CLINIC POLICY AND PROCEDURES MANUAL

1 DALHOUSIE UNIVERSITY FACULTY OF DENTISTRY CLINIC POLICY AND PROCEDURES MANUAL (also see the Schedule of Fees for Dental Services and the Infection Control MANUAL for other CLINIC policies) 2013 -2014 MISSION STATEMENT We promote and provide oral health care as an integral component of overall health, for regional, national and international communities through quality education, research and service. Compiled by The Office of the Assistant Dean, Clinics and Building Services, August 2013 THIS MANUAL IS FOR THE SOLE USE OF THE DALHOUSIE DENTAL CLINIC FACULTY, STAFF AND STUDENTS. Suggestions for improvements are always welcome. Please pass them on to the office of the Assistant Dean, Clinics and Building Services, Level 1, Room 1210. Assistant Manager, Patient and Information Services Available at (click on 'Faculty Policies and Manuals' or you can get a printed copy from the Clinical Affairs Office, Room 1210, Level 1.)

2 2 TABLE OF CONTENTS Important Contact Information .. 6 SECTION ONE - RESPONSIBILITIES, QUALITY ASSURANCE, PATIENT RIGHTS AND PROFESSIONALISM .. 7 CLINIC FEES .. 8 MANDATORY CRIMINAL RECORD CHECK AND VULNERABLE SECTOR CHECK .. 8 STUDENT RESPONSIBILITIES .. 9 SUSPENSION OF PRIVILEGES .. 9 CELL PHONES, PAGERS, IPODS ETC.. 9 PURCHASE OF PERSONAL EQUIPMENT ( loupes and lights) .. 9 POLICY ON STUDENTS AND STUDENT APPLICANTS WITH INFECTIOUS DISEASES .. 9 CHART AUDIT QUALITY ASSURANCE .. 10 FACULTY RESPONSIBILITIES (includes Cell phones, pagers, iPods etc.; CPR & Defibrillator Training) .. 11 STAFF RESPONSIBILITIES (includes Cell phones, pagers, iPods etc.; CPR & Defibrillator Training) .. 13 PATIENT RESPONSIBILITIES (includes Infected Patient) .. 15 CDA CODE OF ETHICS .. 16 CONFIDENTIALITY OF PATIENT INFORMATION - FACULTY POLICY 2009-2010.

3 20 PROFESSIONALISM FOR FACULTY, STAFF AND STUDENTS .. 22 STUDENT CODE OF PROFESSIONAL CONDUCT .. 23 DALHOUSIE DISCRIMINATION AND HARASSMENT POLICY .. 25 SECTION TWO - GENERAL BUILDING INFORMATON AND POLICIES .. 26 A. FIRE AND EMERGENCY EVACUATION PROTOCOL .. 27 B. BUILDING ACCESS .. 29 C. SECURITY INFORMATION .. 29 D. PARKING .. 29 E. CLASSROOMS AND SEMINAR ROOMS .. 29 F. INFORMATION TECHOLOGY SERVICES .. 30 G. ALCOHOL RULES .. 30 H. STUDENT MAILBOXES .. 31 I. STUDENT LOCKERS .. 31 J. WASTE DISPOSAL .. 31 SECTION THREE - GENERAL CLINIC INFORMATION, POLICIES AND PROTOCOLS .. 32 PART 1 - STUDENT INFORMATION .. 33 A. ACCESS TO THE DENTAL CLINIC LEVELS 1 AND 2 .. 33 B. ACCESS TO CLINIC AREAS FOR EXTRA PRECLINICAL PRACTICE .. 33 C. CLINIC CANCELLATION POLICY .. 33 D. DRESS CODE .. 34 E. CLINIC JACKETS AND SCRUB PANTS.

