealing with children in care or families with problems.
The post holder gives and receives confidential information about patients’ medical conditions
and social histories, gives pre- and post operative instructions in relation to sedation and minor
oral surgery procedures and communicates information about appointments and clinical
schedules.
Provide and receive sensitive information requiring tact, motivation, persuasive or negotiating
skills where the client or staff may feel vulnerable, have limited communication or become
hostile or aggressive. These types of skills may be used when encouraging a patient to accept
dental treatment.
12. Physical, Mental, Emotional and Environmental Demands of the Job
PHYSICAL EFFORT/SKILLS
Setting up the clinic for inhalational sedation: assemble inhalational sedation equipment, carry
out safety checks on equipment, and prepare for use.
IT Skills – keyboard skills.
There is a frequent requirement to exert moderate physical effort for several short periods
during a shift.
Frequent requirement for sitting, standing in restricted position for prolonged periods of time,
due to nature of work or type of patient e.g. assisting in varying surgical procedures for several
patients per clinical session and often in a restricted amount of space.
Moving and handling of heavy dental equipment e.g. x-ray equipment.
Awkward and uncomfortable working position caused by physical or mental disability of patient.
MENTAL EFFORT/SKILLS
There is a frequent requirement for concentration where the work pattern is unpredictable and
also a frequent requirement for long periods of concentration e.g. a constant requirement to
concentrate whether assisting during clinical procedures, carrying out reception and
administration duties or decontamination and sterilisation requiring a change from one activity to
another throughout the day.
Maintaining a safe working environment while clinical procedures are carried out.
A requirement for prolonged concentration during lengthy clinical procedures, updating patient
records and paperwork accurately and entering patient information into database.
EMOTIONAL EFFORT/SKILLS
Occasional exposure to distressing or emotional circumstances.
Assisting the clinician in the provision of oral surgery treatment involving a wide range of
patients.
ENVIRONMENTAL DEMANDS
Frequent exposure to body fluids; saliva and blood on a daily basis.
Occasional exposure to physical aggression e.g. from anxious/phobic or special needs patients.
Occasional exposure to verbal aggression e.g. from members of the public looking for dental
services.
Frequent exposure to body odour and unclean patients.
Exposure to nitrous oxide due to patient mouth breathing.
13. Knowledge, Training and Experience Required to do the Job
The post holder must be registered with the General Dental Council and hold the
National Certificate in Dental Nursing or Oral Health Care Dental Nursing SVQ level 3 or
equivalent.
The post holder must hold the National Certificate in Dental Sedation Nursing (equivalent to
SVQ Level 4) and have experience of assisting regularly in the role of sedation dental nurse
where the dentist acts in the dual role of operator/sedationist. The post holder will be a
competent and experienced dental nurse with experience in working in the management of
patients requiring different types of sedation. Must have demonstrable skills, experience and
empathy to manage anxious and phobic patients.
A current portfolio of Continuing Professional Development;
The post holder has a legal requirement to undertake Continuing Professional Development
(CPD) as determined by the General Dental Council (GDC). Current requirements in order to
maintain registration are 150 hours over a 5 year period and should include the following
recommended topics;
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Medical emergencies
Disinfection and decontamination
Radiography and Radiation protection
Legal and Ethical Issues
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Complaints Handling
Oral Cancer: Early Detection
Completion of statutory and mandatory training as required by NHS Ayrshire and Arran.
The post holder must understand the GDC regulations and guidance in relation to provision of
conscious sedation for dental treatment and the Adults with Incapacity Act in relation to the
issue of consent for medical and dental treatment.
The post holder must understand the management of medical emergencies and sedation
related complications.
Excellent communication and interpersonal skills are essential.
Person Specification
Qualifications & Training – Essential Criteria
Registered with the General Dental Council and hold the
National Certificate in Dental Nursing or Oral Health Care Dental Nursing SVQ level 3 or
equivalent.
Qualifications & Training – Desirable Criteria
National Certificate (equivalent to SVQ Level 4) would be desirable but not essential to role e.g.
Radiography or Oral Health Promotion.
Experience – Essential Criteria
Experience in assisting with oral surgery procedures.
Experience – Desirable Criteria
Knowledge – Essential Criteria
Understanding of oral surgery procedures.
Knowledge – Desirable Criteria
Competencies & Skills – Essential Criteria
Able to assist with oral surgery procedures.
Competencies & Skills – Desirable Criteria
Personal Characteristics and Other – Essential Criteria
Flexible approach, while piloting the development of a new service.
Personal Characteristics and Other – Desirable Criteria