Infection Control Flashcards
True or false:
If compliance with regulations are not met, dentists may be fined, lose their licenses to practice dentistry, or face imprisonment
True
What is a BSI?
A system which requires personal protective equipment to be worn for protection against contact with all body fluids, whether or not blood is visible
What does PPE stand for?
Personal Protective Equipment
ADA stands for:
American Dental Association
CDC stands for:
Centres for Disease Control and Prevention
Who makes recommendations through its councils?
American Dental Association (ADA)
Who provides the basis for many of the regulations
Centres for Disease Control and Prevention (CDC)
What is the NIH?
National Institute of Health
A government agency that provides research for the expansion and implementation of knowledge for the enhancement of health, prevention of disease, the lengthening of life, and maintenance of high professional standards
What is the NIOSH?
The National Institute of Occupational Safety and Health
Provides research and prevention programs to aid in the elimination of occupational diseases, injuries, and fatalities
What is the aim of NIOSH? (4)
To complete tasks with: High-quality research Practical solutions Partnerships Implementing research into practice
What is the OSHA?
The Occupation Safety and Health Administration
A regulating body that enforces requirements that state that employers must protect their employees from exposure to blood and other potentially infectious materials (OPIM) while employees are at work
What is OPIM?
Other Potentially Infectious Materials
List the OPIMs (10)
Blood and anything that is visually contaminated with blood
Saliva in dental procedures
Cerebrospinal fluid
Amniotic fluid
Synovial fluid
Pleural, peritoneal, pericardial fluid
Semen and vaginal secretions
Unfixed tissue or organ (other than intact skin) from a human living or dead
HIV-containing cell or tissue cultures, organ cultures, and HIV or HBV-containing cultures, mediums or other solutions
Blood, organs, or other tissues from experimental animals infected with HIB or HBV
What is cerebrospinal fluid?
Brain and spinal fluid
What is amniotic fluid?
Fluid around the fetus
What is synovial fluid?
Joint and tendon fluid
What is pleural fluid?
Lung fluid
What is peritoneal fluid?
Abdominal fluid
What is pericardial fluid?
Heart fluid
When are dental offices investigated for compliance? (3)
After an employee or a patient complaint is made
In any office having 11 or more employees, randomly
By invitation of the office requesting an inspection
Overview of the OSHA bloodborne pathogens standard, every facility must:
Review the ___________ _________ ________
Bloodborne Pathogens Standard
Overview of the OSHA bloodborne pathogens standard, every facility must:
Prepare a _______ _______ _______ ____ outlining the means to _______ and _____ employees
Written exposure control plan
Protect
Train
Overview of the OSHA bloodborne pathogens standard, every facility must:
Update the exposure control plan when _______ in __________ provide safer medical devices and ________ the consideration and implementation of the use of these devices
Changes
Technology
Document
Overview of the OSHA bloodborne pathogens standard, every facility must:
Solicit ___-___________ employees to ________, ________, and select safer products and devices for use in the workplace
Non-managerial
Identify
Evaluate
Overview of the OSHA bloodborne pathogens standard, every facility must:
Train all _________ in a ______ manner (initially, after a job task change, when new devices are implemented)
Employees
Timely
Overview of the OSHA bloodborne pathogens standard, every facility must:
Provide _________ with everything needed in order to meet standard regulations
Employee
Overview of the OSHA bloodborne pathogens standard, every facility must:
Provide ________ __________ ________ (___)
Personal protective equipment (PPE)
Overview of the OSHA bloodborne pathogens standard, every facility must:
Maintain and dispose of necessary ___
PPE
Overview of the OSHA bloodborne pathogens standard, every facility must:
Establish ________ _________ _________ (____) in infection control
Standard operating procedures (SOPs)
Overview of the OSHA bloodborne pathogens standard, every facility must:
