Level 3 Diploma in Dental Nursing

Unit 301 - Reducing risks to health and safety in the dental setting

This unit is about health and safety in a dental nurse’s day to day work. This includes identifying and dealing with risks and hazards in the workplace. This
question book has been designed to enable you to complete the knowledge for the above unit. This workbook is concerned with Health & Safety and reducing
risks in the dental setting, it will consist of a series of questions and require you to research information.

This unit has four learning outcomes

The learner will:
1. Know the hazards in the dental setting
2. Understand organisational and legal requirements for health and safety within the dental setting
3. Be able to act upon hazards in the dental setting
4. Be able to reduce the risks to health and safety in the dental setting

Evidence requirements
A minimum requirement of two observations to cover a range of chairside activities on two different occasions.
Learners must include knowledge evidence to reflect understanding of current Health & Safety legislations and own role in implementing workplace policies.
Suggested methods are verbal and written questions, assignments and/or professional discussions.

It is recommended that 8 guided learning hours should be allocated to this unit. Your assessor will give you training and development to increase your
understanding.

Important words to Remember (these will appear in BOLD throughout the questions):
 Describe – To give an account in speech or writing
 Explain – To make plain or comprehensible
 List – A series of words
 Identify – To establish, determine or ascertain
 Outline – Summary of a text or dialogue
 Analyse – To examine carefully & in detail
 Define – To state the meaning of (a word, phrase)

Page 1 of 7
 Level 3 Diploma in Dental Nursing

s301 - 1.1 Define the terms hazard and risk

Hazard: Risk:
Definition “a danger or risk”. Definition: “a situation involving exposure to danger”.
A hazard is anything that can cause harm. A risk is the chance of someone actually being caused harm by a hazard.

301 - 1.2 Identify working practices which could harm for yourself or others and explain what you would do to minimise these effects including:
a) safe working methods Safe working methods can cover a broad range of topics but if you are not working in a safe manner you may cause yourself unneeded risk
and equipment and risk to all those around you. The basics for keeping your work methods safe are to follow the PPE, H&S, or any other necessary
guidelines for that activity and be aware of your surroundings at all times. There is a risk of harm when using a number of pieces of
equipment in the surgery. To minimise this, ensure that you are following the manufactures instructions completely and any safety advice
they have provided.

b) safe use of hazardous Misuse or handling of hazardous substances is a serious risk to your health, the health of others near you, and potentially the environment if
substances disposed of incorrectly. When using any hazardous substances, you should follow the COSHH guidelines and practices set out in your
practice. A number of substances (such as cleaning products) will have directions of use on the containers that you should also follow.
Wearing the appropriate PPE for different situations is also vital when handling hazardous substances.

b) Smoking Smoking in of its self is a risk to your own health and the health of anyone close to you. If you do need to smoke while working, you would
need to fully change out of your uniform, thoroughly wash your hands and either attend a dedicated smoking area on the premises or leave
the area of the practise until you have completely finished. Also, you would need to ensure the cigarette is completely put out and disposed
of correctly to minimise any risk of fire. When you return to duties, you would need to wash your hands thoroughly again.

b) Eating Eating in the practice is a risk of cross infection both for yourself and any patience after you have finished. To minimise the risks, you would
need to change out of your uniform, thoroughly wash your hands, and attend a staff room to eat. Once you have finished, you can then
change back, wash your hands again and then return to your duties.

b) Drinking Drinking in the practice is a risk of cross infection. You should not bring drinks into the surgeries as there is a risk of airborne contaminants
coming into contact with the container or liquid. You may drink in communal spaces but to ensure your personal safety, you should remove
any PPE that you may have worn in surgery and wash your hands before touching the container or your mouth.

b) Drugs Many drugs can cause unexpected side-affects on a patient and you must be ready and able to handle situations that may arise from an
adverse reaction. To minimise the risk, you should first ensure that you are aware of the patient’s medical history to avoid known allergens
and interactions with any other drugs they may be taking. If they do suffer an adverse reaction, a quick response with the appropriate
treatment (escalation to a health care professional if required) and to report the reaction using the yellow card system. It is also important to
know exactly wear the nearest first aid kit, stationed first aider, and emergency drugs box is located as you may need to get one or both
container and the first aider quickly.

