dental office nurse one of the key employees. It is the nurse who helps the doctor to carry out preventive and therapeutic procedures. Thanks to the participation of the nurse, the activities of the dentist become more effective. In this regard, the search for a responsible, competent and competent nurse is important for any medical institution.

Requirements for a dental office nurse

Her responsibilities depend on the number of staff in the medical facility. For the qualitative implementation of activities, a nurse must have the appropriate personal qualities, know the norms of the current legislation and work in accordance with medical ethics.

Requirement 1. Personal qualities. Entering the dental office, the patient first of all encounters a nurse. That is why she must look appropriate and behave in such a way as to win people over and inspire confidence. This contributes to the establishment of closer contact between the doctor and the patient in the future, already in the course of treatment.

Requirement 2: Appearance. The dental office nurse must look neat and tidy. All personal hygiene requirements must be strictly observed. Not only the appearance of the nurse depends on this, but also safety, since the possibility of infection in the surgical department in this case is minimized. The nurse needs to cut or pin up her hair shortly, preventing their contact with the working area and instruments while assisting the dentist. It is impossible to work in rings, bracelets and other jewelry, as they damage gloves and contribute to the accumulation of bacteria, which is unacceptable.

Requirement 3: Personality. Clients of dental offices are unrestrained. This must be taken into account and work, while maintaining calm, courtesy and a friendly attitude. Only in this case, the nurse of the dental office can win over any patients.

Requirement 4: Speech. The calm soft timbre of the nurse inspires confidence in the client. When talking to a patient on the phone, she should speak clearly and distinctly. In order to avoid misunderstanding, it is better to talk about the features of treatment in a simple language, without professional vocabulary.

Requirement 5: Concentration. The nurse should remain vigilant, not missing a single detail in her work. When filling out the patient's medical records, she must be accurate and attentive. When assisting a dentist, it is important to work correctly. This is especially true in emergency situations.

Requirement 6: Punctuality. The staff of the dental office must be punctual - the smooth operation of the entire medical facility depends on this. Note that punctuality should also be inherent in patients.

Requirement 7: Medical ethics. Dentist staff must:

• focus primarily on the interests of the patient;
• respect the wishes and choice of the client;
• take care of the confidentiality of the information received;
• Collaborate with peers and professionals from other industries for the benefit of patients;
• work to improve their professional knowledge;
• be qualified to work in their industry.

Requirement 8: Fundamentals of medical ethics in practice. There are a number of requirements for employees of dental offices and institutions of a different nature:

• each specialist of a medical institution is responsible for any of his actions;
• the interests of the client are above all, only after them are their own interests and desires of colleagues;
• communication with the patient is based on certain principles of ethics, including when complaints are received;
• dental office staff should act on the basis of professional competence, actual capabilities and knowledge;
• specialists must remember the precautions and apply them when there are threats to the patient;
• employees of dental offices (nurses and other staff) must act competently, if there is any doubt about the correctness of the manipulations, consultation of higher persons is necessary;
• communicate with the patient courteously and politely;
• before starting treatment, the consent of the client is required;
• patients should be told in detail about the features of treatment (pros, cons, risks), price and alternative options. Only after that the visitor decides whether to undergo treatment in this dental office or not;
• information provided by patients is confidential;
• access to information data should be limited.

A nurse in a dental office should not perform therapeutic actions in the oral cavity of patients - this is not in her competence. She also does not take x-rays (in the absence of additional training).

At the same time, the nurse, at the request of the dentist, can give certain recommendations to the client on caring for the oral cavity in several cases. For example, if:

• the dentist is sure that the nurse has a sufficient level of competence;
• the doctor is aware that he is responsible for the recommendations given by the dental office nurse.

There are a number of ethical principles described in the middle of the twentieth century. A modern nurse should remember them, applying them in practice.

1. A nurse in a dental office or other medical institution must be honest and loyal. In the course of her work, she should maximize her potential.
2. Information provided by the employer and patients is confidential not only for ethical reasons, but also for legal reasons. Patient records are strictly confidential. The nurse must understand that if confidentiality is violated, she is threatened with dismissal.
3. A nurse should strive to improve professional abilities. If the actions required of her cannot be performed at the proper level, she is obliged to inform the doctor about this.
4. If the dental office nurse discovers problems that could harm patients or staff, she should report this to senior staff at the facility.

Job responsibilities of a dental office nurse: general, specific, administrative

There is a job description for a dental office nurse. It must operate in accordance with the following requirements:

1. Maintain cleanliness throughout the day.
2. Ensure that the temperature in the office is adequate.
3. Pay due attention to clear working time planning: this is important for both patients and dentists. If for some reason it is not possible to complete the treatment within the specified time frame, it is imperative to inform the patient about this.
4. Particular attention must be paid to the issue of confidentiality. Information in the case histories, information voiced in the course of financial transactions and personal conversations, are not disclosed, as well as data relating to the reaction of the patient's body to medical procedures and activities.
5. The nurse of the dental office should be able at any time to use the phone number of intensive care, maintenance, taxi, find out what schedule public transport runs on.
6. The nurse is obliged to control the expiration date of materials, the serviceability of instruments and dental units.
7. When working with drugs for various purposes, the nurse must follow the manufacturer's instructions exactly.
8. The nurse should be in contact with the dental laboratory staff to avoid delays in sending and receiving work.
9. Employees of the medical institution must be able to use the equipment provided to them.
10. All personnel must be trained and properly behave in an emergency.