Maintain a ______ ______ __
Sharps injury log
Overview of the OSHA bloodborne pathogens standard, every facility must:
Offer the ________ _ vaccination series to all employees
Hepatitis B
Establish a ___________ plan, including ______ _________ and follow-up procedures (for example, ____________ _________ to ____________)
Postexposure
Medical evaluation
Occupational exposure
Needlesticks
Overview of the OSHA bloodborne pathogens standard, every facility must:
Provide communication on __________
Biohazards
Overview of the OSHA bloodborne pathogens standard, every facility must:
Establish standards for ________ and _________ of hazardous waste
Handling
Disposing
Overview of the OSHA bloodborne pathogens standard, every facility must:
Maintain records of ________, _________ _ vaccinations, and ________ incidents
Training
Hepatitis B
Exposure
OSHA-Mandated Training for Dental Employees:
A copy of the _________ _________ ________ and specific information regarding the meaning of the standard
Bloodborne Pathogens Standard
OSHA-Mandated Training for Dental Employees:
Information about __________ pathogens, both the ____________ and _______ of the diseases
Bloodborne
Epidemiology
Symptoms
OSHA-Mandated Training for Dental Employees:
Information about the _____-____________ pathways of bloodborne pathogens
Cross-contamination
OSHA-Mandated Training for Dental Employees:
A written copy or a means for employees to obtain the _________‘/______‘ written exposure control plan
Employer’s
Office’s
OSHA-Mandated Training for Dental Employees:
Information on the ____, ________ _________ of _______ _______________, and how each is identified in relation to bloodborne pathogens and other potentially infectious materials (____)
Tasks
Category placement
Employee classifications
OPIM
OSHA-Mandated Training for Dental Employees:
Information regarding the _________ _ vaccine
Hepatitis B
OSHA-Mandated Training for Dental Employees:
Information about _________ _________, including ___: ____ __________; standard precautions, including _________ ___________; and ___________ __________
Exposure reduction PPE Work practices Universal precautions Engineering practices
OSHA-Mandated Training for Dental Employees:
Information about ____ __ __ and ____ __ _______, if an emergency involving blood or OPIM arises
What to do
Whom to contact
OSHA-Mandated Training for Dental Employees:
Information about the procedure to follow if an incident of _____ ________ occurs, how to report the ________, and what type of medical follow-up is available at no cost to the employee
Blood exposure
Incident
OSHA-Mandated Training for Dental Employees:
Information about the ____________ __________ and follow-up that the employer provides
Postexposure evaluation
OSHA-Mandated Training for Dental Employees:
A copy of the ____ ______ _____________ _________
OSHA Hazard Communication Standard
OSHA-Mandated Training for Dental Employees:
______ ____ ______ (___) (formerly known as material safety data sheets, ____) as part of the ________ __________ ______ of ______________ and ________ of _________ (___)
Safety Data Sheets SDS MSDS Globally Harmonized System Classification Labelling Chemicals GHS
OSHA-Mandated Training for Dental Employees:
The ___________ for employees to ask questions of the individual giving the information
Opportunity
When are cross-contamination pathways formed?
When pathogens travel from patients to dentists, dental assistants, dental hygienists, dental laboratory technicians, and other patients
Pathogens can also travel from ______ _________ to ________
Dental personnel
Patients
Where can the cross-contamination then go?
To the families and friends of the dental personnel or patients
What is the chain of infection?
Describes the elements of an infectious process
What is in the chain of infection?
Agent
Host
Environment
What must the chain of infection include?
Several essential elements or “links in the chain” for the transmission of microorganisms to occur
What tasks belong in Category 1 in Exposure Determination?
Tasks that involve exposure to blood body fluids such as saliva, and body tissues
What professions does Category 1 in Exposure Determination encompass?
Dentist
Dental assistant
Dental hygienist
Dental laboratory technician
What tasks belong in Category 2 in Exposure Determination?
