NSCC Patient Clinic Protocol
NSCC Patient Clinic Protocol
Learners will be required to participate in a one-week preventive patient clinic. This course allows the learner an opportunity to contribute to a service-learning experience, consistent with NSCC’s values. Semesters I and II theory and hands-on skills are integrated in this clinic.
- All students are required to arrive no later than 8:00AM for clinic set-up and to prepare to see patients.
- Student should consistently demonstrate an obligation to be answerable for own actions, words and language.
- Students are required to be in full clinical uniform and must display the professional image sought after by the health care industry.
- Each student should foster collaboration among team members and lead, motivate or support when appropriate.
- Students must be engaged in learning, which includes their interactions with patients, peers and faculty.
- Students must adhere to safety and infection control protocols.
- Students must be present in clinic at all times, until an instructor informs you of your lunch break. If you need to briefly leave your assigned area, inform a peer so that they can cover for you. (ex: washroom break)
- All students are required to remain in clinic until all documentation and duties are completed. Documentation includes patient chart and student manual.
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Self- Evaluation |
Instructor Evaluation |
Instructor’s Comments |
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Vital Signs |
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Oral Evacuation and/or Instrument Transfer |
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Oral Assessment |
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Oral Hygiene Instruction |
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Coronal Polishing |
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Topical Fluoride |
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Bitewing Radiographs or Images |
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Periapical Radiographs or Images |
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Panoramic Image |
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Pit and Fissure Sealant |
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Desensitizing Agent |
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Preliminary Impression |
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Overall Patient Treatment Evaluation |
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Safety measures followed |
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Infection control protocols followed |
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Demonstrates professionalism and appropriate communication skills |
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Instructor_________________________ Date: _____________ Successful / Unsuccessful
Comments:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Self- Evaluation |
Instructor Evaluation |
Instructor’s Comments |
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Vital Signs |
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Oral Evacuation and/or Instrument Transfer |
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Oral Assessment |
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Oral Hygiene Instruction |
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Coronal Polishing |
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Topical Fluoride |
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Bitewing Radiographs or Images |
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Periapical Radiographs or Images |
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Panoramic Image |
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Pit and Fissure Sealant |
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Desensitizing Agent |
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Preliminary Impression |
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Overall Patient Treatment Evaluation |
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Safety measures followed |
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Infection control protocols followed |
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Demonstrates professionalism and appropriate communication skills |
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Instructor_________________________ Date: _____________ Successful / Unsuccessful
Comments:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Self- Evaluation |
Instructor Evaluation |
Instructor’s Comments |
|
Vital Signs |
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|
Oral Evacuation and/or Instrument Transfer |
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|
Oral Assessment |
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|
Oral Hygiene Instruction |
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|
Coronal Polishing |
|
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|
Topical Fluoride |
|
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|
|
Bitewing Radiographs or Images |
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|
|
|
Periapical Radiographs or Images |
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|
|
|
Panoramic Image |
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|
|
Pit and Fissure Sealant |
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|
|
|
Desensitizing Agent |
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|
Preliminary Impression |
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|
Overall Patient Treatment Evaluation |
|||
|
Safety measures followed |
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|
|
|
Infection control protocols followed |
|
|
|
|
Demonstrates professionalism and appropriate communication skills |
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|
|
Instructor_________________________ Date: _____________ Successful / Unsuccessful
Comments:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________
|
|
Self- Evaluation |
Instructor Evaluation |
Instructor’s Comments |
|
Vital Signs |
|
|
|
|
Oral Evacuation and/or Instrument Transfer |
|
|
|
|
Oral Assessment |
|
|
|
|
Oral Hygiene Instruction |
|
|
|
|
Coronal Polishing |
|
|
|
|
Topical Fluoride |
|
|
|
|
Bitewing Radiographs or Images |
|
|
|
|
Periapical Radiographs or Images |
|
|
|
|
Panoramic Image |
|
|
|
|
Pit and Fissure Sealant |
|
|
|
|
Desensitizing Agent |
|
|
|
|
Preliminary Impression |
|
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|
|
|
|
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|
|
|
|
|
|
|
|
|
Overall Patient Treatment Evaluation |
|||
|
Safety measures followed |
|
|
|
|
Infection control protocols followed |
|
|
|
|
Demonstrates professionalism and appropriate communication skills |
|
|
|
Instructor_________________________ Date: _____________ Successful / Unsuccessful
Comments:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________
|
|
Self- Evaluation |
Instructor Evaluation |
Instructor’s Comments |
|
Vital Signs |
|
|
|
|
Oral Evacuation and/or Instrument Transfer |
|
|
|
|
Oral Assessment |
|
|
|
|
Oral Hygiene Instruction |
|
|
|
|
Coronal Polishing |
|
|
|
|
Topical Fluoride |
|
|
|
|
Bitewing Radiographs or Images |
|
|
|
|
Periapical Radiographs or Images |
|
|
|
|
Panoramic Image |
|
|
|
|
Pit and Fissure Sealant |
|
|
|
|
Desensitizing Agent |
|
|
|
|
Preliminary Impression |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Overall Patient Treatment Evaluation |
|||
|
Safety measures followed |
|
|
|
|
Infection control protocols followed |
|
|
|
|
Demonstrates professionalism and appropriate communication skills |
|
|
|
Instructor_________________________ Date: _____________ Successful / Unsuccessful
Comments:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________
|
|
Self- Evaluation |
Instructor Evaluation |
Instructor’s Comments |
|
Vital Signs |
|
|
|
|
Oral Evacuation and/or Instrument Transfer |
|
|
|
|
Oral Assessment |
|
|
|
|
Oral Hygiene Instruction |
|
|
|
|
Coronal Polishing |
|
|
|
|
Topical Fluoride |
|
|
|
|
Bitewing Radiographs or Images |
|
|
|
|
Periapical Radiographs or Images |
|
|
|
|
Panoramic Image |
|
|
|
|
Pit and Fissure Sealant |
|
|
|
|
Desensitizing Agent |
|
|
|
|
Preliminary Impression |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Overall Patient Treatment Evaluation |
|||
|
Safety measures followed |
|
|
|
|
Infection control protocols followed |
|
|
|
|
Demonstrates professionalism and appropriate communication skills |
|
|
|
Instructor_________________________ Date: _____________ Successful / Unsuccessful
Comments:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________
