Routine Procedures Date skills Demonstrated Skills not passed Second review date Evaluator comments



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Routine Procedures

Date skills Demonstrated

Skills not passed

Second review date

Evaluator comments


Initial Date: _____________ Dental Assistant Competency Test Final Date: _______________

Employee: ________________________

Evaluator: _________________________ Evaluator: _________________________
1

Operatory set up:

DA is able to prepare operatory for routine dental procedures specified by provider

2

Amalgam set up:

DA is able to correctly set up for amalgam procedures

3

Composite set up:

DA is able to correctly set up for composite procedures

4

RCT set up:

DA is able to correctly set up for RCT procedures

5

Crown/Bridge set up:

DA is able to correctly set up for crown/bridge procedures

6

Oral Surgery set up:

DA is able to correctly set up for routine and complex oral surgery procedures

7

Observation:

DA is able to anticipate Dentist's needs during the procedure

8

Radiology:
8-a

DA has completed training tapes, passed exam, and is 18 years or older


8-b

DA uses safe radiation exposure practices


8-c

DA uses lead apron appropriately


8-d

DA wears personal safety radiation badge consistently


8-e

DA uses correct exposure setting for patients size


8-f

DA knows pregnancy radiation protocols and procedures


Routine Procedures

Date skills Demonstrated

Skills not passed

Second review date

Evaluator comments

8-g


DA chooses the correct Kodak mount for the radiographic exam being performed
8-h

DA accurately fills Kodak mounts with x-rays in the correct orientation


8-i

DA labels x-rays with correct tooth numbers in Kodak


8-j

DA knows how to create a Context in Kodak


8-k

DA can complete an FMX series in 30 minutes or less including panorex


8-l

DA must achieve good diagnostic quality with accuracy of 90% on digital x-rays


9

Panorex:
9-a

DA is able to correctly follow opening and closing procedures with the panorex and its software

9-b

DA can correctly position patient in panorex


9-c

DA uses correct infection control technique between patients


9-d

DA can correctly apply software settings according to the patient’s body type and produce a diagnostic quality panorex film

10

Sterilization:
10-a

DA is able to demonstrate correct procedures required to handle both non-sterile and sterilized instruments

10-b

DA is able to remove Blood and debris



from instruments prior to bagging or wrapping
Routine Procedures
Date skills Demonstrated

Skills not passed

Second review date

Evaluator comments

10-c


DA demonstrates the correct use of personal protective equipment
10-d

DA is aware of cross contamination potential


10-e

DA demonstrates pre-autoclave instrument preparation: bags, dates, wrap


10-f

DA knows the correct autoclave setting to be used


10-g

DA is able to recognize

non-sterile vs. sterilized instruments
10-h

DA follows the guidelines in the Dental Sterilization SOP


10-i

DA is able to demonstrate

correct procedures to complete spore testing for heat sterilizers (Autoclave/Statim)

10-j


DA demonstrates correct documentation procedures for heat sterilizers (Autoclave/Statim)

11

Operatory, Disinfection, Maintenance:


11-a

DA demonstrates correct Operatory Opening Procedures


11-b

DA demonstrates correct Operatory closing procedures


11-c

DA correctly disinfects the operatory between patients


11-d

DA follows the guidelines in the Dental Room Turn Around SOP



Routine Procedures

Date skills Demonstrated

Skills not passed

Second review date

Evaluator comments

12

Scheduling:


12-a

DA can schedule appointments in eCW


12-b

DA can modify eCW appointment statuses (cancel, No Show, ready, rescheduled, confirmed, and refuse/unable)

12-c

DA Correctly records Dentist/Hygienist next visit instructions in eCW


12-d

DA demonstrates appropriate phone etiquette


13

eCW Record Maintenance
13-a

DA Understands and Observes HIPAA Regulations


13-b

DA understands the eCW schedule and all color tracking in eCW


13-c

DA is able to update the following categories in eCW progress notes: Medications, Medical History, Allergies, Surgical History, Hospitalization History, Social History, and Vitals

13-d

DA correctly answers patient smoking, chewing tobacco, and alcohol screening questions in Social History section of eCW 90% of the time



13-e

DA is able to check patient’s pain level and blood pressure. These need to be correctly entered in the Vitals section of eCW 90% of the time

13-f

DA understands which eCW template to use for the HPI section of the eCW progress note



Routine Procedures

Date skills Demonstrated

Skills not passed

Second review date

Evaluator comments

13-g


DA understands how to print patient education through eCW and does this for 90% of initial and periodic exam appointments

13-h


DA is able to assign eCW note to a provider
13-g

DA is able to switch appointment from one provider to another when moving an appointment in eCW

14

Open Dental Charting:
14-a

DA is able to accurately chart in Open Dental from Dentist /Hygienist dictation


14-b

DA is able to use all of the charting tools in Open Dental (chart restorations, missing teeth, primary teeth, move teeth, and draw on tooth chart)

14-c

DA is able to correctly write a complete group note in Open Dental for a procedure that they performed (such as impressions)



14-d

DA should be able to save the tooth chart to images in Open Dental for 90% of exam appointments

14-e

DA needs to sign the Open Dental “Prevention Counseling” procedure code 90% of all appointments



14-f

DA can create an Open Dental CommLog and Popup


14-g

DA can set complete Open Dental appointment card with correct procedures and provider (who completed the procedures) for 90% of appointments

14-h

DA is able to accurately transfer procedure codes from Open Dental to eCW and complete all sections of the eCW “Procedure Codes” section


Routine Procedures

Date skills Demonstrated

Skills not passed

Second review date

Evaluator comments

14-i


DA can navigate eCW enough to find:

Past encounters, Patient Discount, last Health HX, Insurance, Patient Documents

15

Consent Forms:
15-a

DA is able to correctly complete

consent forms for N2O, extractions and RCT TX in Open Dental. Consents must be signed and printed

16

Price Quotes:


16-a

DA is able to correctly complete quote

for RCT, crown/bridge, endo, partials/dentures, operative, and oral surgery treatment

17

Lab:


17-a

DA is able to take impressions while following cross-contamination protocols


17-b

DA is able to pour clinically acceptable models without air bubbles


17-c

DA is able to complete lab slip in Open Dental


17-d

DA can explain steps and time involved in partial/denture process


17-e

DA can take a blood sugar level and correctly enter the information into eCW so that it counts for Meaningful Use




Dental Director: ______________________________

Date: ______________________




Dental Director: ______________________________

Date: ____________



Dental Director: ______________________________

Date: ____________



Dental Director: ______________________________

Date: ____________



Dental Director: ______________________________

Date: ____________



Dental Director: ______________________________

Date: ____________



Dental Director: ______________________________

Date: ____________



Dental Director: ______________________________

Date: ____________




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