301-1.2 Range 1c) How could non-compliance with the following practice procedures cause harm to yourself or others in the practice?
The procedure in the event of an emergency Personal Presentation Moving and handling

Page 2 of 7
 Level 3 Diploma in Dental Nursing

If you don’t follow the procedure, you could Your personal presentation can become a cross- When moving and handling items such as stock,
exasperate your own injury if you are the cause of infection issue if you do not follow ‘best practise’. especially large boxes, there is a correct method
the emergency or you could potentially cause In cases of unclean or incorrectly worn uniform, to safely lift and store items to ensure you do not
more harm to the victim. Non-injury-based you can bring bacteria into the practice and take it hurt your back or any joints while lifting
emergencies (power issues or a fire) could cause home with you, risking yourself and others around something. Once you have re-located the item
panic and injury if you do not respond calmly and you. Jewellery and untied long hair can pass you then would need to store it in an appropriate
in the correct manner. bacteria onto any surface they come into contact place to prevent it falling onto you or anyone else
with, mostly creating risk to others. Inappropriate and also ensure it is not a tripping hazard for
footwear can cause a risk to you, either by not anyone in the practice.
supporting your own personal health and safety or
causing a cross-infection concern if they cannot
be appropriately cleaned.

301- 1.3 Identify aspects of the dental setting which could harm self or others.
Within the dental surgeries, there are a number of instruments, pieces of equipment, and substances that can be harmful to everyone if you mishandle
them. One of the biggest risks to the patient in the room, is the risk of cross infection. It is up to the nurse to ensure that infection control is kept on top of
throughout the procedure and that everything used in the procedure is appropriately sterilized. On the nurse and dentist side of cross infection, it is
important to wear, use, and dispose of their PPE in an appropriate manner.

During the procedures, you may use a number of hazardous substances and intricate pieces of equipment that will need to be handled in accordance with
manufacture instructions and/or health and safety guidelines. You must also ensure that any drugs that may be given are administered safely and the
patient is observed for any potential adverse reactions. Once everything has been concluded, you will also meet a hazard when it comes to
decontamination procedures. These hazards would be manually scrubbing instruments, disposing of waste in a safe and appropriate manner, and correct
use of any cleaning chemicals.

Outside of the surgery, there are other hazards such has cable control (to prevent tripping hazards), stock management (safe manual handling and
storage), and more infection control risks throughout the building.

301 - 2.1 Identify organisational and legal requirements for health and safety in a dental setting
a) Health & Safety at Work Act 1974 The health & safety at work act makes it clear that all employees are responsible for not only their own health and
safety but the health and safety of everyone who may be on the premises. The employee’s responsibilities within this

Page 3 of 7
 Level 3 Diploma in Dental Nursing

are to follow all policies and training provided to them. We have to report any suspected health problem that could be
related to work and not enter certain designated areas unless authorised. We will also need to ensure we do not misuse
any equipment that is meant for controlling risks and report immediately any apparent faults in procedures or
equipment.

b) Control of Substances Hazardous to Under COSHH, all dental practices must have a risk assessment of all chemicals and potentially hazardous substances
Health (COSHH) on the premises. The report will include the hazards at hand, how they can be avoided, and how to deal with the hazard
if it happens. In practice, these materials can include sodium hypochlorite, acid etchants, mercury, x-ray fixers, and
flammable materials. Employers have to ensure that we are aware of the risks, inform us of the controls in place to
avoid the hazard, and ensure that the controls are working properly.

c) Environmental Protection Act 1990 The environmental protection act covers the duty of care the practice has in regards to the disposal of waste.
To ensure you comply, you need to identify the person responsible for waste management in the practice, and ensure
all members of staff are trained in the proper waste disposal methods. You need to segregate the waste under the
HMT01-05 regulations and they need to be collected by licensed waste collectors. The practice will need to keep the
transfer notes relating to the waste for three years after the date of collection and quarterly consignee returns
documentation. The practice would also register with the Environment Agency as a hazardous waste producer if more
than 500 kg of hazardous waste is produced
annually.

