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Foundational Skills for Clinic > Infection Control and Safety > Flashcards

Infection Control and Safety Flashcards

1
Q

Regulations & Guidelines

A

§Occupational Safety & Health Administration (OSHA)
§Centers for Disease Control & Prevention (CDC)
§American Dental Association (ADA)
§Texas Department of State Health Services (DHSH)
§Texas Commission on Environmental Quality (TCEQ)
•

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2
Q

Training Requirements

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3
Q

Bloodborne Pathogens OSHA 1910.1030

A
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4
Q

Bloodborne Pathogens (BBP)

A
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5
Q

Body fluids that can harbor BBP:

§Blood
§Semen and vaginal secretions
§Saliva involved in dental procedures
§Synovial fluid
§Cerebrospinal fluid
§Human tissue and cell cultures
§All body fluids containing blood

A
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6
Q

Occupational Exposure*

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7
Q

Why Is Infection Control Important in Dentistry?

A
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8
Q

Potential Routes of Transmission

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9
Q

GOAL: Break the Chain of Infection

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10
Q

Preventive Measures

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11
Q

Engineering Controls

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12
Q

Personal Protective Equipment (PPE)

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13
Q

Clinic Gown

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14
Q

Clinic policy states, “Clinic gowns are not to be worn outside of the clinic.”

§This includes:
§Offices
§Stairwells
§Food service areas
§Non-clinical areas
§Waiting areas
§
§

A
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15
Q

When working in a clinical dental laboratory:

n

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16
Q

Nitrile gloves are available to be worn when treating nonsurgical patients.

A
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17
Q

Surgical Gloves – LATEX FREE

A

Sterile disposable gloves must be worn during all surgical procedures.

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18
Q

HEAVY DUTY Utility Gloves

A
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19
Q

PROPER FOOTWEAR

A

CLINIC POLICY - Clean, leather, leather-like or heavy-duty fabric, closed toe shoes, with hose or socks must be worn at all times.

These shoes may not be worn in clinics

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20
Q

Masks

A

Masks must be worn to protect:

§Face
§Oral & nasal mucosa

§Masks must be changed if they become damp
§The mask must be changed for each new patient, except for short exams!
§If a face shield is worn it must be worn at the same time as a surgical mask
§
§
Special Masks

A laser plume face mask must be worn during a laser or electrosurgery procedure!

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21
Q
A
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22
Q

Protective Eyewear

A

§Must be worn to protect from aerosol & spatter
§Regular eyewear must have side shields
§Side shields must be securely attached to the eyewear frame, abutting the lenses & free of vents or openings

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23
Q

Administrative Controls

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24
Q

Hepatitis B Vaccination

A

§Available at no cost to employees
§
§All health care workers must have vaccination
§
§Employees can decline vaccination, but must sign a declination statement
§
§