The dental office nurse has certain administrative responsibilities:

• Maintains cleanliness in the dental office
• receives patients and representatives of dental organizations;
• registers patients for appointments;
• maintains records related to patient care;
• orders and stores drugs;
• maintains financial records;
• works with correspondence.

When using a computer, a nurse can perform her secretarial duties faster and more efficiently. A computer is not only a typewriter, it is also a file cabinet and an account book. Thanks to him, it is very convenient to store and search for documents, fill in and display data. In addition, important information is safe.

Specific duties of a dental office nurse

The job description of a nurse can be different. Nurses have different responsibilities: it all depends on the direction of the dental office.

In the therapy room

In the therapeutic dental office, patients treat dental caries and any of its complications, non-carious lesions, periodontium (if there is no periodontist in the clinic), and affected mucous membranes. Caries in dental offices is eliminated both conservatively, without dissecting hard tissues and restoring the structure with special remineralizing agents, and surgically, dissecting hard tissues under anesthesia, followed by placing a filling on the defect.

When treating complications of caries, the dentist removes all altered hard tissues, the neurovascular bundle or pulp decay from the root canal, processes the root canals using special tools and medicines, and then seals them and the defect of the crown tooth.

Non-carious lesions are also treated with conservative methods. In this case, remineralizing agents are used and the areas with defects are sealed. Often, prosthetics are performed instead of therapeutic measures. In some cases, dentists whiten their patients' teeth to achieve the best effect from an aesthetic point of view.

Periodontium in the therapy room is treated by removing dental deposits from the teeth, splinting and anti-inflammatory treatment are carried out, bandaging the gums with various drugs and prescribing a general treatment.

Diseases of the oral mucosa, as a rule, are treated as follows: the dentist anaesthetizes the affected area, treats it with antiseptics, sometimes with proteolytic enzymes, keratoplastic agents that work to heal the affected areas.

A nurse, working in a therapy room, performs almost the same actions as in other rooms. Namely:

• disinfects and sterilizes dental instruments necessary for the dentist-therapist at work;
• prepares the workplace of the doctor before his shift;
• maintains cleanliness in the workplace;
• processes handpieces, a dental unit, a table for storing instruments and other things necessary for work;
• replenishes the supply of tools and materials spent in the treatment of patients;
• performs subcutaneous, intramuscular and intravenous injections under the supervision of a dentist if there are urgent situations.

If there is no assistant in the dental office, the nurse can:

• help isolate the working field (retract cheeks, lips, tongue, using a dental mirror, use a vacuum cleaner, saliva ejector, rubber dam);
• prepare a carpool syringe before anesthesia, draw an anesthetic into the syringe, performing anesthesia with a conventional syringe;
• prepare antiseptic solutions for work, mix filling materials for installing fillings on areas affected by caries and root canals, as well as preparations for therapeutic dressings for periodontal disease.

In the prevention room

This office focuses primarily on disease prevention. The specialists working in it evaluate the hygienic condition of the oral cavity, check whether there is a possibility of caries and periodontal disease. A dentist consults patients, teaches the basics of brushing teeth, selects individual hygiene products, removes dental deposits, prescribes a rational diet, and conducts remineralizing therapy.

It should be noted that programs are being developed at the moment, the purpose of which is to prepare nurses for certain stages of prevention. The dental office nurse, under these programs, will:

• educate patients about oral care;
• control the acquired skills;
• conduct controlled brushing of teeth;
• select means and hygiene items;
• to conduct active and passive sanitary-educational work (the first point includes conducting conversations, lessons, lectures; the second - the distribution of newspapers, brochures, the creation of stands; conduct remineralizing therapy).
• prescribe a diet
• filling documents.

Enterprises, schools, and pre-school institutions should be the basis for organizing preventive cabinets. Nurses of these dental offices should carry out similar actions.

In the surgical room

In surgical rooms, doctors remove teeth from patients and perform operations that can be performed on an outpatient basis. Specialists perform periostotomy, vestibuloplasty, frenectomy, frenuloplasty, curettage, patchwork operations, open abscesses. Sometimes in surgical rooms anesthesia is given to patients of other dentists.

Surgical Dental Nurses:

• in the course of work, they provide the tools necessary for the doctor, as well as balls, drains, napkins;
• dry the surgical field using gauze napkins, creating a comfortable environment for the doctor to carry out therapeutic measures;
• the patient's lips are fixed in the desired position during operations on them, as well as during the correction of the frenulum and the removal of neoplasms;
• thread the needle if you need to suture wounds.

In the orthopedic office

In orthopedic rooms, carious and non-carious defects on the hard tissues of the teeth, defects in the dentition are eliminated, using various designs and prostheses (if the teeth are completely missing), and the deformities of the dentition are corrected. In this case, periodontal disease and diseases of the temporomandibular joint are treated by involving other specialists.

In orthopedic treatment, removable and non-removable structures are made that replenish the integrity of hard dental tissues and the dentition. Thanks to such dental solutions, defects and deformities in the oral cavity disappear, and the ratio of the elements of the temporomandibular joint is normalized. In the manufacture of these structures, the necessary measures are carried out in several stages. For some, the orthopedist is responsible, for others, the dental technician.

The dental office nurse performs general manipulations, and can also:

• help to mix materials and corrective compositions when taking impressions (this is especially true for a technique carried out in several stages);
• assist in the isolation of the working field;
• mix pre-prepared portions of cement powder and liquid for fixation in order to temporarily or permanently fix non-removable structures;
• to supply instruments, parts, structural elements during the work of an orthopedist.

Increased attention should be paid to timely disinfection. Alginate impressions and models should be processed, according to which products are made in the shortest possible time with the likelihood of shrinkage and reduction in size.