4 35 F. STUDENT VOICE MAIL .. 36 G. PHANTOM HEADS .. 36 H. STUDENT YEAR END CLEARANCE POLICY .. 36 I. STUDENT FEES - MANDATORY (see Faculty of Dentistry Calendar) .. 37 J. STUDENT TAX RECEIPT REQUESTS .. 37 K. CLINIC SUPPLIES AND LOCATION OVERVIEW .. 37 L. STUDENT SPECIAL CLINIC ASSIGNMENTS AND ROTATIONS .. 37 M. CHILDREN IN CLINIC .. 38 1. Who do not have an appointment .. 38 2. Minors Treated in Faculty of Dentistry Clinics .. 38 Minors at Harbour View and Nelson Whynder Clinics .. 38 Permission to allow minors to attend clinics without parental supervision .. 38 N. CHILD ABUSE .. 39 What is the Law Regarding Child Abuse? .. 39 Responsibilities of Faculty Supervisors and Students .. 39 What is Child Abuse? .. 39 Where to make a report .. 40 3 PART 2 - CLINIC - GENERAL .. 40 A. ACCESS TO CLINIC SUPPLIES AFTER 4:30 PM DAILY.

5 40 B. CLINIC ATTENDANCE/ABSENCE .. 40 C. CROSS BLOCKING .. 41 D. STUDENT CLINIC SUPERVISION .. 42 E. STUDENT PATIENT CARE RESPONSIBILITIES UNTIL GRADUATION .. 42 F. STUDENT RELATIONSHIPS WITH PATIENTS .. 42 G. APPOINTMENT PROCEDURES - DENTAL STUDENTS .. 44 PART 3 - GENERAL PATIENT INFORMATION (AXIUM, PATIENT CHARTS ETC.) .. 46 A. CLINIC INFORMATION SYSTEM (AXIUM) BOOKINGS/APPOINTMENTS .. 46 B. CHARTS .. 46 C. PATIENT CHARTS/DOCUMENTATION .. 46 D. CONSULTATION RESULTS .. 46 E. MEDICAL HISTORY .. 46 F. treatment PLANS .. 46 G. PATIENT CONSENT TO treatment .. 47 PART 4 - CLINICAL PATIENT INFORMATION (REFERRALS, CATEGORIES ETC.) .. 47 A. PATIENTS REFERRED TO PRIVATE PRACTICES .. 47 treatment Too Complex .. 47 Continuance, Expedition, Correction or Repeat of treatment .. 48 B. PATIENTS REFERRED TO THE DALHOUSIE CLINICS BY PRIVATE PRACTICES.

6 48 Limited treatment Patients .. 48 Comprehensive treatment Patients .. 48 Implant Maintenance Patients .. 48 Orthodontic Maintenance Patients .. 48 C. PATIENT CLASSIFICATION - MEDICAL .. 49 D. MEDICAL CONSULTATIONS .. 50 E. MANAGEMENT OF CHILDREN AT DALHOUSIE DENTAL CLINIC .. 50 PART 5 - FEE GUIDE POLICIES .. 50 A. General Fee Policies .. 50 Fees for Dental treatment Services for Students, Staff Members of Dalhousie University .. 51 Endodontic Fees .. 51 Laboratory Fees .. 51 Denture Fees .. 51 Orthodontic Fees .. 52 TMD Fees .. 52 Restorative Fees .. 52 Miscellaneous Fees .. 52 Fee Waivers and Refunds/Credits .. 52 B. Forms of Payment .. 52 C. Delinquent Accounts .. 53 D Responsibilities of Students .. 53 E. Patients on Social Assistance .. 53 F. Claims (Maritime Medical Services Insurance) for Pediatric Patients.

7 53 G. Third Party Payments .. 54 H. Incorrect/Insufficient Address .. 54 I. Cancellation POLICY /"No Show" POLICY .. 54 J. Responsibility/Replacement/Repair Information .. 54 Range of Services Available .. 54 Unsatisfactory Care .. 54 Referrals to Dentist Practicing External to the CLINIC .. 55 Damaged/Broken/Lost Appliances .. 55 K. Relative Value Units (RVU s) .. 55 PART 6 - MEDICAL EMERGENCIES .. 56 1. Medical Emergencies During Regular CLINIC Hours (Chart) .. 56 2. Emergency Response Carts .. 56 3. AED's .. 56 4. Medical Emergencies After Regular CLINIC Hours .. 57 4 PART 7 - DENTAL EMERGENCIES .. 57 1. Dental Emergency Care During Regular CLINIC Hours .. 57 2. Emergency Care after regular CLINIC hours and during CLINIC closures .. 59 After Hours Dental Emergency Coverage (flow chart).