All tasks that involve no exposure to blood, body fluids such as saliva, or body tissues, but occasionally may involve unplanned tasks from Category 1
What professions does Category 2 in Exposure Determination encompass?
Receptionist
Coordinating assistant
So on
What tasks belong in Category 3 in Exposure Determination?
All tasks that involve no exposure to blood, body fluids such as saliva, or body tissues
What professions does Category 3 in Exposure Determination encompass?
Accountant
Insurance assistant
So on
Describe the Written Exposure Plan
Documents the specific exposure determination for each employee and identifies a schedule of implementation (how and when provisions of the standard will be implemented)
Step 1 of Written Exposure Plan
All employees list tasks they perform in each job classification, and then identify which category they fall under. Any employee who may have any occupational exposure at any time is covered under the OSHA Bloodborne Pathogen standard
Step 2 of Written Exposure Plan
The office must have a schedule for implementation
How and when are the hepatitis B vaccinations being offered to employees?
How and when are the post exposure evaluation and office follow-up procedures accomplished?
How and when are new devices identified and implemented?
How and when is the recordkeeping accomplished and updated?
Step 3 of Written Exposure Plan
A manual and procedure plan must be written to cover methods of compliance for office PPE and safety issues Personal protective equipment Engineering controls Housekeeping controls Work practice controls
Step 4 of Written Exposure Plan
A written policy on how exposure incidents are evaluated is required. Included in each evaluation are the circumstances that surrounded the incident and how they can be corrected. A sharps injury log must be maintained. Why type of evaluation will be done by the office if an exposure incident occurs?
What does the FDA stand for?
Food and Drug Administration
What is the FDA?
Food and Drug Administration, a division of the U.S. Department of Health and Human Services and it regulates the manufacturing and labelling of medical devices and solutions
What does EPA stand for?
Environmental Protection Agency (EPA)
What is the EPA?
A federal regulatory agency involved in the safety and effectiveness of disinfecting and sterilizing solutions
What is the OSAP?
The organization for Safety and Asepsis Procedures, a national organization, encompasses dental health care workers, distributors of dental equipment and materials, health care instructors, dentists, and others in the field of dentistry
What is an agent (of infection)?
Entity that is capable of causing disease
What do agents of infection include?
Biological agents
Chemical agents
Physical agents
What is an biological agent?
Living organisms that invade the host, such as bacteria, virus, fungi, protozoa, and rickettsiae
What is a chemical agent?
Substances that can interact with the body, such as pesticides, food additives, medications, and industrial chemicals
What is a physical agent?
Factors in the environment, such as heat, light, noise and radiation
What is a reservoir?
A place where the agent can survive
What must a reservoir that promotes the growth of pathogens contain?
Proper nutrients (oxygen and organic matter) Maintain proper temperature Contain moisture Maintain a compatible pH level Maintain the proper amount of light exposure
What are some common reservoirs? (4)
Humans
Animals
Environment
Fomites
What is a fomite?
An object, such as instruments or dressing, that is contaminated with an infectious agent
What is a portal of exit?
The route by which an infectious agent leaves the reservoir to be transferred to a susceptible host
What are some portal of exits? (7)
Body secretions: Sputum Semen Vaginal secretions urine Saliva Feces Blood Draining wounds
What is a mode of transmission?
