Entry into the clinic system, review dental concerns and formulate a treatment plan.
Mondays, Wednesdays (8am to 12pm)
8am – 9am; 10am; 11am
Thursdays (1pm to 4pm)
1pm; 2pm; 3pm
July thru December – Resident keeps all patients.
January thru April – Resident can keep patient or refer to Clinic Coordinator for other assignment.
PRELIMINARY PATIENT DENTAL CARE
Patient Information Date of Assessment:_______________
Patient Name__________________ Age:___________ Dentsyst #_________________
Available (circle): M T W Th F Home Phone:_________Work Phone:____________
Specific Areas of Needed Dental Care:
( ) Deep Caries ( ) Amal. Core ( ) Dent. Rep. ( ) Interim PD
( ) Fract. Tooth ( ) Other:
( ) Class I ( ) Class II ( ) Class III ( ) Class IV
( ) Urgent ( ) Surgical ( ) Biopsy ( ) Pre-Prosth.
( ) Urgent ( ) Caries Control ( ) Single Root ( ) Multi Root
( ) Anterior Caries ( ) Posterior Caries ( ) Simple TP ( ) Complex TP
( ) Ant. Crowns ( ) Post. Crowns ( ) Ant. Bridge ( ) Post. Bridge
Removable Prosthodontics: U= upper L=lower B=both
( ) Reline ( ) Repair ( ) Complete ( ) Partial
( ) Space/Crowding ( ) Crossbite ( ) Tipped Abutment ( ) General
The above were checked ( ) without ( ) with radiographs
Comments/ Special Management of Patient: ________________________________________________________
Screening Faculty Signature:_______________________
Initial Case Disposition
( ) Pre-Doctoral ( ) Clerkship ( ) Postgraduate
( ) Endo Only ( ) Ortho Only ( ) AEGD ( ) SPC
Assign to Oral Surgery first, then: ______________________________________________
Final Case Disposition
Assign to: ______________________________ Dentsys: ____________ GP:___________
Signed: __________________________________________________ Date:__________
Revised 10/01/94 mfr
UMB Dental School
Managing and Reporting an Exposure to Blood, and Other Potentially Infectious Materials
1. If an exposure has or may have occurred:
A. Immediately remove the instrument or tool that resulted in the exposure from the instrument tray, so it is not reused (if reused, a DOUBLE exposure has occurred)
2. DO NOT DISMISS THE SOURCE PATIENT/INDIVIDUAL:
A. If the source individual has been dismissed, maintain his or her contact information.
(1) A Dental School Nurse will contact the source patient to set up an appointment when he or she can return for blood testing as follow up to the exposure incident.
B. If there is no nurse available proceeded with steps 3, and 4 below, but in step 5 skip to C.
3. Remove gloves (do not throw them away if exposure to hands is believed to have occurred, but a glove breech is not obvious):
A. Put gloves in a separate small red bio-hazardous waste disposal bag so they can be checked to verify that a puncture occurred (perform first aid as applicable; described in step 4 below, then check glove for leak as needed).
(1) Don PPE and carefully fill glove(s) with water, twist open end to seal, and apply pressure as you observe for a leak. (If glove has a hole in it, an exposure took place, even if there is no wound on the hand.)
4. Provide first aid to the exposed area:
A. Wash any wounds briskly with soap and water, apply disinfectant and bandage as needed.
B. Flush eyes and mucous membranes with clear cool water for 15 minutes.
5. Report the exposure, or double exposure:
A. Monday through Friday prior to 5pm:
(1) Contact a Dental School Nurse to report the exposure. Patient Care Coordinators can help.
(2) If a Dental School Nurse cannot be contacted by any other means, page the emergency response team from one of the clinic phones; follow instructions posted on the pink sign above the wall phone, or use pager number 9-410-389-1324 and enter nearest room/quad#.
B. Tuesday, Wednesday and Thursday (C-3 Clinic) from 5pm to 7pm only:
(1) Page the nurse using the emergency response team pager number
9-410-389-1324 entering nearest room/quad #, or use a clinic wall phone and follow instructions posted on the pink sign above the phone.
C. If there is no nurse coverage or no nurse available:
(1) Go to one of the nurses offices (Room 2318 or Room 4317).
(2) Take a student injury packet for instructions on how to contact the Needlestick Hotline, or page the Needlestick Hotline @ 8-2337; ID #7845 and enter a 9 digit call back number. You may use the nurse’s phone and phone number.
(3) Stay near the phone until someone returns your page & they will advise you how to proceed.
(4) After reporting to the Needlestick Hotline (step (2) above), return to your patient and ask if he or she would be willing to return for a free, confidential blood test for HIV, Hepatitis B and Hepatitis C (OSHA/MOSH protocol). If pt. agrees, notify dental school nurse the next business day, with the time the patient will return.
(5) Always report the details of the incident to the dental school as soon as possible (email notification is acceptable).
6. Complete paperwork necessary for dental school injury/exposure reporting:
A. Complete Report of Special/Adverse Incident from inside Student Injury Packet, and submit it to a nurse.
B. Report incident Online at http://incident.umaryland.edu\ (user name is: dental\ followed by your first initial and last name with no spaces between; password is: your dental school PC password). Follow online report with a verbal or email report to a nurse, if a dental school nurse was unavailable at the time of the exposure incident.
Staff Procedure- Follow Student Post Exposure Guidelines steps 1. through 6. listed above.
1. In addition, the incident will need to be reported to Environmental Health and Safety (EHS) so that a claim number can be assigned for Workers’ Compensation. All of the necessary forms for State and Corporate Employees and Dental School Volunteers are located in a bin on the nurses’ office doors (Rooms 2318 and 4317).
A. State Employees can also go to the UMB EHS website
http://www.ehs.umaryland.edu/riskmgmt/InsuranceManual/med_treat.cfm for the necessary forms to be filed electronically, or printed and faxed immediately, or as soon as possible
B. Corporate Employees - may download forms from the UMB EHS website
(1) Forms for Corporate Employees are not to be sent to UMB EHS.
(2) Forms need to be submitted immediately to the Corporate HR Manager in Cubical 6425 in the Dental School Building.
C. Volunteers need to complete a Report of Special/Adverse Incident (in appropriately labeled yellow folder in bin on nurse’ office door) and a JE Authorization form (in appropriately labeled blue folder).