It is necessary to disinfect wax bases and bite rollers, structures made by a direct method in the patient's oral cavity, avoiding deformation of the wax during the work. If wax parts are damaged, orthopedic products made according to these models become unusable.

In the orthodontic office

A doctor working in an orthodontic office makes structures to correct anomalies in individual teeth, as well as bite and dental arches. Designs are removable and non-removable, with a different mechanism and location. The manufacture of orthopedic structures is carried out by a laboratory method.

A nurse in an orthodontic office performs almost the same actions as when working in an orthopedic office.

Nurse's working day plan in the dental office

1. Comes at the appointed time. She is wearing a clean surgical suit. A prerequisite is well-groomed nails and the absence of jewelry.
2. Turns on dental units, checks ventilation, temperature and light levels in the office.
3. Checks how well the room is cleaned.
4. Checks the sterilizer indicator readings and logs the data.
5. Disinfects work surfaces.
6. Processes handpieces in assytine, uses autoclave and disinfectant wipes, pours fresh liquid into ultrasound.
7. Tests all hardware to make sure it is working correctly.
8. He looks at where the patient records are, the registration book, the necessary medicines, the first-aid kit, checks that all of the above are in their places.
9. He prepares the dental office for the visit of the first patient, lays disposable towels where necessary, puts out gloves, glasses, a mask, takes out a tray with sterile instruments (it has a probe, a mirror, tweezers).

During a patient visit, the nurse:

1. Returns the dental chair to its original position before the patient enters the office.
2. He is convinced that the dentist knows the name of the client, why he came, during what time he needs to be served.
3. Checks if the dentist has all the necessary documentation for the patient, including medical history, radiographs (if available).
4. Once again informs the doctor about the characteristics of the patient, for example, about an allergy to a particular drug, loss of consciousness, previous diseases.
5. Removes instruments that are not required during the treatment and examination of the patient.
6. Politely, with a smile, greets the patient, addresses him by name, introduces him to the doctor. Takes away from the client personal belongings that interfere with the treatment, and leaves it in the place designated for this.
7. Helps the patient to take a comfortable position in the dental chair, lays a new disposable bib, changes the glass of mouthwash, puts down tissues. Gives goggles to the patient to be treated in a horizontal position.
8. Contributes to the creation and maintenance of a friendly atmosphere in the dental office, ensuring patient comfort.
9. During treatment, the dental office nurse ensures dryness in the working field and good visibility for the doctor performing certain manipulations.
10. Promptly provides the dentist with the necessary tools and materials.
11. Closely monitors the patient in order to inform the doctor in an emergency about various manifestations, complications, symptoms (these include, for example, vomiting, fainting of the patient).
12. Before leaving, the visitor makes sure that his face and clothes are in their original condition, without traces of medical materials.
13. Repeats for the patient the recommendations of the dentist, if necessary, writes them down. If you need to transfer certain materials to the dental laboratory specialists, you need to disinfect them, pack them carefully and make sure that all documentation is completed.
14. Registers the performed medical actions. For this purpose, a daily record of the work of the dentist is intended.
15. Prepares the dental office for the next patient.
16. Washes and sterilizes used instruments. Washes and disinfects work surfaces and spittoon, replaces disposable saliva ejector and vacuum cleaner with a new one.
17. Prepares new necessary materials for single use.
18. Checks if all the necessary tools and records are available to receive the next client of the dental office.

At the end of the working day, the dental office nurse

1. Washes and sterilizes the instruments used in the treatment of the last client. Sterilizes and lubricates handpieces according to manufacturer's instructions. Immerses the saliva ejector system in a disinfectant liquid. Washes, disinfects the spittoon, work surfaces. Returns unused materials and tools to their original place.
2. Disinfects products intended for transfer to the dental laboratory, checks the relevant documents.
3. Processes used x-ray films. They are checked and stored along with the relevant documents.
4. Enters into the log book information about therapeutic measures for the last client. Copies are entered into the computer.
5. Collects household and ordinary garbage in containers and gives it to cleaners.
6. Garbage may contain items that have come into contact with blood or saliva. These are, for example, empty cartridges from anesthetics. Such waste is sealed and distributed in specially marked containers.
7. It distributes used objects with sharp edges into special hard, non-puncture waste containers. We are talking about glass anesthetic ampoules, suture needles, burs, endodontic instruments, which can scratch the skin and tear gloves. For the storage of special waste (expired medicines, harmful, toxic, caustic substances, solutions that are used for x-rays, anesthetic cartridges), solid separate containers are provided.
8. In a special order destroys preparations containing mercury, and extracted teeth with amalgam fillings. All this cannot be disposed of as ordinary medical waste, as it emits toxic mercury vapor.
9. All necessary documents on the collection of medical waste are kept by individual employees with the appropriate authority.
10. The log book should contain all the necessary notes for the next day.
11. Dental units are turned off at the end of the working day.
12. Cabinets with medicines, windows, doors and the registration desk are closed.

How a Dental Nurse Should Help in an Emergency

In the dental office, there must be a first aid kit with certain medicines, thanks to which the nurse provides first aid. Help is required if blood gets on the skin and mucous membranes of the patient, cuts are formed, etc. The first-aid kit must contain:

• scissors;
• albucid (20% sodium sulfacyl solution);
• fingertip or gloves;
• 1/5 eye and nasal droppers;
• bandage and cotton;
• weighed potassium permanganate for 0.05% solution;
• adhesive plaster;
• 70% ethyl alcohol solution;
• 5% iodine solution.

