The Online Journal of Clinical Audits, Vol 8, No 4 (2016)

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Tarun Kumar Mittal, Julia Scott, Karen Drage


Aims – 1. Record the quality of orthodontic impressions for clinicians working in hospital services in Devon and Cornwall.  2. Identify common minor errors in impressions to provide relevant individual feedback.  3. Develop useful audit tool to use for staff development, particularly for new staff/trainees.  Standards: 100% of orthodontic impressions should be fit for purpose, 90% of orthodontic impressions should be high quality, with minimal errors.


Methods – Over two cycles (March 2014 – July 2014 & January 2015 – April 2015), 4 hospital orthodontic units participated in the audit.  10 & 13 clinicians participated in cycles 1 & 2 respectively. 8 clinicians participated in both cycles.  Each participating clinician submitted 30 consecutive impressions for assessment.  The orthodontic laboratory technician(s) in each unit scored the overall quality of impressions taken in that unit using a standardised collection proforma.  Six commonly occurring minor impression errors that may affect the quality of the impression were also recorded for each impression.  Individual feedback was given to all clinicians following the first and second cycles.


Results – Cycle 1: 10 clinicians submitted 300 impressions.  99.6% were ‘fit for purpose’ and 86% were high quality.  Cycle 2: 13 clinicians submitted 390 impressions.  99.6% were ‘fit for purpose’ and 80% were high quality.  There were differences and inconsistency in marking between units.


Conclusions – There was little change between cycles.  Staff turnover makes comparisons more difficult.  The development of standardised illustrations to aid consistent marking of orthodontic impressions between units would be useful.

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