d) Ionising Radiation (Medical Exposures) IR(ME)R cover all aspects of radiography from equipment selection, installation, and radiographic procedures and
Regulations (including local rules) protocols. They classify persons involved in radiography as follows: IR(ME)R referrer, IR(ME)R practitioner, and
IR(ME)R operator. This can all be completed by one person (a single clinician) or several may be involved in each
stage of the process. The operator who carries out the X-ray must be someone who is fully trained in radiography to
ensure their safety and the safety of the patient. However, an untrained person may be considered an operator if they
have been involved in processing, mounting, or QA of the image as this is a safe activity. There will also be a radiation
protection adviser to advise about observance of the regulations and safety matters connected to ionising radiation.
They will carry out the risk assessments, create contingency plans, radiation protection programmes, and observe local
rules.

e) Reporting of Injuries, Diseases and If an injury in the practice results in a person spending 24 hours in hospital for treatment or requires sick leave for three
Dangerous Occurrences Regulations 1995 or more days, it needs to be reported to HSE under RIDDOR by phone and an accident report form should be sent to
(RIDDOR) them within 10 days. A report must also be made if the injury involves a fracture of the skull, spine, pelvis, or limbs, loss
of sight, unconsciousness, explosions/fires, major mercury spills, or acute illness from exposure to a pathogen. This
everyone within the practice bar patience currently undergoing a treatment.

301 - 2.2 Describe the process for reporting risks to health and safety within the dental setting.
a) Using organisational procedures If I identify a health and safety risk at work, my first point of call is to report this to our practice manager. Our practice
manager deals with issues that come up in day-to-day activities and if she can resolve the issue herself, she will do so
then and there. Otherwise, she will call the appropriate persons (e.g. mechanical technician or an engineer) and ensure

Page 4 of 7
 Level 3 Diploma in Dental Nursing

the location or item is clearly marked as out of use until the issue has been resolved.

b) By reporting differences between work If I were to see another colleague misusing a piece of equipment, who it would be reported to would vary depending on
practices and organisational legal the person. For example, if I saw another nurse incorrectly using an auto-clave in a dangerous way or in a way that does
requirements and manufactures not adhere to infection control, this would be reported to our in-house training nurse. The training nurse is in charge of
instructions. providing all practical in-house training and would be the one to have the discussion with the nurse in question.

However, if the person who misused the equipment were a dentist or clinician, this would go directly to the practice
manager. The practice manager would be the one to have the conversation with them regarding the safety issues that
may have ensued.

2m 301 - 3.1 Give an example of a time when you have reported hazards to the identified responsible person
a) manager There was an incident when I was shutting down a surgery for the day and while changing the clinical bins, I saw an
extracted tooth on the top of a clinical waste bag. I was unsure of how to handle this, so I got the managers assistance. She
advised me to change my disposable gloves for heavy duty gloves to take the tooth from the top of the bag and place it in the
sharps box for appropriate disposal. She then arranged to have a conversation with the team working in the room to ensure
safe practices in the future.

b) supervisor There was an incident where I had been working in the decon room and when I retrieved a tray out of the auto-clave, I
noticed that a scalpel had the blade left in it. I was unsure of how to handle this situation as I know a nurse is not supposed to
remove the blade, and we did not have a sharps box for the decon room as sharps would not ordinarily enter the decon
room. I went to get the head nurse (my direct supervisor), for advice regarding the best action. She placed the scalpel into a
transport box to take it to the initial surgery, have the dentist dispose of the blade in their sharps box, and then returned the
handle to me for re-processing.

c) section leader or health When I went to go into the decon room one day, there were a number of boxes that had been stored in the doorway to keep
and safety representative them out of sight of patients until they could be put away properly. However, this was a clear tripping risk for me as I come in
and out of the room. I reported this to our safety representative to advise other colleagues of a safer location to store stock
intake until it can be sorted properly. I was able to place the stock in our unused waiting room out of the way until I was able
to process the new stock.