In all treatment rooms there should be sets of medicines to provide assistance. The dental office nurse completes consumables and medicines. For each set, a separate box is allocated, on which information about the intended use of medicines is applied. For example, "To provide urgent assistance in asthmatic attacks." The expiration date and algorithms for the actions of the staff are indicated on the medicines.

The list of equipment, medicines and tools for first aid kits intended for emergency care is stated in the Decision of the Council of the Dental Association of Russia dated September 18, 2007 "On measures to ensure the safety of dental services to the population." The Dental Association of Russia (StAR) recommends medicines and instruments.

Legal aspects of the work of a dental office nurse

A nurse in a dental office must competently perform their duties. In addition, the nurse is also a witness. Often, patients complain about the unscrupulous behavior of the dentist. The nurse is present at all medical events, and therefore can objectively judge the situation. The third party has the right to vote. Thanks to the testimony of a nurse, both the doctor and the patient can be protected. This is an important legal aspect. If the nurse leaves the dental office, the door to the room remains open until another nurse or other person arrives.

Any type of interference without the consent of the client can lead to legal proceedings. Before a patient agrees to a particular procedure, dentistry must provide him with full information about the essence of the treatment, tell him about the expected price, warn about possible side effects, complications and offer alternatives.

Consent can be both oral and written, which is more optimal. This is especially important for anesthesia and other medical procedures that can lead to complications and cause side effects. The written consent of the patient implies the date and signatures of both parties: the dentist and the client on the document. If treatment is planned for a patient under 16 years of age and a patient with an intellectual disability, parental or legal guardian consent is required.

Labor protection of a nurse in a dental office

The staff of the dental office will experience significant emotional and physical stress. In this regard, there is often a threat to the health of specialists. The dental office nurse also experiences the stress and risks associated with her professional activities. There is an instruction on labor protection for a nurse, in which certain provisions are prescribed, namely:

General safety requirements

Subject to the requirements for labor protection in the dental office, the likelihood of infection and overwork is minimized. Among the main types of dangers that may affect employees of dental offices, we can distinguish:

• the possibility of catching a virus or infection when interacting with patients;
• overwork, increased nervous and physical stress;
• electric shock in the event of a possible short circuit.

All employees of the dental office, including nurses, must be of age, with a complete medical education. Each specialist accepted in a medical institution should be instructed on compliance with safety standards. At least once every six months, specialists are re-instructed. The annual testing of acquired knowledge is obligatory.

Every employee is required to comply with the following requirements:

• work in strict accordance with the job description; there are instructions from the dental office nurse and rules for other professionals;
• be able to provide first aid in an emergency;
• be aware of fire safety requirements and strictly follow them.

Both nurses and other employees of the dental office must pay close attention to personal hygiene, wear special suits, use personal protective equipment that the administration constantly provides.

Safety requirements during the work shift

Before starting work, the ventilation system is turned on. It is required to check the serviceability of electrical equipment, turn on the ground, make an appropriate entry in the log. You need to pick up tools in good lighting. Local lighting should be 10 times brighter than general lighting to ensure visual comfort for the specialist.

To protect themselves from infections, specialists wipe their hands with bactericidal preparations.

Rubber gloves are a must. They process tools and prepare cleaning solutions. After working with each patient, washing hands with neutral soap and then drying them with a dry towel is required. Before work, a protective cream is applied to the hands. At the end of the working process, the overalls are removed and placed in a specially designated place for storage. It is necessary to turn off appliances and ventilation.

Forbidden:

1. Use of faulty devices and devices.
2. Leaving them turned on unattended, placing them in close proximity to flammable objects.
3. Use of products without labels.
4. Work with disconnected communications: heating, electricity, sewerage and without overalls.
5. Storage in the office of items that are not related to work.

In the event of an emergency, all employees of the dental office must strictly follow the instructions. Subject to safety standards, the health of specialists and patients of dentistry will be preserved.

Safety requirements in emergency situations

In the event of an emergency, the staff of the dental office must report this to the head. If an electric shock occurs, other injuries occur, you must act in strict accordance with the instructions and provide first aid to those who have been exposed to current.

If the power supply is interrupted, there is a short circuit, an interruption in the power supply, there is a smell of burning, the employees of the dental office are required to turn off all electrical appliances and call a specialist. The electrician will fix the problem.

In case of fire, it is necessary to evacuate patients, call the fire brigade, extinguish the fire with primary specialized means before the arrival of the brigade.

If the water supply communication systems break down, sewerage, ventilation, heating fail, work is suspended until the accident is eliminated.

Safety requirements at the end of work

At the end of the day, the employees of the dental offices put the workplaces in order, turn off the ventilation, take off the sanitary suits and put them in the places designated for this. Dressings made of gauze for sanitation are handed over, and disposable respirators are disposed of.

Employees working with medical devices and equipment must turn them off and switch them to the mode prescribed in the instructions for use.

Wet cleaning in all rooms should be carried out every day. General cleaning, which includes washing floors, walls, doors, windows on the inside and window sills, should be carried out at least once a month.

The nurse is one of the most important employees of the dental office.

She helps the doctor with treatment and diagnostics, prepares the office for the start of the appointment and cleans it after the end of the work shift.

In the article we will talk about the role of a nurse in dentistry and her duties, as well as list the main points of her job description. Download the finished job description for a dental office nurse.

From the article you will learn

Dental nurse - a specialist who has a secondary medical education in the specialty "Nursing", "General Medicine" or "Obstetrics", as well as who has undergone additional training in the course "Nursing in Dentistry".

Every 5 years, a dental nurse undergoes training in continuing education programs throughout her career.

