Download Certificate in Special Care Dental Nursing

Journal of Disability and Oral Health (2002) 3/1 27–29
Certificate in Special Care Dental
Nursing
M Wanless
Dental Office, The Health Centre, Geoffrey Street, Preston, UK
Abstract
This paper describes the development of the qualification in Special Care Dental Nursing, from its
innovation under the auspices of the British Society of Dentistry for Disability and Oral Health to its
adoption by the NEBDN. The outline of the assessment process is described.
Key words: Special care, dentistry, nursing
The National Examining Board for Dental Nurses
(NEBDN) has set up a new qualification for dental nurses
entitled, Special Care Dental Nursing. The qualification has
been awarded to 45 candidates from across England, Wales
and Scotland. Awards have also been made to those candidates who passed the pilot examinations run by the British
Society of Disability and Oral Health who developed the
original concept of such a course and examination. The
certificate marks a new approach in NEBDN qualifications
as it is based on a blend of assessments in the workplace
and training centre, and a written examination. It allows
candidates to demonstrate their skills in their own workplace
rather than relying solely on their ability to pass a traditional
knowledge-based examination. This is in line with an NVQ
approach and adds to the already impressive list of qualifications now available for dental nurses.
As the qualification is new, NEBDN has initially accredited a limited number of training centres. It is hoped that
more training centres will now set up courses and the
certificate will soon be available nationwide.
Candidates
Candidates must be actively working in dental special care
and be on the National Voluntary Register for Dental Nurses
which is held by the British Association of Dental Nurses.
To be on this register they need to have the National
Certificate, an equivalent qualification or a recently established NVQ. They will also need the support of their
employer to be able to attend the training course and to
validate the activities for the Portfolio of Experience, which
is an essential part of the assessment.
Assessment format
The Portfolio of Experience is designed to enable the
candidates to demonstrate their application of knowledge
and skills in practical situations. It is in three parts as shown
in Table 1. Part A is a logsheet in which dental nurses must
Table 1. Assessment format
1. Portfolio of Experience
Part A – Logsheet
• Evidence of involvement in care of 20 patients with special
needs
Part B – Expanded Case Studies
• Detailed description of the care of 3 patients
Part C – Evidence of Competence:
• moving and handling
• promotion of oral health
• physical and emotional support
• achieving access to the mouth
• medical emergencies
provide evidence of their involvement in the care of 20
patients with special needs. They must include at least one
patient from eight different groupings to ensure a breadth
of experience. The groupings are shown in Table 2.
So, for example, the dental nurse may complete a logsheet
which records the visit of a patient with learning difficulties
giving salient details of the patient, their oral health condition, care plan, the effect of their condition on their oral
health care plan and possible problems that may be
encountered. Both the candidate and the supervising
dentist are encouraged to comment on the dental nurse’s
involvement.
Part B is an expanded case study component in which a
more detailed description of the care of three patients from
different groups is required. This must include the care of
at least one patient treated in a dental surgery and one treated
in another setting. More detail is required than for the
logsheets and this should include a description of the
patient’s general and social circumstances, consideration of
the role of other healthcare workers, voluntary and social
services and liaison with them. The candidates are also
encouraged to describe their role in the provision of care
and reflect on how the needs of the patient have been met
28 Journal of Disability and Oral Health (2002) 3/1
Table 2. People whose health and social care needs may require special oral health care provision
1 Groups whose health and social care needs are likely to require special oral health care treatment.
1.1 general health conditions and related medication
• cardiovascular diseases (eg angina, coronary artery thrombosis, heart valve disorder, stroke)
• blood and bleeding disorders (eg anaemia, haemophilia, effect of prescribed anticoagulants)
• respiratory disorders (eg asthma, respiratory infections)
• diseases of the liver and kidney and gastro-intestinal diseases (eg diabetes)
• infectious diseases (eg TB, HBV, HCV, HIV, MRSA)
• immuno-suppressed states (especially pre and post organ transplants)
• terminal illnesses
• auto-immune diseases
• neurological disorders (eg epilepsy, multiple sclerosis, Alzheimers)
1.2 mental health needs (eg psychoses, neurosis)
1.3 learning disabilities
1.4 autistic spectrum disorders (ASD)
1.5 physical disabilities :
• sight, hearing, speech impairments
• congenital disabilities (eg cerebral palsy, muscular dystrophy)
• acquired disabilities (eg arthritis, Parkinson’s disease)
1.6 alcohol, drug and substance misuse
1.7 fear of, anxiety about, oral health treatment
1.8 older people
Table 3. Written examination
Paper A – an unseen case study
Paper B – structured short answer questions
over a period of time.
Part C is described as Evidence of Competence. To
complete this part during their course of training, students
must demonstrate their competence in the following five
areas: moving and handling, promotion of oral health and
prevention of disease, physical and emotional support,
achieving access to the mouth and medical emergencies. Their
competence is marked against written standards. The training centre provides the internal verification of the marks,
with NEBDN appointing an external verifier.
There is also a written examination which comprises two
parts. Paper A is an unseen case study. The candidate is
provided with a brief description of a client’s social, medical and dental situation and is required to demonstrate their
understanding of how these affect the oral health care that
is likely to be needed. Paper B is made up of compulsory,
structured short answer questions, which are designed to
assess the candidate’s knowledge and their ability to apply
this to situations that may be encountered in clinical and
community settings. The written paper is summarised in
Table 3.
In contrast to other NEBDN examinations, the students
can sit this examination in their own training centre.
The experience of candidates
To complete the assignments, candidates have to be involved
in the care of a wide range of patients. For some candidates this has meant extending care outside those groups
Figure 1. The successful candidates from the first course in
Special Care Dental Nursing to be held in Leeds: Back row
(L to R): Suzzane Jeffcoat, Lesley Kaye, Sandie Edam,
Louise Chegg. Front row (L to R): Melanie Leek, Beverly
Hollingworth
seen on a regular basis. Comments from the candidates
indicated that this had been a very worthwhile experience
that had increased their knowledge and understanding. Whilst
a number had been concerned that they may not have been
able to contact clients in all groups, in fact this proved less
difficult than anticipated.
Candidates confirmed that the preparatory course and
assignments had involved a lot of hard work but were of
considerable benefit. Some found that this style of assessment was preferable to the traditional examination as it gave
them the opportunity to demonstrate their skills rather than
relying on the ability to regurgitate academic knowledge,
thus supporting the advantages of the newly introduced
NVQ assessment for dental nurses. The successful candidates from the first course are shown in Figure 1.
Wanless: Certificate in Special Care Dental Nursing 29
6DA BKJKHA
Following the success of the first assessments this examination will now be available on a regular basis from centres
that have gained their accreditation. There will be some minor
modification of the assessment in the light of feedback from
the candidates, centre managers and tutors. NEBDN would
like to express its gratitude to all those who worked so hard
to set up the BSDH pilot examinations in Special Care Dental
Nursing. This has been an invaluable springboard in developing this new and exciting qualification. Gratitude is also
due to those centre managers, tutors and especially the
candidates who undertook the first assessment. It is hoped
that the assessment of competence in special care dental
nursing will become a crucial part of clinical governance
for those working in the area and provide a vehicle for
career development for those extremely dedicated dental
nurses who are such vital members of the dental team.
Further details of this new qualification, or other
NEBDN awards are available from NEBDN, 110
London Street, Fleetwood, Lancashire, FY7 6EU, UK.
Telephone: 01253 778417.
Address for correspondence:
Dr M Wanless
Dental Office
The Health Centre
Geoffrey Street
Preston PR1 5NE
UK