The process that bridges the gap between the portal of exit of the infectious agent from the reservoir and the portal of entry of the susceptible “new” host
What are some modes of transmission? (4)
Contact transmission
Airborne transmission
Vehicle transmission
Vector-borne transmission
Contact transmission involves the ________ transfer of an agent from an ________ person to an __________ person through ______ or ________ contact with the ________ person. Contact with the infected person is called ______ contact. Direct contact can occur through unprotected contact with infected ______, such as _____ or ______
Indirect contact takes place when ______________ are transmitted to an ______ or _______ first and then transferred to another person when the person touches the object or surface
Physical Infected Uninfected Direct Indirect Infected Direct Fluids Blood Saliva Microorganisms Object Surface
Airborne transmission occurs when a ___________ person is exposed to contaminated ________ or ____ _________ that are suspended in the ___. The longer the particle is suspended, the greater the chance it will find an available ____ __ _____ in the human host
Susceptible Droplets Dust particles Air Port of entry
Vehicle transmission occurs when the agent is transferred to a susceptible host by contaminated __________ objects, such as ______ ___________, ______, ____, ____, _____, and _____
Inanimate Dental instruments Water Food Meat Drugs Blood
Vector-borne transmission occurs when an agent is transferred to a susceptible host by _______ means, such as __________, _____, _____, ____, and other _______
Animate Mosquitoes Fleas Ticks Lice Animals
What are some examples of diseases transmitted through contact transmission? (3)
STDs (Sexually Transmitted Diseases)
Colds
Flu
Examples of direct contact of health care provider with patient (2)
Touching
Secretions from client such as blood and saliva
Examples of indirect contact with fomites (6)
Clothing Health-care equipment Instruments used in treatments Personal belongings Personal care equipment Diagnostic equipment
Examples of moisture/dust particles in the air (4)
Coughing
Talking
Sneezing
Airborne droplets from dental handpiece
What organism relies on airborne transmission?
Measles
What spores are transmitted in an airborne powder form?
Anthrax
Examples of contact with contaminated inanimate objects (6)
Water Blood Drugs Food Urine Salmonellosis (contaminated food)
Examples of contact with contaminate animate hosts (3)
Animals
Insects
Lyme disease (ticks)
What is a portal of entry?
The route by which an infectious agent enters the host
What are the six portals of entry?
Integumentary system Respiratory tract Genitourinary tract Gastrointestinal tract Circulatory system Transplacental
Describe the integumentary portal of entry
A break in the skin or mucous membrane
Describe the respiratory portal of entry
Inhaling contaminated droplets
Describe the genitourinary portal of entry
Contamination with infected vaginal secretions or semen
Describe the gastrointestinal portal of entry
Ingesting contaminated food or water
Describe the circulatory portal of entry
A bite from insects or rodents
Describe the transplacental portal of entry
A transfer of a microorganism from the mother to the fetus via the placenta and umbilical cord
What is a host?
Simple or complex organism that can be affected by an agent
An individual who is at risk of contracting an infectious disease
What is a susceptible host?
Person who lacks resistance to an agent and is vulnerable to a disease
What is a compromised host?
Person whose normal defence mechanisms are impaired and is, therefore, more susceptible to infection
What can influence the susceptibility to and severity of infections of a host?
Age Concurrent disease Stress Immunization/vaccination status Lifestyle Occupation Nutritional status Heredity
How can lifestyle influence the susceptibility to and severity of infections of a host? (3)
Practices, such as:
Having multiple sex partners
Sharing needles
Tobacco and drug use
How can occupation influence the susceptibility to and severity of infections of a host? (2)
Forms of employment that involve increased exposure to pathogenic sources, such as needles or chemical agents
How can nutritional status influence the susceptibility to and severity of infections of a host?
People who maintain targeted weight for height and body frame are less prone to illness
How can heredity influence the susceptibility to and severity of infections of a host?
Some people are naturally more susceptible to infections than others
Name the keys to eliminating infection between an agent and a reservoir (3)
Cleansing
Disinfection
Sterilization
Name the keys to break the chain of infection between the reservoir and portal of exit (3)
Promoting proper hygiene
Maintaining clean dental operatories
Ensuring the use of clean equipment in patient care
Name the key to breaking the chain of infection between the portal of exit and mode of transmission
Block the exit of the infectious agent
The dental assistant must maintain clean dressings on all injuries or wounds
Name the key to breaking the chain of infection between the mode of transmission and portal of entry
Dental assistants must always wash their hands between cases that may involve contact with contaminated items
Name the key to breaking the chain of infection between the portal of entry and the host (2)
Maintaining skin integrity
Using sterile techniques for patient contact
Name the key to breaking the chain of infection between the host and the agent
Eliminate the infection before it begins
What are the primary routes of microbial transmission in the dental office? (3)
Direct contact
Indirect Contact
Inhalation/Aerosol
Microbial transmission:
How does direct contact work?