★ Whether it is necessary to prescribe the requirements of the professional standard in the job description, find out in the System Chief Nurse

Key Responsibilities of a Nurse in Dentistry

The job of a nurse in dentistry is to:

• preparation of workplaces for dentists, control of the availability of the necessary tools, materials, inventory, documents;
• control of serviceability of the drill;
• maintenance of the workplace of a dentist in proper condition;
• sterilization and layout of instruments and products on a sterile table;
• assistance to the doctor at the reception, in carrying out medical manipulations (isolation of the working field, abduction of lips and cheeks, anesthesia, etc.), as well as in the preparation of material for fillings;
• compliance with the rules and techniques for the operation of dental equipment and instruments;
• compliance with the standards for the consumption of materials, medicines;
• monitoring the good condition of electromechanical equipment (in case of a malfunction, the equipment is disconnected from the network, it is necessary to inform the management about what happened);
• registration of requirements for medicines, dressings;
• obtaining medicines and dressings from the elderly nurse;
• control of safety of labels on vials;
• participation in the conduct of sanitary education among patients;
• regular professional development (reading specialized literature, participation in seminars, symposiums, conferences and other types of educational activities).

Samples and special collections of standard procedures for nursing, which can be downloaded.

The role of a nurse in dentistry is enormous, but she does not have the right to conduct sanitation and treatment on her own. She can only give the patient recommendations for caring for the oral cavity in some cases - for example, her qualifications are enough for this and the doctor understands that he is responsible for the advice given by the nurse.

In order to perform their professional duties at a decent level, a dental office nurse must have a certain set of personal qualities, know the legal framework for their activities and comply with the norms of medical ethics and deontology.

The dental nurse is required to:

1. Consider the interests of patients, respect their choice and desires.
2. Maintain medical confidentiality.
3. Collaborate with peers and other professionals for the benefit of patients.
4. Possess a sufficient base of knowledge and skills to carry out work in their industry.
5. Constantly improve your professionalism.

Job description

The dental nurse participates in the preparation of equipment and technology, monitors its serviceability, and also controls the proper sanitary condition of the dental office.

It is desirable that she has organizational skills and is able to competently organize the work of junior medical staff, nurses, cleaners and a dental equipment maintenance specialist.

The most important thing that a dental nurse does is to provide the office with all the necessary materials and medicines, as well as high-quality disinfection of instruments and medical devices.

The work of a nurse in a dental clinic involves:

• participation in the distribution of patient flows;
• organization of their reception;
• distribution of doctors by workplace;
• paperwork;
• special attention to minor patients and patients with acute pain.

Disposal and disinfection of carpul dental needles

Nurses are often interested in the question: is the process for disposing of carpool syringes and disposable injection needles the same?

The answer is in the Chief Nurse System.

A qualified and enterprising nurse in dentistry always takes an active part in the treatment and diagnostic procedures carried out by the doctor.

In addition, she can carry out a number of manipulations on her own. Her participation in the treatment process can increase the efficiency of the dentist several times.

In large dental departments and clinics, the functionality can be distributed among all nurses. Separation is made by the head or head nurse.

Responsibilities of a nurse in the operation of dental units

In order for all dental units to work for a long time and properly, it is necessary to comply with the requirements for their operation and carry out their systematic maintenance.

These tasks are the responsibility of a dental nurse. There is a specific schedule for servicing dental equipment.

Before starting work, the dental nurse checks:

• the presence of water;
• serviceability of the sewer system;
• serviceability of the compressor and the presence of liquids in the tanks;
• tools, tips;
• dentist chair.

In addition, it disinfects control panels, switches, handles, tools, chair surfaces and spittoons.

After the appointment is over, the nurse conducts:

1. Disinfection of all surfaces, switches, handles and tools.
2. Replacement of the tips of the vacuum cleaner and saliva ejector.
3. Cleaning the spittoon bowl.

After the completion of the work shift, the nurse:

• cleans the spittoon bowls;
• pours disinfectant into the sewerage system;
• disconnects the power supply from the chair, compressor and unit;
• shuts off the water supply faucet;
• releases air from the air system of the unit and the compressor;
• drains water from the hydraulic system;
• disinfects control panels, switches, handles, chairs, spittoons;
• pours condensate out of the compressor receiver;
• checks the oil level in the compressor crankcase, handpiece lubrication system and hydraulic system;
• lubricates all swivel and roller joints.

Handpiece care

Caring for the tips, which is also the responsibility of the dental nurse, consists in regularly lubricating them with a special lubricant made from technical oil and heated vaseline in a ratio of 1 to 3. The resulting mixture is cooled. Sometimes ready-made lubricants are released in the form of aerosols.

Turbine tips are lubricated through the air supply channel, and mechanical models - in accordance with the instruction manual. The outer surfaces of the tips are treated with a 1% solution of chloramine twice for half an hour.

Work on disinfection and cleaning of the dental office

After each use, mouthwash glasses are soaked for an hour in a 3% solution of chloramine, after which they are rinsed with clean water.

The disinfectant solution cannot be used a second time - it changes after the disinfection of each batch of glasses.

After each patient, the spittoons are treated with bleach or 3% chloramine for 1 hour. It is also acceptable to use 0.4% Septodoreforte and 0.1% Clorsept.

What mode of disinfection is needed in dentistry offices

Using examples, we will explain the features of the requirements for surface treatment of therapeutic dentistry rooms, and show how the delimitation of the working space in the dental office is determined in the Chief Nurse System.

In stationary spittoons with a closed hole, a 10-20% solution of bleach or a 3% solution of chloramine is poured. The spittoon is closed with a cap for 60 minutes.

