Implant nursing Continued »
• Finished, hands and arms should be dried using a sterile towel and aseptic technique. You are now ready to don your gown and sterile gloves. The sterile area will be
set up with everything that could possibly be needed for the procedure, including surgical instruments, sterile gauze and extra suction tips (these can easily get blocked when carrying out surgical procedures). The sterile nurse should be providing adequate retraction and moisture control at all times as well as being acutely aware of the areas of the surgery that she can and cannot touch during the procedures. Another thing to consider
is the use of non-latex prod- ucts. This will benefit the team and the patients as the number of latex sensi- tivities and allergies is on the increase. It is best practice to aim to be latex free to reduce the chance of an allergic reaction. All dentists will have their
own preferences when it comes to instruments, but below is a basic list of surgical instruments (figure ı). ı. Minnesota retractor 2. Cat’s paw retractor 3. Tissue tweezers 4. Needle holders 5. Scissors 6. Mitchell’s trimmer 7. Periosteal elevator (small) 8. Periosteal elevator (large) 9. Periodontal probe ı0. Blade handle ıı. Spencer-Wells forceps.
The use of local decon-
tamination units are making all dental care professionals aware of ‘zoning’ techniques, a useful skill to have when working with implants. Nurses who are non-sterile
are responsible for main- taining the clinical area outwith the sterile zone. This can include changing programme settings on equipment, opening pre- sterilised packets for the sterile nurse, drafting a surgical report for the dentist, recording drill usage charts and keeping a copy of implant labels. By no means should the
non-sterile nurse be consid- ered to have the ‘easy job’. Making the most of the time available and forward thinking should reduce the need for a nurse to be standing waiting and make the appointment more efficient. For more advanced proce-
dures involving sinus lifts, block grafts or augmentation, there is a whole new set of procedures and equipment to learn. The excellent advanced nurse’s course run by the ADI was very useful for expanding my knowledge and skills in this area. I would urge all team members involved in implant dentistry to join. Having a practice set of
surgical drapes and gowns is a good idea to use for training new staff members and honing the skills of the more experienced team members. Implants may not be an everyday occur- rence and having the items to
ABOUT THE AUTHOR
Tara Crabtree has worked as a dental nurse for six years and qualified with her national certificate in 2010 with a merit pass. She has been involved in implant work since 2009 when joining Botanics Dental Care in the west end of Glasgow, working with Dr Colin Gardner. After completing several implant training courses and attending the ADI team confer- ence in 2010, Tara decided to join the ADI as a DCP member to keep her knowledge up to date. She recently attended the ADI Advanced Nurse’s Course in Edinburgh.
practice with can really help boost confidence on the day.
Useful training tips • Good planning prior to the appointment – know what to expect and what you need. Be prepared for the unexpected as quite often it happens! • Create check lists and photo guides to aid set up • Regular ‘dress rehearsals’
“Rinse hands and arms by passing them through the water in one direction only, from fingertips to elbow”
44 Scottish Dental magazine
using a spare drape kit and gown • Reflective learning. After the appointment discuss with the rest of the team how it went, is there anything to be learned from what happened? Did it go well? How can we improve? • Engage with the patient – possibly have a dedicated nurse for the whole implant journey that the patient can get to know and call if they need advice • If in any doubt seek advice, don’t be afraid to ask • Join a professional body, such as the ADI, to keep up to date with protocols and training. Dental nurses have been
granted professional status, which is fantastic for our profession. We have worked hard to get where we are now. I am fortunate to work within a team who fully appreciates the role that a dental nurse plays. I have been lucky enough to have been supported initially by an experienced nurse from another practice who has a wealth of experience on the subject, along with excellent help from implant company reps, dentists and fellow nurses. Implants may seem daunting
to the inexperienced, but they are not something to be feared. There is always the opportunity to learn more and gain more experience and that is what I aim to do. We are now in an environment where patients are much more informed and have a better idea of what is expected from their dental care professionals. Training and CPD must be
at the forefront of everyone’s minds and it is important that dental nurses are aware of the implications and the risk to their GDC registration is they do not follow procedure. It is now essential that we not only have these procedures and protocols in place, but that we are also able to demonstrate that we have followed them for each and every case.
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