Stage 1 Visit 1 efnwklf PDF

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Stage 1 Visit 1 Competency Revision Notes !

2.1.2 Maintains confidentiality in all aspects of patient care The Data Protection Act (1998) • The DPA is designed to protect personal data stored on computers or in an organised paper filing system. • Individuals have legal rights to control information about themselves. • The act defines eight data protection principles to ensure that information is passed lawfully: 1. Personal data shall be processed fairly and lawfully. 2. Personal data shall be obtained only for one or more specified and lawful purposes, and shall not be further processed in any manner incompatible with that purpose or those purposes. 3. Personal data shall be adequate, relevant and not excessive in relation to the purpose or purposes for which they are processed. 4. Personal data shall be accurate and, where necessary, kept up to date. 5. Personal data processed for any purpose or purposes shall not be kept for longer than is necessary for that purpose or those purposes. 6. About the rights of individuals e.g. personal data shall be processed in accordance with the rights of data subjects (individuals). 7. Appropriate technical and organisational measures shall be taken against unauthorised or unlawful processing of personal data and against accidental loss or destruction of, or damage to, personal data. 8. Personal data shall not be transferred to a country or territory outside the European Economic Area unless that country or territory ensures an adequate level of protection for the rights and freedoms of data subjects in relation to the processing of personal data.

Patient Record Competency • Ensure that your patient record that you are using for this competency (and in fact any record you are going to show the examiner states that consent to use the record has been obtained!) • Use a simple abbreviation of VCO or VCG (verbal consent given/obtained) somewhere on the record to indicate to the examiner the patient has given access to their record for examination purposes • SO…lets go through some common questions/scenarios • A patient refuses consent, what do you do? You cannot state on their record consent was given/obtained and you can’t use this for exam purposes • You work for Specsavers, an independent optician calls your practice asking for a copy of a patient’s prescription, what do you do? You ask the independent opticians if you can speak to the patient first to obtain consent, confirm the details with the patient then you are allowed to forward over a copy of the prescription to the opticians. State on the patient’s record that consent was obtained and where you are sending a copy to. • An 18 year olds mum calls asking for her daughters contact lens prescription, what do you do? As the patient is over the age of 16 years old you need to ask their consent first! Even if it’s a family member!

© InstaOptometry 2018

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Stage 1 Visit 1 Competency Revision Notes !

2.2.2 Is able to work within a multi-disciplinary team Roles within an optometry practice • • • • • • •

Store Manager Assistant Store Manager Optometrists Contact Lens Optician Dispensing Optician Pre-registration Optometrists/Dispensing Opticians Optical Assistant/Advisor

What you might get asked…! In your practice if you need to book holidays or time off work who do you go to? (Might seem like an odd question but it shows you are aware of who to go to if you need help with anything in your practice) Have knowledge of your local referral pathways, CCG schemes and shared cared schemes in your area you work in! A useful tip is to look on your local LOC committee website.

© InstaOptometry 2018

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Stage 1 Visit 1 Competency Revision Notes !

2.2.3 Is able to work within the law and within the codes and guidelines set by the regulator and the profession GOC Code of Conduct • Familiarise yourself with the pdf file on this link, you do not need to know the code of conduct off by heart https://www.optical.org/en/Standards/Standards_for_optometrists_dispensing_opticians.cfm • The GOC code of conduct defines the standards of behaviour and performance expected of all optometrists and dispensing opticians. • As a healthcare professional you have a responsibility to ensure the care and safety of your patients is first, whilst maintaining a professional standard. Role of the GOC: it is the UK regulator for the optical professions with statutory responsibility for setting standards.

Laws within Optometry Opticians Act 1958 This act gave us the power through Parliament to state that we as optometrists are the statutory regulator for the optical professions in the UK.

Medicines Act 1968 This Act of Parliament governs the control of medicines for human use and for veterinary use, which includes the manufacture and supply of medicines. The Act defines three categories of medicine: Prescription only medicines (POM), Pharmacy medicines (P) and general sales list (GSL).

Mental Capacity Act 2005 The Mental Capacity Act 2005 provides a framework for people who lack capacity to make decisions for themselves, or who have capacity and want to make preparations for a time when they may lack capacity in the future. It sets out who can take decisions, in which situations, and how they should go about this. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/497253/Mentalcapacity-act-code-of-practice.pdf

What you might get asked…! Here the usual common questions tend to be case scenarios, so familiarise yourself with the basics of the above, you DO NOT need to know them in full, just what they do and a rough idea of what the purpose of them are will be just enough. Most commonly students get asked questions related to the mental capacity act 2005: E.g. If a patient came in who was mentally ill and you needed to refer them urgently, who would make the decision? Here the correct answer would be along the lines of “Under the mental capacity act 2005 the patient themselves should be asked first, but if however they are unable to make a decision the first person in their line of care whether it is a relative or carer would make the decision”.

© InstaOptometry 2018

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Stage 1 Visit 1 Competency Revision Notes !

3.1.1 Uses instruments to measure corneal curvature and assess its regularity What is keratometry? • The keratometer is an instrument that is used to measure the front surface (approximately 2-4mm) curvature of the cornea • It provides us information such as: • The radii of curvature of the cornea • The directions of the principal meridians of the eye, determining if the astigmatism is with-therule or against-the-rule (note: a key factor in contact lens fitting – see visit 2 notes where this will be discussed more) • The degree of corneal astigmatism • The presence of any corneal distortion.

Types of keratometer 1. Bausch & Lomb: one position keratometer – measures two meridians at the same time & contains two prisms

2. Javal-Schiotz Keratometer: two position keratometer – measures one meridian at a time

B&L One position keratometer

JS Two position keratometer Advantages

Quick to use

Used for patients with irregular astigmatism. Less focussing errors so less inaccuracies More accurate as longer working distance

Disadvantages Assumes meridians are at 90 degrees to each other

Uses radii scale – if falls at extreme end of arc, it becomes non-linear inaccuracy.

Shorter working distance therefore measurement errors Vertical and horizontal mires imaged at the same time

© InstaOptometry 2018

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Stage 1 Visit 1 Competency Revision Notes !

3.1.7 Assesses the tear film Features of the tear film include: • • • • • •

Optical properties: smooth optical surface (gives best visual acuity) Nutrition: supplies essential nutrients (i.e. oxygen, glucose, amino acids) Waste removal: removes waste products (i.e. carbon dioxide, lactate) Transparency: prevents desiccation Mechanical: flushed away debris / lubricates Antibacterial: helps to prevent infection from: lysozyme, lactoferin & immunoglobulins

Tear film assessment: • History: Px may have had previous problems with CL wear (i.e. reduced wear times, discomfort towards the end of the day or discomfort in a particular environment) • Symptoms of poor tear film: irritation, grittiness, tiredness, soreness • Three things that need to be assessed are the 3 S’s: Secretion, Staining & Stability

Secretion (measurement of tear volume) Schirmir’s strip: • A filter strip hooked over the lower lid – we measure the tear creep over 5 minutes •...