Waste material from spittoons is poured with 10% calcium hypochlorite or 20% chlorine lime milk for half an hour.

After that, it is placed in the trash can. In addition, disinfection of canal fillers and spent pulp extractors is carried out.

Sterile instruments from the table are strictly forbidden to be touched by hands. For this, sterile tweezers are used, which are changed every 2-3 hours.

The sterile table is covered for 6 hours. The date and time of the cover is fixed. Instruments that have not been used are re-sterilized without pretreatment.

Responsibilities of the Dental Nurse in an Emergency

The composition of the first aid kit in case of contact with biological material on the skin and mucous membranes, cuts and injections with tools:

• scissors;
• albucid 20%;
• disposable gloves;
• pipettes;
• dressing materials;
• potassium permanganate to prepare a solution of 0.05%;
• ethanol 70%;
• iodine 5%;
• adhesive plaster.

Emergency kits should be available in every dental office. The dental nurse is responsible for their staffing.

The kit is placed in a box with an inscription on the purpose (for example, "For the provision of emergency care for anaphylactic shock"), a list of medicines and materials, expiration dates and procedures for health workers.

Before the patient enters the office, the dental chair must be returned to its original position. Make sure you and the dentist know the patient's name, the purpose of the visit, and the time allotted to see the patient.

• Check if the dentist has all the necessary documents for the patient, including medical history, radiographs, if any.
• Remind the dentist of the characteristics of this patient, for example, the presence of allergic reactions to certain drugs, a predisposition to loss of consciousness, previous diseases.
• Instruments that will not be needed for the examination and treatment of this patient should be removed.
• Greet the patient by name with a smile and introduce them to the doctor. Take the patient's things that interfere with him and leave them in a place specially designated for this.
• Position the patient comfortably in the dental chair, put on a new disposable bib, change the glass of mouthwash, put down tissues. Patients who will be treated in a horizontal position are given goggles.
• Always remember that what is everyday work for you can be stressful for the patient. Therefore, it is necessary to create a friendly atmosphere in the surgical room.
• During the treatment of the patient, the nurse must ensure the dryness of the working field and good visibility.
• Timely transfer the necessary tools and materials to the dentist.
• Carefully observe the patient in order to inform the dentist in time about possible complications (fainting, vomiting, etc.).
• Before releasing the patient, make sure that there are no traces of treatment materials on his face and on his clothes.
• Repeat to the patient the recommendations given by the dentist, write them down if necessary.
• If there are materials that should be given to the dental laboratory, they should first be disinfected, carefully packaged and make sure that the documents required for this are completed.
• The performed medical manipulations are recorded in the journal of the daily record of the work of the dentist.
• The next step is to prepare the dental office for the next patient.
• Used instruments must be washed and sterilized. The spittoon and work surfaces are washed and disinfected, the used disposable vacuum cleaner and saliva ejector are replaced with new ones.
• New necessary disposable materials are being prepared.
• The availability of all necessary tools and records for the next patient's appointment is checked.

I. General part

The main tasks of the nurse of the dental office are the implementation of medical and diagnostic appointments

Dentist and assistance to him in organizing a specialized

Medical assistance to the population living in the area of ​​activity

Polyclinics, as well as workers and employees of attached enterprises.

Appointment and dismissal of a dental nurse

The office is carried out by the chief physician of the polyclinic in accordance

with current legislation.

The dental office nurse reports to

Directly to the dentist and works under his supervision.

In her work, a nurse in a dental office

Guided by this job description and other official documents.

II. Duties

To perform their functions, the nurse of the dental office is obliged to:

1. Prepare workplaces before an outpatient appointment with dentists, controlling the availability in the required quantity

Medical instruments (burs, canal fillers, etc.), medicines, inventory, documentation.

2. Check the health of the drill before starting work.

3. Sterilize and lay out the instruments on a sterile

4. Help the doctor at the reception in the preparation of filling material, during various manipulations.

5. Observe the rules for the use of equipment, tools, the consumption of medicines, filling material.

6. Monitor the serviceability of electromechanical equipment,

In the event of a malfunction, disconnect it from the network and put it in

The fame of the administration.

7. Write out requirements for medicines, cotton wool, etc. and receive them from the head (senior) nurse.

8. Strictly monitor the preservation of the labels on the vials.

9. Participate in health education

Among the sick.

10. Systematically improve your skills by studying

Relevant literature, participation in conferences, seminars.

The dental office nurse has the right to:

Submit requirements to the administration of the polyclinic to create the necessary conditions at the workplace, ensuring the high-quality performance of their duties;

Take part in meetings (meetings) when discussing

The work of the dental office;

Receive the necessary information to perform their functional duties from a dentist, senior medical

Sisters of the department (responsible for the cabinet), chief medical officer

Require visitors to comply with the internal regulations of the clinic;

Master a related specialty;

Give instructions and supervise the work of junior medical staff of the dental office;

To improve their skills in the workplace, improvement courses in the prescribed manner.

IV. Job evaluation and responsibility

Evaluation of the work of a nurse in a dental office

Carried out by a dentist, chief (senior) medical

Sister on the basis of accounting for the performance of her functional

Responsibilities, compliance with internal regulations, labor

Disciplines, moral and ethical standards, social activity.

The nurse of the dental office is responsible for the fuzzy and untimely implementation of all items

this instruction. Types of personal responsibility are determined

In accordance with applicable law.

