A quality improvement project to improve the quality of medical emergency aide-mémoires.

Introduction Medical emergencies occur within the dental setting and we have a duty of care to manage them appropriately. Due to perceived anxiety in handling medical emergencies, aide-mémoires were developed to improve staff confidence in the management of these stressful situations.Methods A survey was carried out at The Royal London Dental Hospital to assess knowledge and experience in use of existing supportive materials for medical emergency management. New colour-coded flashcards were subsequently developed, providing guidance to identifying and managing medical emergencies. A questionnaire was produced assessing clinicians' awareness of existing prompts and preferences in relation to the new flashcards. Updated cards were incorporated into simulated medical emergency teaching and evaluated afterwards through a questionnaire.Results A total of 50 responses were gathered across departments to the questionnaire regarding preliminary flashcards: 95% favoured the flashcard approach and felt they would be more helpful managing medical emergencies. The new flashcards were used by 18 clinicians in medical emergency simulation and 17 (94%) felt that using the cards improved their confidence in the handling of medical emergencies.Discussion The flashcards have been perceived to be useful in the handling of medical emergencies within our dental hospital. A similar project may be beneficial to clinical teams working across dental settings.

Implementation of a 'was not brought' pathway in paediatric dentistry.

Introduction The dental team play a vital role in ensuring that vulnerable children are followed up and suspected safeguarding concerns are shared, which includes recognising the importance of missed dental appointments. Concerns are less likely to be missed when there are robust pathways in place. This paper aims to discuss the importance of a was not brought (WNB) pathway for children who miss dental appointments and to offer advice on its implementation in practice.Methods A three-cycle retrospective case note review was carried out to identify follow-up children who WNB to their dental appointments, and the follow-up that had occurred as a result.Results In cycle one, 16% of children who were not brought were managed according to the audit standards. Therefore, a WNB pathway was developed and audited three months and 12 months following; cycle two showed 32% adherence with the pathway, and 28% in cycle three. The biggest barrier in all cycles seems to be related to the administration of letters.Discussion Investigators felt that the possible barriers to achieving audit standards were the implementation of a new dictation system, limited time on clinic and a possible anxiety surrounding the management of safeguarding issues.Conclusion Pathways and resources have been made available for dental professionals to use in their practice to guide management of children who were not brought to dental appointments. As we have shown, there are barriers to implementation of such pathways which service providers must work to overcome, to protect the children that we treat and ensure that they are being kept safe in line with General Dental Council standards.