An individual has direct contact with a lesion or microorganism while performing intraoral dental procedures
Microbial transmission:
How does indirect contact work?
An individual has contact with the microorganism through other means, such as contaminated instruments, supplies, or equipment
Microbial transmission:
How does inhalation/aerosol work?
An individual contacts the microorganism through inhalation
When does inhalation/aerosol transmission usually happen?
When the high-speed handpiece, or the ultrasonic cavitron is used
Dental assistant should have the _____________ necessary to fight off _________ that are encountered because of his or her close proximity to patients during dental treatment
Vaccinations
Pathogens
True of false:
Taking patient’s medical history will identify the infectious diseases that patients have
False
Important to update this information, both verbally and in writing as the patient’s medical history may not identify the infectious diseases that the patients have
What is one of the most important ways to prevent the transfer of microorganisms from one person or object to another person?
Handwashing
Define chemical antisepsis
Inhibiting the growth of causative microorganisms
Handwashing is both a __________ cleaning and _______ _________
Mechanical
Chemical antisepsis
How is chemical antisepsis achieved during handwashing?
Utilizing antimicrobial soap
At the beginning of each day, every member of the team is to complete _ consecutive rounds of __-second hand washes
2
15
Dental team members must wear protective ________ during specific phases of dental treatment
Eyewear
What is eyewear worn during specific times of a procedure for?
Protection from body secretions, aerosol pathogens, teeth etc.
A splatter of _____ and ______ can transfer infectious diseases
Blood
Saliva
What diseases can be transferred by splatters of blood and saliva?
Hepatitis
Herpes simplex
Aerosol droplets that contain microorganisms can cause an eye infection known as ____ ___ (______________)
Pink eye
Conjuncitivitis
Gloves are used as a barrier to _______________
Microorganisms
When should gloves be worn?
Anytime a team member anticipates contact with saliva or blood
Includes saliva- or blood-contaminated surfaces, instruments, or mucous membranes
What are the primary types of gloves that are used in the dental office? (7)
Latex gloves Vinyl/synthetic gloves Synthetic polymer gloves Overgloves Utility gloves Polynitrile gloves Nitrile gloves
Masks should be worn any time that splatter or aerosol of ______ or _____ can occur
Saliva
Blood
How do masks help?
Protects the patient and dental assistant from communicable diseases
Masks should be placed along the eye-wear before ________ _____ and _______ gloves
Washing hands
Gloves
Important that mark is placed _______ so that it fits ______ against the ____ and stays in place during procedures
Properly
Snugly
Face
Generally, the _______ side of the mask is on _______ surface for quick identification
Coloured
Outside
True or false:
Masks should be removed after the procedure by gasping the ties or attachments
True
Can you reuse masks?
No
Rules of masks during dental treatment
Use a new mask for each patient
Replace the mask if it becomes moist or wet
Never let the mark dangle around the neck or from the ear; remove and discard after each use
What are protective clothing?
Uniforms
Laboratory coats
Gowns
Clinic jackets
When should protective clothing be worned?
Should only be worn in the dental office (taken off when going out)
Protective clothing should be changed _____, or immediately if __________ with ____ ______
Daily
Splattered
Body fluids
Protective clothing must close _______ at ____ and around _____ area
Tightly
Neck
Cuff
Protective clothing must be ____ ______ when sitting
Knee-length
Protective clothing must be ________ in the office, or sent to a _______ service
Laundered
Laundry
When are barriers used in a dental office?
