Implant nursing
“A quick chat and a hello will make the patient feel that their procedure is important and their feelings are being taken into consideration” Tara Crabtree
Fig 1 Basic instrument tray for implant surgery
Taking the time to get to
know your patients is very useful, it instils trust and co-operation. Even if you have a patient who has no nerves about the appointment or is used to having the procedure, it is still good practice to have a quick chat with them prior to the appointment to find out how they are. As we are well aware, some patients don’t like to tell you how they are really feeling. A quick chat and a hello
will make the patient feel that their procedure is important and their emotions are being taken into consideration. For the dental team it could be just another appointment in the day, but for the patient it is an event, one that may have required some planning, time off work and considerable investment.
The set up Well in advance of the appointment, all consent forms, medical histories, implants, healing abutments, augmentation materials and lab work should be checked. If there is any doubt, then this should be clarified prior
to the appointment. When first starting out in the world of implants, all of the different components, systems and small items of equipment can seem daunting. Nurses who are new or relatively new to this kind of work should review equipment and proce- dures prior to the appointment with a more experienced staff member. Creating proto- cols for every procedure and having a photo set up checklist for instruments and equip- ment can save time and aid with training. It provides a quick reference for nurses to refer to if they are struggling with the set up. This provides piece of mind
for the nurse and the dentist and minimises the risk of errors. The stringent nature of
the infection control policies means that everything must be standardised and any small error could have a big impact. Placing a dirty, non-sterile pair of gloves on a sterile area could mean a complete new set up process. There are two different
roles for the dental nurse during implant surgery: sterile
and non-sterile. Both of these roles are of equal importance, working closely together during the set up to keep things as sterile as possible. This requires practice, communi- cation and training within the team to work effectively. The idea of surgical asepsis
is important to all surgical procedures. Protocols for preparation, sterilisation and correct storage of instru- ments should be followed at all times. The dental team have to aim to reduce the number of micro-organisms in contact with the surgical site, utilising strict protocols. A surgical hand and forearm scrub should be undertaken by all members of the team. This is a very important step in reducing the risk of infec- tion. Only then should the team don a surgical gown, sterile gloves and hat. All team members in sterile gowns will remain in the sterile zone at all times. The purpose of surgical hand scrub is to: • Remove visible debris and micro-organisms from the nails, hands, and forearms • Reduce the microbial count
• Reduce growth of micro- organisms. The procedure for the timed
five-minute scrub consists of: • Removal of all jewellery and nail varnish/false nails (rings, watches, bracelets) • Washing hands and arms with soap. Ensure the correct temperature – excessively hot water is harder on the skin, dries the skin and is too uncomfortable to wash with for the recommended time • Start timing. Scrub each side of each finger, between the fingers, and the back and front of the hand for two minutes • Proceed to scrub the arms, keeping the hand higher than the arm at all times. This prevents bacteria from contaminating the hand • Wash each side of the arm to the elbow for one minute • Repeat the process on the other hand and arm, keeping hands above elbows at all times • Rinse hands and arms by passing them through the water in one direction only, from fingertips to elbow
Continued » Scottish Dental magazine 43
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