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Self-Audit

This form requires completion for students carrying out course related procedures in their own workplace. Students are required to complete all sections noting that in section 20 you are only required to complete the information related to the speciality of the course you are registerered on.

Please ensure you have the following documents to hand before completing this audit

  • Your infection control policy and procedures document
  • A photograph of your current health and safety poster
  • A photograph of your public liability certificate
  • A photograph of your up to date pressure vessel insurance
  • Your radiography QA process
  • Your latest test certificate for radiography equipment
  • Current complaints procedure and policy

1) General

 

2) Practice Details

 

3) Audit Details

 

4) Staffing

 

5) QA Scheme / Clinical Governance

 

6) CQC Details

 

7) Data Protection

 

8) Education Facilities

Yes No
Staff Room
Computer Access with Internet
Library – Books/Journals
 

9) Medical Emergencies

Yes No
Portable oxygen cylinders
Emergency airways
An emergency portable aspirator
Automated external defibrilator
Glyceryl trinitrate (GTN) spray (400mg/dose)
Salbutamol aerosol inhaler (100mg/actuation)
Adrenalin injection (1:1000 1mg/ml)
Aspirin dispersable (300mg)
Glucagon injection (1mg)
Oral glucose gel midazolam 10mg (buccal)
A method of checking drugs
Appropriate drug storage
Suppliers and batch ID records
Appropriate training records for the use of emergency drugs and CPR
A fully automatic defibrillator
 

10) Infection Control

Please upload your infection control policy and procedures document below
 

11) Decontamination

 

12) Protective Personal Equipment

 

13) Waste Disposal

 

14) Health and Safety

Please upload a photograph of your current health and safety poster below
 
Yes No
Fire
Equal Access
COSHH
Please upload a photograph of your public liability certificate below
 
Please upload a photograph of your up to date pressure vessel insurance certificate below
 
 

15) Radiography

Digital Wet Film None
OPG
Lateral Ceph
Intra-oral
CBCT scanner
Please upload your radiography QA process below


Please upload a copy of your latest test certificate for radiography equipment below
 
 

16) Clinical Photography

 

17) Record Keeping

Yes No
Social and dental history
Medical history
Extra-oral examination
Soft tissue examination
Full case assessment
Teeth present charting
Peridontal assessment
Full dental charting
Study models
Photographs
Radiographic examination
Radiographic report
Clinical Treatment Notes (contemporaneous signed and dated)
Diagnosis
Treatment Plan
Options discussed
Consent
Pre-treatment instructions
Post-treatment instructions
 

18) Complaints

Please upload a copy of your current complaints procedures and policy below
 

19) Document Upload

Attach file
No files are currently attached.
 

20) Course Specific Information

 
a) Orthodontics
(Diploma in Orthodontic Therapy and MSc in Orthodontics)
 
Yes No
URAs
Removable Functionals
Fixed Functionals
Fixed Appliances
Straightwire
Self-ligation
Tip Edge
Lingual
Vacuum Formed Systems (e.g. Invisalign)
b) MSc Implant Dentistry

 
Yes No
A preoperative check list for the implant nurses
A trained implant nurse (Sterile nurse) and a ‘floater’ nurse
An equipment checklist for implant placement
Detailed postoperative instructions
A telephone number for the patient to contact you on in the case of an emergency?
 
c) MSc Endodontics

 
 
d) MSc Restorative and Aesthetic Dentistry

 
Yes No
Undertake an aesthetic/cosmetic assessment?
Undertake risk based diagnosis/treatment planning?
Use a face bow and semi adjustable articulator?
Use a dental surveyor for partial denture design?
 

Submission

I confirm the information provided on this form is correct at the time of submission and will inform the department should any changes arise


 
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