Creation date: 2001

Certification report of a nurse of the dental department of the Central Clinical Hospital of the Ministry of Health of the Russian Federation
Full Name
for 2000

Moscow, 2001

Due to the high prevalence of dental diseases, dental care in our country is one of the most widespread forms of medical care. Most of the dental patients (98.5%, i.e. the vast majority) are indicated for treatment in a polyclinic. This is due to the high prevalence of dental caries and its complications. Every year, conservative methods of treatment of both therapeutic and surgical diseases occupy an increasing place. The number of extracted teeth is reduced and the number of cured teeth is increased. If in the recent past the ratio of extracted teeth and cured ones was 1:1, now it is 1:10. This has been achieved thanks to the therapeutic and practical success of dental science.

Every year, new methods of diagnostics and treatment are introduced into dental practice, which allow diagnosis, treatment of patients and rehabilitation.

I. Characteristics of the place of work

According to Order No. 8 dated March 26, 2001, the Federal State Institution "Central Clinical Hospital of the Ministry of Health of the Russian Federation" was reorganized in the form of a merger into the State Institution "State Medical Center of the Ministry of Health of the Russian Federation" and is a medical and preventive institution that has in its consisting of a hospital and a polyclinic, in which patients receive emergency and planned medical care.

The dental department of the polyclinic is represented by two services:

1. Department of orthopedic dentistry, consisting of an office for an appointment with an orthopedic doctor and a dental laboratory.
2. Actually the dental department, which consists of four therapeutic rooms, one surgical and one periodontal rooms.

For these two departments there is a registry with a file of dental patients. The receptionist makes a preliminary appointment by phone and provides background information for patients.

In the dental department, assistance is provided to the attached contingent of departmental organizations that have concluded contracts for medical care with the Central Clinical Hospital No. 1, and patients are also accepted for cash. In addition, it is possible to provide dental care at home, as well as treatment of patients undergoing treatment in a hospital. The nurse prepares for home visits and assists the doctor.

1. Department of orthopedic dentistry

The Department of Orthopedic Dentistry has in its staff:

Reception in the orthopedic department is carried out in two shifts by two orthopedic doctors. The dental laboratory is equipped with the latest electronic equipment from leading Western companies. For the manufacture of dentures, materials of 3-4 generations are used. The following types of services are provided to the population:

• Production of metal-ceramic crowns.
• Production of one-piece prostheses.
• Manufacturing of removable prostheses.
• Manufacture of clasp prostheses with lock fastening.
• Manufacturing of plastic crowns.

2. Dental department

The dental department has in its staff:

In the dental department, the technical re-equipment and repair of offices was completely carried out. The rooms are equipped with dental units Eurostar”(made in Italy), as well as all the necessary equipment and tools for work.

To improve the quality of diagnostics, modern electronic equipment is used, for example, a handpiece with an apex locator " Marita"(Japan), apparatus for determining the viability of the pulp" didi test"(USA). Equipped with an X-ray room, where a radiovisiograph is installed " Trophy Elities» (France) with computer wiring in all offices.

Each dental office has:

• Glasperline sterilizers (Italy) for immediate sterilization of the necessary instruments.
• Boxes ultraviolet " TAU-steril» (Italy) for storage of sterile instruments.
• Devices « Piezo Master» (Switzerland) for removing dental deposits with different nozzles, as well as for root canal treatment.
• Halogen lamps (USA, Germany) for setting seals from light-curing materials.
• bactericidal lamps.
• Monitors for viewing R-images
• Medical dental furniture « Lotus» (Italy), which includes the workplace of a nurse and a doctor.
• Built-in air conditioners.

II. Areas of activity of a nurse

1. Assisting the doctor

Nurses are the closest assistants to a dentist and make a huge contribution to the prevention and treatment of dental diseases. The efficiency of a dentist working with a nurse is 50% higher than that of a dentist working without a nurse.

The duties of a dental assistant include the following:

1. Preparation of the workplace for the arrival of the doctor.
2. Preparation of the necessary instruments and medicines for anesthesia, applications, fillings.
3. Patient call.
4. Sitting in a comfortable position of the patient in the chair, so that it is convenient for both the patient and the doctor.
5. Invitation of the dentist to the patient.
6. Setting up a dental light.
7. Submission of instruments to the doctor.
8. Ensuring the prevention of infectious infection of the patient and staff.
9. Work with saliva ejector and vacuum cleaner.
10. Independent carrying out of hygienic measures, determination of indices and evaluation of the effectiveness of preventive measures taken together with the doctor.
11. Together with the administrator, the appointment of a return visit date for the patient.

2. Maintenance of the anti-epidemic regime

For the prevention of nosocomial infections, strict adherence to the sanitary and epidemiological regime in the department, as well as compliance with asepsis and antisepsis, is of great importance. All work in this direction is carried out on the basis of the methodological letter "On the organization of sanitary-hygienic and disinfection-sterilization regimes in dental institutions", developed by the State Committee for Sanitary and Epidemiological Supervision of the Russian Federation. Supervising the implementation of these rules is carried out by the senior nurse.

Hermetically sealed plastic containers for pre-sterilization cleaning and disinfection of instruments, as well as separate containers for burs, are installed at each workplace of a nurse.

Pre-sterilization cleaning and disinfection of instruments

Pre-sterilization cleaning and disinfection is carried out simultaneously with a 5% solution " Alaminol» with an exposure of 1 hour.

Means " Alaminol"is a blue liquid, odorless, has detergent properties. It is effective against bacteria, fungi of the genus Candida, viruses (including pathogens of HIV, SARS, hepatitis, herpes, rotoviruses).