Wherever possible in all aspects of the dental office
Any area where contamination is possible during dental treatment that can covered should be _______
Covered
Barriers are made specifically for areas that have been hard to disinfect in the past such as what?
Tubing and hoses for the handpieces
List the level, advantages, disadvantages and time required for effectiveness for Chlorine Dioxide
Level: High
Advantages: Rapid disinfection
Disadvantages, corrosive to metals, requires ventilation, irritating to eyes and skin
Time Required for Effectiveness: 5-10 minutes
List the level, advantages, disadvantages and time required for effectiveness for Glutaraldehyde
Level: High
Advantages: Used for low- and high-level disinfection and sterilization, many have a 28-day use life
Disadvantages: Some are corrosive to metal, requires ventilation, irritating to the eyes and skin
Time Required for Effectiveness: 10-90 minutes
List the level, advantages, disadvantages and time required for effectiveness for Ortho-Phthalaldehyde
Level: High
Advantages: Used to disinfect without causing sensitivity, many have a 28-day use life
Disadvantages: May turn some plastics blue or green, and does not sterilize
Time Required for Effectiveness: 10-12 minutes
List the level, advantages, disadvantages and time required for effectiveness for Iodophor
Level: Intermediate
Advantages: Rapid disinfection and used as holding solution for impressions
Disadvantages: May discolor white or pastel vinyls, surface disinfectant or holding solution, irritating to eyes and skin
Time Required for Effectiveness: 10 minutes on surfaces
List the level, advantages, disadvantages and time required for effectiveness for Sodium Hypochlorite
Level: Intermediate
Advantages: Rapid disinfection
Disadvantages: Corrosive to metals, irritating to skin and eyes, diluted solution is unstable, must be mixed daily
Time Required for Effectiveness: 5-10 minutes
List the level, advantages, disadvantages and time required for effectiveness for Phenolics
Level: Intermediate
Advantages: Available as sprays or liquids
Disadvantages: Skin and mucous membrane irritation, cannot be used on plastics
Time Required for Effectiveness: 10 minutes
List the level, advantages, disadvantages and time required for effectiveness for Alcohol
Level: Cleaner only
List the temperature, time, ability to monitor and special considerations for liquid chemical sterilization
Temperature: Room temperature
Time: 6-10 hours
Ability to Monitor: Difficult
Special Considerations: Proper ventilation required, does not remain sterile after process
List the temperature, time, ability to monitor and special considerations for ethylene oxide sterilization
Temperature/Time: Heated unit 120 degrees Fahrenheit or 48.8 degrees Celsius for 2-3 hours, Room temperature for 12 hours
Ability to Monitor: Difficult
special Considerations: Proper ventilation, additional 24 hours to dissipate gas after sterilization
List the temperature, time, ability to monitor and special considerations for dry heat sterilization
Temperature/Time: 340 degrees Fahrenheit or 171 degrees Celsius for 1 hour
Ability to Monitor: Easily monitored
Special Considerations: Limited rust or corrosion of equipment, not for use with plastics or paper
List the temperature, time, ability to monitor and special considerations for chemical vapor sterilization
Temperature/Time: 270 degrees Fahrenheit or 132 degrees Celsius for 20 minutes
Ability to Monitor: Easily monitored
Special Considerations: Proper ventilation, special solution required
List the temperature, time, ability to monitor and special considerations for steam under pressure sterilization
Temperature/Time: 250 degrees Fahrenheit or 121 degrees Celsius for 30 minutes wrapped
Ability to Monitor: Easily monitored
Special Considerations: Requires distilled water, may corrode instruments, not for use with many plastics
List the temperature, time, ability to monitor and special considerations for steam(flash) autoclave sterilization
Temperature/Time: 270 degrees Fahrenheit or 132 degrees Celsius for 3 minutes unwrapped
Ability to Monitor: Easily monitored
Special Considerations: Requires distilled water, may corrode instruments, not for use with many plastics