8 60 3. Pediatric Dental Emergencies .. 59 PART 8 - SAFETY AND ASEPSIS PROCEDURES .. 61 A. CUBICLES - HOUSEKEEPING AND INFECTION CONTROL .. 61 B. REMOVAL OF RUBBER DAMS ETC. PRIOR TO PATIENT LEAVING CLINIC AREA .. 61 C. MANAGEMENT OF LATEX-SENSITIVE PATIENTS .. 62 D. PREVENTION OF INFECTIVE ENDOCARDITIS .. 62 E. ANTIBIOTIC PROPHYLAXIS FOR PATIENTS WITH TOTAL JOINT REPLACMENT .. 63 F. PRESCRIPTION WRITING AND MEDICATION DISPENSING .. 66 G. SEDATION OF PATIENTS .. 66 H. NEEDLESTICK, PUNCTURE WOUND POLICY .. 67 I. MANAGEMENT OF EXTRACTED TEETH .. 67 J. INFLUENZA VACCINATION PROGRAM .. 67 K. INFECTION CONTROL CHECKLIST FOR DENTAL CUBICLES .. 68 L. INFECTION CONTROL MONITORING .. 68 M. MANAGEMENT OF PATIENTS WITH HERPETIC LESIONS .. 68 Oral Health Care Workers with Herpetic Whitlow .. 69 N. PROCEDURES FOR INSTRUMENT REPROCESSING/STERILIZATION.

9 70 PART 9 - RADIOGRAPHIC POLICIES FOR DALHOUSIE DENTAL CLINIC .. 70 A. RADIOLOGY UNIT .. 71 B. PRECLINICAL: Radiology Labs - Preclinical Training - Film .. 71 Radiology Labs - Preclinical Training - PSP Plates .. 71 Preclinical Student Darkroom and Portable Processors for films .. 71 Preclinical Endo Typodont Processing .. 71 PART 10 - DENTAL EQUIPMENT - CARE AND MAINTENANCE .. 72 PART 11 - OCCUPATIONAL HEALTH POLICIES .. 72 A. WHMIS .. 72 B. Chemical Spill Instructions .. 72 C. Recommended Practices for Potentially Hazardous Materials Instruments and Equipment .. 72 D. Eye Protection .. 74 E. Scent Free / Smoke-Free POLICY .. 74 F. Waste Disposal (includes Chemical and Biomedical Wastes) .. 74 G. Minor Injuries/Illness (Faculty, Staff, Students and Building Visitors .. 76 PART 12 - PROCESSING LABORATORY ORDERS (DENTAL CLINICAL SCIENCES REQUIREMENTS).)

10 76 A. PATIENT ACCEPTABILITY .. 76 B. OCCLUSAL SPLINTS/BITE PLANES/NIGHT GUARDS .. 77 C. FINISHING, RUBBER WHEELING AND POLISHING PFM AND CAST GOLD RESTORATIONS .. 77 D. PROVISIONALS .. 78 E. DUAL ARCH IMPRESSION LAB/CLINICAL PROTOCOL .. 79 F. CUSTOM TRAY FABRICATION .. 79 G. CHECK STEPS FOR PATIENT treatment IN ALL CLINICS .. 79 H. FABRICATION OF ORTHODONTIC RETAINERS .. 80 I. REPLACEMENT/REPAIR POLICY FOR PROSTHESIS/DEVICES .. 80 PART 13 - PROCESSING LABORATORY ORDERS (DENTAL LABORATORY REQUIREMENTS) .. 81 PART 14 - ORAL PATHOLOGY POLICIES AND PROCEDURES (CONSULTS, BIOPSIES ETC.) .. 84 5 PART 15 - DISPENSARY GUIDELINES .. 86 PART 16 - NEW CLINICAL AND PRECLINICAL SUPPLIES AND EQUIPMENT .. 87 SECTION FOUR - SPECIFIC CLINIC SUPPORT UNITS .. 88 BUILDING SERVICES UNIT .. 89 CLINICAL AFFAIRS OFFICE.