dish the dirt Flashcards
how many links are in the chain of infection
6
how to stop infection spread
break the chain of infection as early as possible
what are the 6 links in the chain of infection
infectious agent
reservoir
portal of exit
means of transmission
portal of entry
susceptible host
what is a common cause for contamination in dental surgery
aerosols
which areas in the dental surgery had the highest level of contamination following 12 Tx session
Scaling followed by cavity preps
Aerosol peaks within 30 mins
No aerosols detected in waiting area
No aerosolised blood detected
% of contamination after treatment before cleaning of 3 in 1 syringe buttons
40%
% of contamination after treatment before cleaning of tap handle
20%
% of contamination after treatment before cleaning of light handle
18%
% of contamination after treatment before cleaning of operating cart handle
10%
% of contamination after cleaning of 3 in syringe buttons
10% (drop from 40%)
% of contamination after cleaning of tap handles
4% (drop from 20%)
% of contamination after cleaning of light handle
18%
no change
- forgot to be cleaned
- touched after cleaning
% of contamination after cleaning of operating cart handle
2% (drop form 10%)
4 classes in spaudling classification
critical (high risk)
semi critical (medium risk)
non critical (low risk)
minimal risk
critical (high risk) spaudling class
Items in contact with normally sterile body sites
Forceps, periodontal scaler
examples of critical (high risk) spaudling class
Forceps, periodontal scaler
semi-critical (medium risk) spaudling class
Items in contact with intact mucous membranes
Dental handpiece, mirror
examples of semi-critical (medium risk) spaudling class
Dental handpiece, mirror
non critical (low risk) spaudling class
Items in contact with intact skin
light cure
example of non critical (low risk) spaudling class
Light cure
minimal risk spaulding classification
Items not normally in contact with intact skin
Dental chair
example of minimal risk spaulding classification
Dental chair
how should low risk (non-critical) items be cleaned
Decontamination process
- Cleaned or chemically disinfected
- Detergent wipe
how should minimal risk items be cleaned
Cleaned
- Chemically disinfected in risk assessed circumstances
what are house keeping surfaces
non-critical environment surface
- Not directly touched during dental treatment and carry the lowest risk of disease transmission
Wall, floor, sink etc
what are clinical contact surfaces
Contaminated from patient materials either by direct spray or spatter generated during dental procedures (aerosols_
or
By contact with gloved hands of dental health care personnel
- Light, spittoon, drawer handles, computer
Need to remove gloves – hand hygiene and gloves replaced
antibiogram
an overall profile of antimicrobial susceptibility testing results of a specific microorganism to a battery of antimicrobial drugs.
what are 2 types of transmission
direct or indirect
what is the most common transmission method for infection
skin contact
- hand hygiene
how long can influenza A & B survive on steel and plastic
24-28hrs
how long can influenza A & B survive on cloth, paper, and tissues
<8-12hrs
what are key objects to consider for transmission
objects that are commonly touched but not cleaned
- Keyboard
- Light switch
- Tap handles
- Remote controls
- Seats
- Telephone
what is a consequence of GDPs being exposed to infections more than normal people
have significantly raised antibody titres compared to controls
e.g. flu A & B, RSV
what are common portal of entrys
mouth, noe, ear
- touch hair, ear, mouth, nose often without realising
SICPs
standard infection control precautions
help prevent infectious agent
- National Infection Prevention and Control Manual
what are 3 important things to consider when assessing reservoirs for infectious agents in the dental surgery
surface design and material
cleaning
- hospital standard in detergent wipe (should disinfectant be used to?)
declutter
preventing recontamination
- don’t have exposed instruments not needed for that pt out
cleaning definition
The physical removal of contamination
what 5 things does cleaning require
Water
Detergency
Mechanical action
Temperature
Time
4 common issues with surface cleaning
Body fluids form surfaces films = facilities bug attachment
- Charged organic soils more difficult to remove and protect bugs from dehydration
Visual assessment of cleanliness = poor measure of invisible soiling
Visual clean can = large numbers of bugs and residues
Cleaning process potential to recontaminate surfaces with organic soil and microbes
- Buckets/mops & solutions
OK for deep clean or for surgery not used for a while but not for between pt
definition of detergent
A group of synthetic organic water soluble agents that have wetting agent, emulsifying and soil holding properties
what are the 4 EU detergent regulations
Biodegradability
Specific labelling requirements
Provision of data
Restriction on Phosphates
disinfection definiton
A process for the removal or destruction of microbes not usually including bacterial spores
Quantitative definition - ability to produce a 5 log reduction in a defined bacterial population
high level disinfectant
Kills all microbes (including mycobacteria) but not large numbers of bacterial spores
Usually require longer contact time (hours)
low level disinfectant
Kill most vegetative bacteria, some fungi and some viruses in a practical period of time (<10 mins)
what are 4 factors that can impact disinfectant efficacy
Organic matter
When dried or coagulated matter
Time of exposure
Coverage of large or irregular areas
what are the limitations of using disinfectant wipes
There can be a short exposure time to the disinfectant
- How long time to wait before can use the environment
- Contact time - wipes roughly 1 min (some used to be 4hrs)
Incomplete coverage with large surface areas
Other factors can interfere
- surface properties etc
disinfectant and detergent are compatible with work surfaces
—-not damage
—-smooth no joins that could get trapped
portal of exit can be limited by use of what in dental tx
rubber dam
- helps with moisture and
good aerosol control
5 moments for hand hygiene
before touching a pt
before clean/aseptic procedures
after body fluid exposure/risk
after touching a pt
after touching pt surroundings
what can protect staff and pt
PPE
covers portal of entry
- protects against splashes and splatter
4 items of PPE that must be worn by all chairside team at all time
apron
mask
glasses/visors
gloves
what could be the infectious agent
anything - take all precautions
what can influence the reservoir
Surface design, Surface material, Cleaning, Role of detergents
what can help control the portal of exit
good aerosol control and rubber dam placement
2 common modes of transmission
hands
fomites (on objects or materials)
who is a susceptible host
everyone
- vaccinations can limit
what can prevent infectious agents entering host
PPE
