Conscious Sedation in Dentistry Guidance Update Consultation Feedback

Transcription

1 Conscious Sedation in Dentistry Guidance Update Consultation Feedback Consultation is the opportunity for anyone with an interest in the guidance to provide feedback and influence its development. We welcome your views on this draft guidance as part of the formal consultation process. Please complete and return this form by 3 rd February 2017* to: Freepost Licence RSSH-ETXY-ZKBL scottishdental.cep@nes.scot.nhs.uk SDCEP (Sedation Consultation) Dundee Dental Education Centre Frankland Building * Please note that feedback received after Small s Wynd this date may not be considered. Dundee, DD1 4HN A collation of all feedback received, with our responses, will be available on request. This may identify the source of comments received from an organisation or in an official capacity but not those received from individuals. About you Providing this information allows us to understand respondents interests in the topic and to clarify comments, if required. Individuals' personal details will only be used for this purpose and will not be included in collated feedback or otherwise shared. Please note that we are unable to consider anonymous responses. Name: Arianne Matlin Professional role: Health and Science Policy Adviser Sector, e.g. GDS, PDS/CDS, hospital: All areas of dentistry Responding: as an individual ; on behalf of an organization address: arianne.matlin@bda.org Address: 64 Wimpole Street, London W1G 8YS Specific interest/role in topic: Represent dentists in all areas of practice If organisation, please give full name: British Dental Association Questions are included under the following headings: 1. Guidance Content 2. Supplementary Information 3. Guidance Presentation 4. Guidance Development 5. Implementation 6. Equality 7. Additional comments 1

2 1. Guidance Content Please indicate the extent to which you agree or with the following statements on the five point scale and provide comments or explanation, as appropriate. For questions 1a-1j adequately covers means that the recommendations are reasonable and sufficient information is provided. 1a) Section 1 (Introduction) adequately covers the background to the guidance agree 1b) Section 2 adequately covers the environment for conscious sedation agree 1c) Section 3 adequately covers preparation for conscious sedation agree Page 14, line 12: may be helpful. Surely it is mandatory to measure oxygen saturation and heart rate by pulse oximetry. Page 15, line 6: Consent must be obtained at a separate assessment visit prior to the procedure. This practice is not employed medically and we strongly oppose the requirement for an additional appointment, which places a real strain on the service. In addition, this requirement means that consent might not be valid if the operator differs between appointments, which is frequently the case. 1d) Section 4 adequately covers conscious sedation techniques agree 1e) Section 5 adequately covers conscious sedation for children and young people agree We would welcome greater emphasis on behavioural management, which is very important for both children and adults. Many dental hospitals in England employ psychologists who work very effectively with anxious patients. There are also CBT courses for dental professionals, to facilitate working with these patients. 1f) Section 6 adequately covers recovery and discharge agree 2

3 1g) Section 7 adequately covers records and documentation agree 1h) Section 8 adequately covers clinical governance and audit agree 1i) Section 9 adequately covers training in conscious sedation agree We welcome the fact that experienced members of the dental sedation team already engaged in the provision of sedation can continue to practice and engage in ongoing training. We also welcome the recognition that ILS and PILS should be adapted to needs of dental practice. 1j) Section 10 adequately covers recommendations for future research Ongoing audit and research would be welcome. agree 1k) Do you think any additional content should be included within the guidance? 1l) Do you think any of the current content within the guidance is unnecessary? 3

4 2. Supplementary Information Please indicate how you think each of the following is on the five point scale. Where possible, please provide explanations to support your answers (e.g. comment on the level of detail, whether the information is adequate, if not, why not). 2a) Summary of the Guidance (Pages 3 and 4) The summary points are, but could be more clearly set out, for example with numbering. 2b) Appendix 2 Summary of Staffing Requirements 2c) Appendix 3 Learning Outcomes for Life Support Training The list of training needs is helpful and reinforces any gaps in knowledge. 2d) Appendix 4 Patient Records and Documentation This is very helpful for IV sedation, but not all items on the list are necessary for inhalation sedation. 2e) Appendix 5 ASA Physical Status Classification System A different ASA is used for paediatrics. 4

5 2f) Examples of patient information provided in the IACSD report Standards for Conscious Sedation in the Provision of Dental Care, referred to in the draft guidance 2g) Is there any other supplementary information or are there any supporting tools that you think should be provided with the guidance? Please provide more details: 3. Guidance Presentation Please indicate the extent to which you agree with the following statements and provide comments or explanation, as appropriate. 3a) The information is clearly presented (i.e. the language and format used is helpful) agree 3b) The key recommendations are clearly stated agree 3c) It is helpful to indicate the strength and basis for each key recommendation agree 5

6 4. Guidance Development Please indicate your response to this question and provide comments or explanation, as appropriate. How confident are you in the manner in which the guidance has been developed (see Appendix 1)? confident confident 5. Implementation Please answer these questions assuming the consultation draft of the guidance is published. 5a) What might be the barriers to implementing this guidance? We feel that the guidance is excessively bureaucratic in its assessment criteria, procedure and paperwork for sedation with nitrous oxide and oxygen. Much of this document duplicates the IACSD guidance. The status of the SDCEP guidance is unclear with respect to that of IASCD. This is likely to cause confusion. 5b) What might help the implementation of this guidance? It would be helpful to have a clear message regarding the gold standard guidance for dental professionals. 5c) If you provide sedation, will you have to change your current practice to fully implement this guidance? N/A 6. Equality This question refers to potential discrimination, including by age, disability, ethnicity, gender, gender identity/transgender status, religion or belief, sexual orientation, geographical location or whether a person is a carer Do you think that any particular groups or individuals (guidance users or patients) are likely to be discriminated against by the guidance? Please provide more details: 6

7 7. Additional comments Please comment on any other aspects of the guidance here: Page 3, line 6: the recipe book reference might be regarded as flippant and could be re-phrased. Thank you for taking the time to contribute to this consultation. Our consultation process aims to be transparent and, on request, we will provide a summary of comments received and our responses. This summary may identify the source of comments received from an organisation or in an official capacity but not those received from individuals. 7