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25
Good Work Place Practices
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Good Work Place Practices (cont.)
§Follow SOPs §NEVER recap needles with two hands! §Establish & maintain clean & dirty zones §Decontaminate work surfaces §At start & end of procedures §Immediately after spill §Before removal of equipment §Survey work area §Note locations of all necessary equipment, waste containers, disinfectants, soaps §Wash hands frequently, always between patients & always before leaving work area! §DO NOT eat, drink, or apply cosmetics in the work area §Practice proper personal hygiene for the dental clinic setting §Label containers - hazard communication §Chemical & biological working stocks §Dispose of waste properly §
27
Exposure Control Plan
§Written plan to eliminate exposure to blood & body fluids §Exposure determination §Plan must be accessible §Compliance §UTHSC-H Dental School Clinic §https://db.uth.tmc.edu/clinical-resources/clinic-manual §UTHSC-H Biological Safety Manual §http://www.uth.edu/dotAsset/390565ef-163c-4c5d-9bbb-ca10dff5c6e9.pdf §
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Injury Prevention
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Injury Prevention (cont.) Burs §Must be removed from handpiece immediately upon completion of patient treatment
Burs §Must be removed from handpiece immediately upon completion of patient treatment
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Recapping Anesthetic Needles
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Recapping Anesthetic Needles
§Use the “one-handed scoop” technique to recap if a recapper is not available §§NEVER use two hands!
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Sharps
33
Discard in sharps containers §Used needles §Blades, scalpels §Burs §Anesthetic cartridges §Broken glass
Discard in sharps containers §Used needles §Blades, scalpels §Burs §Anesthetic cartridges §Broken glass
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Sharps – Red Handled Lab Knife
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Maintain the Clinical Worksite
§Worksite must be maintained in a clean & sanitary condition §Equipment & work surfaces must be cleaned & disinfected before & after procedures, & after any contact with blood or other potentially infectious materials (OPIM) §Protective covering must be used to cover equipment and work surfaces §Biological waste & contaminated materials must be disposed of in appropriate biological waste containers
36
Clinical Contact Surfaces
§Risk of transmitting infections greater for clinical contact surfaces than for general housekeeping surfaces §Clean & disinfect surfaces §Apply barriers
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Routine Surface Decontamination
Sani-Cloth Plus Disinfectant §EPA registered §Meets OSHA & CDC guidelines §Double ammonium chloride & alcohol §Tuberculocidal, bactericidal & virucidal §Use on surfaces in dental operatories
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Sani-Cloth Plus Disinfectant
40
Routine Surface Decontamination
41
Surface Covers
42
Dental Dam
Provides protection from aerosols and spatters
43
Clinical Computer Equipment
§Procedures should be followed to avoid contamination of electronic equipment when possible § §If it will be necessary to enter data while a patient is in the operatory, barrier protection for equipment must be utilized & high touch areas must be disinfected§Follow established guidelines §
44
Computer Equipment
45
Hand Hygiene
§On average only 40% of health care workers regularly wash their hands§Non-compliance with hand hygiene is associated with healthcare associated infections and spread of multiresistant organisms. § Proper hand washing is VITAL to infection prevention! You may not realize you have germs on your hands! Wash your hands, even if gloves have been worn… Before patient contact, including between different patients After contact with anything contaminated During patient care: §Before & after treatment procedures §Between glove changes §Immediately if skin is contaminated or an injury occurs
46
Proper Hand Washing
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Hand Hygiene (cont.): Alcohol Hand Sanitizers
48
Good Work Place Practices (cont.)
§Eating & drinking prohibited in all clinical areas §Do not wear jewelry in clinic areas §
49
Hair
nHair should be short & well-managednLong hair should be pulled back or completely covered with a surgical cap to minimize the possibility of contamination nBeards, mustaches, or other facial hair must be neatly trimmed to fit under the mask
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Fingernails
52
Blood (or OPIM) Spill Clean up
53
Biological Waste Disposal
nBlood, saliva or OPIM saturated items must be discarded in biohazard bags at chairside nBiohazard bags must be maintained in hard-walled, leakproof, secondary containment nSmall biohazard bags must be discarded in larger biohazard bags (at the dispensary) nPlace sharps in appropriate hard-walled, leakproof sharps container nDo not overfill (no more than ¾ full.) See “fill line” nCall for pickup – UTHSC-H Waste Line 713-500-5837
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Regulated Medical Waste
§Contaminated waste disposal §Sharps disposal §In compliance with OSHA, DSHS & TCEQ § §§
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Injury/Potential Exposure
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REMEMBER! §If you have received a puncture or laceration injury from a contaminated needle or instrument… § §REMOVE THE ANESTHETIC SYRINGE OR INSTRUMENT FROM CASSETTE – DO NOT REUSE INSTRUMENT !
REMEMBER! §If you have received a puncture or laceration injury from a contaminated needle or instrument… § §REMOVE THE ANESTHETIC SYRINGE OR INSTRUMENT FROM CASSETTE – DO NOT REUSE INSTRUMENT ! DO NOT DISMISS THE PATIENT!
58
Medical Surveillance
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Rights
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Record Keeping
§Medical records related to exposure incidents must be retained for duration of employment plus 30 years §Training records must be maintained for three years §
61
Tuberculosis
§ §Caused by Mycobacterium tuberculosis § §Spread by airborne droplets – coughing, sneezing, speaking§Also considered to be bloodborne §
62
Patient Assessment for Risk of Tuberculosis
Routinely ask all patients: §Do you have a history of TB disease? § §Do you have symptoms suggestive of TB? §
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TB Presentation & Isolation
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Patients with History or Symptoms of Undiagnosed TB
§Should be referred promptly for medical evaluation of possible infection§Should not remain in the dental facility any longer than required to arrange a referral § §Should wear surgical mask while in the dental facility§Should have urgent dental care provided in areas that can provide TB isolation §
65
``` Patients with History or Symptoms of Undiagnosed TB (cont.) ```
§Should have elective dental treatment deferred until a physician confirms that the patient does not have infectious TB§If diagnosed as having active TB, elective dental treatment should be deferred until no longer infectious §
66
Dental Unit Waterlines & Biofilm
§Microbial biofilms form in small bore tubing of dental units §Biofilms serve as a microbial reservoir §Primary source of microorganisms is municipal water supply §
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Dental Unit Water Quality
69
Dental Unit Water Quality (cont.)
§For routine dental treatment, meet regulatory standards for drinking water: ## Footnote \< 500 CFU/mL of heterotrophic water bacteria § §ADA standards: \< 500 CFU/mL of heterotrophic bacteria
70
WATER TREATMENT – SCHOOL OF DENTISTRY
Central system that provides treated water to each dental unit throughout all clinics. Dental Unit Water Lines (DUWL) must be flushed for 30 seconds prior to and after each patient appointment
71
Fire Alarm Design
72
Safe Handling & Ergonomics
73
X-Ray & Laser Safety
§Special training is available for personnel that will use X-Rays & Lasers §Programs are available for individuals who are pregnant § §

Foundational Skills for Clinic (5 decks)

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