301 - 3.2 How would you deal with the following hazards in the dental workplace?
a) Mercury spillage Mercury spillages have a specific clean up kit that should be used. This would include the following: disposable gloves, paper towels, bulb
aspirator (for large mercury drops), vapour mask, sealable container, and a mercury absorbent paste. You need to try to combine the
droplets, and pick up as much of the mercury as possible with the syringe. Then apply the absorbent paste to the area and then gather
the waste into a clearly marked container with a lid. Ventilating the room is essential and the send the waste mercury for reclaiming or

Page 5 of 7
 Level 3 Diploma in Dental Nursing

disposal as toxic waste.

b) Radiation Before taking any radiograph, the patient needs to have a clinical examination to ensure their safety and that the radiograph is necessary.
When taking a radiograph of any kind you must be at a safe distance (2m away from the tube/beam). You should not enter the area when
the x-ray is being operated and when you are done, completely turn off the machine.

c) Cross infection Cross infection hazards can be avoided by using the appropriate decontamination methods for equipment and instruments as well as
wearing the correct PPE and removing it in a safe manner. I will ensure that at the beginning of a procedure, we are using only sterilized
instruments, and fresh disposable items. All surfaces will have been cleaned before setting up for the patient. I would also be wearing
PPE to the appropriate level for the treatment we are completing. At the end of the procedure, I would remove all instruments and
disposables and take them to the dirty zone before cleaning the surfaces again. Once completed, I would manually scrub each reusable
item before placing them in the auto-clave for sterilization. When completed, I can remove my PPE and dispose of them in the clinical
waste, thoroughly clean my hands before starting the process again.

d) Environmental factors Environmental hazards to dental workers can be issues such as musculoskeletal complications. This can affect nurses, dentists, and any
other clinicians. To avoid these hazards using the correct chairs, supports, and postures are vital to avoid the hazards. I would need to
ensure I have my nurses’ stool at the correct height so I do not have to strain my back to view what I am doing during a treatment. Ensure,
I have time to stretch and move around often during the day and to keep the correct posture during different activities during the day.

e) Spillages Spillages should be cleaned up quickly and with the correct methods e.g. bodily fluids should be covered in paper towels and an
appropriate disinfectant and left for 5 minutes before putting in clinical waste. If cleaning then results in a slippery floor, it is important to
then put out a wet floor sign to warn anyone entering the area.

f) Waste disposal You must follow the appropriate waste disposal methods set out by HTM01-07. Using the correct containers for each item and ensuring
they are emptied in the correct manner. Containers include: Clinical waste bin, sharps box, heavy metals box, teeth box, general waste,
and recycling.

g) Sharps Sharps should be collected in a specific yellow-lidded container with a sticker on the front labelling it as from the practice and which room
it is from. When the container is full, you will shut the opening in the lid, write the date and your initials. It will then be sent off for
incineration. Sharps can include needles, broken glass, ampoules, scalpels, blades, and sometimes amalgam free teeth.

301 - 4.5 How do you contribute to Health and Safety within the workplace?
I personally contribute to health and safety at the practice by following all the outlined guidance and procedures. By following all the guidance on how to use
equipment, safe storage and handling of different items, dress code, PPE, and other behaviours in the practice, I keep myself safe and aid in the safety of
others throughout the day. Every dental nurse also has many responsibilities when it comes to infection control in different areas of the practice, staying on
top of this is a constant thought throughout everything I do within the day.

Page 6 of 7
 Level 3 Diploma in Dental Nursing

Maths Activity:
You are contracted for 40 hours a week at £7.50 an hour. You usually work 45 hours a week (overtime is paid at £8.00 per hour)
Calculate how much you will earn in a week, a month & a year. Show your calculations.

Show your working out here:

All calculations are showing earnings before tax.

Week – 45 hours (40 at £7.50, 5 at £8.00) 40*7.50= 300, 5*8=40

Total weekly earnings - £340

Month – 4 working weeks (340*4=1360)

Total monthly earnings - £1360

Year – 52 working weeks (340*52=17,680)

Total yearly earnings - £17,680

Page 7 of 7