In addition, the tool Alaminol» is used for disinfection of surfaces of furnishings, appliances, equipment. For this, a 1% solution of alaminol is used with an exposure of 60 minutes.

For mechanical pre-sterilization cleaning of instruments, ultrasonic devices are used. Earring" And " Transsonic».

For local anesthesia in the dental department, carpool aspiration syringes and sterile disposable needles are used. Before and after the manipulation, syringes are disinfected by wiping twice with a sterile alcohol gauze swab. At the end of the shift, syringes are sterilized in a dry-heat cabinet at a temperature of 180 degrees for 60 minutes; needles after disinfection are subject to disposal.

Dental mirrors immediately after use are soaked in a 5% solution of " Alaminol» for 60 minutes, then rinsed under running water, dried with a sterile cloth and stored in a sterile tray in an ultraviolet box. Immediately before the patient's appointment, dental mirrors are sterilized for 60 seconds in a glasperline sterilizer.

Dental tips are disinfected by wiping (before and after use) the outer surfaces and the burr channel twice with a sterile gauze swab moistened with 70% ethyl alcohol. After use, small endodontic instruments and burs are placed for cleaning from organic particles in a solution consisting of equal parts of 10% ammonia and 3% hydrogen peroxide solution. Then they are disinfected in a 5% solution " Alaminol» within 30 minutes, followed by sterilization in a dry-heat cabinet.

The quality control of pre-sterilization cleaning is carried out by the head nurse at least once a week using an azopyram test. The quality of cleaning from detergents and drugs is checked by a phenolphthalein test.

Sterilization

In the dental department, sterilization of medical instruments is carried out in a separate, specially designated room. Thermo-temporal indicators are used to control the quality of sterilization.

Surgical instruments after locking and processing are packed in special bags. The advantage of these bags is that they remain sterile for up to two weeks. Sterilization is carried out in dry ovens GP-40 for 60 minutes at a temperature of 180 degrees.

Diapers, gauze pads, cotton swabs are sterilized in autoclaves. All material is pre-packed in kraft bags.

All medical offices are equipped with glasperline sterilizers, with the help of which immediate sterilization is carried out. Glasperlin sterilizer is a container (up to one liter) filled with ceramic balls that are heated to a temperature of 240 degrees. The working surface of the instrument is placed in this environment: a dental mirror (for 60 seconds), burs and endodontic instruments with plastic holders (for 20 seconds), tweezers, probes, scalpels (for 15 seconds).

The main advantage of this sterilization method is:

1. Short instrument sterilization time.
2. Small dimensions and constant readiness of the device for work.
3. Possibility of carrying out emergency sterilization in the presence of the patient.

Disposal of medical waste

Before disposal, all disposable medical devices and medical waste must be disinfected. Disinfection is carried out in closed containers in specially designed rooms.

Used disposable syringes, gloves, saliva ejectors are disinfected in a 3% chloramine solution, then collected in bags and disposed of centrally.

The needles are also pre-disinfected, collected in a special container and disposed of.

Cotton and gauze swabs are disinfected in a 3% solution of chloramine for 120 minutes, after which they are disposed of.

General and current cleaning

The current cleaning of the premises is carried out 2 times a day using a 1% solution of chloramine and detergents, followed by ventilation and ultraviolet irradiation for 30 minutes.

General cleaning of therapeutic rooms is carried out once a month using a 3% solution of chloramine. Walls, furniture and equipment are treated with a 1% Alaminol solution with an exposure of 60 minutes. General cleaning of the surgical room is carried out using the same means once a week.

After general cleaning, the cabinet is irradiated with ultraviolet light for 2 hours. As a result of the operation of bactericidal lamps, the air in the room is ionized, nitrogen oxides and ozone are formed, so the room must be ventilated.

3. Prevention of occupational infection

In order to prevent infection of medical personnel, disposable gloves, masks, goggles are used. If necessary, protective helmets and aprons. Flavored deodorant tablets are used for rinsing the mouth. Disposable bibs, glasses, syringes are intended for the patient.

Each doctor's office is equipped with a first aid kit for the prevention of HIV infections.

• If infected or suspicious material gets on the skin, it is necessary to treat it with 70% ethanol solution, wash it with soap and water and repeat the treatment with 70% ethanol solution. Don't rub.
• If the infected material gets on the mucous membranes, they must be immediately treated with a 0.05% solution of potassium permanganate; rinse the mouth and throat with 70% ethyl alcohol solution. Don't rub.
• In case of injections or cuts, blood should be immediately squeezed out of the wound and the wound should be treated with a 5% iodine solution.

Reporting data for 2000

In total, 30,226 patients were admitted, and 75,350 standard units of labor intensity were worked out.

• primary patients – 13,940
• filled teeth - 28253:
  • about caries - 21,260
  • for complicated caries – 6,900
  • teeth treated in one visit for complicated caries - 2,816
• a course of treatment for periodontal disease - 1,106
• a course of treatment for diseases of the oral mucosa - 405
• teeth removed - 2240
• inspection in the order of planned sanitation - 7,522
  • of those examined needed sanitation - 1852
  • sanitized from among those identified during the planned sanitation - 1822

Nurses of the dental department have the knowledge and skills necessary to work with doctors in all offices of the department. If necessary, they can replace each other at the workplace (surgery, periodontics). During the work, the nurses act as a doctor's assistant, keep all the necessary documentation, in addition, they conduct therapeutic and preventive conversations with patients. They explain how to properly care for the oral cavity, which pastes, rinses, etc. to use.

Five nurses have the I qualification category, almost all of them have a specialist certificate. There is an atmosphere of friendly support and mutual assistance among the employees.