Infection Prevention And Control And Decontaminaton Flashcards
Why is prevention and control of infection important?
To prevent the transfer of microorganisms from the patient to dental team, dental team to patient, patient to patient, dental surgery to community, community to patient
Different microorganisms that can be found?
Bacteria, viruses, fungi, parasites, prions
Stages of infection
Prodromal stage: feels normal, slightly off colour. Before overt signs.
Overt infection: signs there is something not right
Chronic infection: carrier status and can be infectious to others
Mode of transmission of microorganisms
Direct contact, indirect contact (touching fomites), indirect contact by inoculation by contaminated objects, droplet infection, airborne infection by aerosol infection.
What are aerosols?
Particles < 5micrometers
How long can aerosols remain airborne for?
Hours/days
How are aerosols generated?
Air-rotor/cavitron aerosol
Mode of entry of microorganisms
Mucous membranes, ingestion, inhalation, breaks in the skin
What is done to stop infection?
Standard infection control precautions (SICPs)
Additional precautions to SICPs
Transmission based precautions (TBP). These prevent infections that spread:
- via direct contact with patient or indirectly from patients immediate care environment
- via droplets spread over short distances (at least 1metre) via droplets from the respiratory tract of individuals directly onto mucosal surface of another individual
- via airborne aerosols from the respiratory tract of one individual directly onto a mucosal surface of another individual
Why do we treat everyone as infectious?
Cos some will know and tell you, some won’t know and some will know and won’t tell you.
Must Do’s of infection control
Hand hygiene, uniform and PPEA, disinfectants/antiseptics, equipment, water quality, decontamination, waste disposal, sharps handling and disposal, sharps injury
What does nosocomial infection mean
That the infection has been acquired in a healthcare setting
Hand hygiene
Bare below elbows Gloves are only as clean as the hand inside Short nails and no nail varnish Wedding band only and must wash beneath Kara must be taped high up arm
Effective hand decontamination
Soap at start and end of duty for visible dirt on hands and if there is a norovirus outbreak
Alcohol for visibly clean hands 20 second rub, never on gloves and use soap if sticky residue
Surgical scrub for surgical work
The time for right hand hygiene
Before patient contact Before an aseptic procedure After body fluid exposure work After patient contact After contact with patient surrounding
Uniform and dress code
Hair tied back and contained
Religious headwear changed daily
Footwear must protect the foot and be safe to wear and be wipeable
Scrubs are uniform and protected with PPE, changed daily
ID badge for clinical duties - clip badge
PPE - mask, gloves, goggles, visa, apron/sleeves
What potential sources of microorganisms are found in aerosols?
Saliva, blood, crevicular fluid, exhaled lung products, alimentary canal products
How are aerosols tried to be reduced in splatter or splash?
Pre-procedural rinse of 1 minute of hydrogen peroxide mouth-rinse.
What are aerosol generating procedures AGPs?
Mechanically create and disperse aerosols by air rotor handpieces. Make the patient gag/cough.
What are aerosol generating exposures AGEs?
How long you are exposed to the aerosol. The AGP is reduced by mitigating factors, e.g. rubber dam, high volume suction.
PPE for non AGPs
Apron (single use)
Fluid resistant surgical face mask type IIR
Gloves
Visor/goggles
PPE for AGPs
Gown (single use) Filter face piece (FFP3) respirator mask Gloves Visor Theatre hat
What is donning and doffing
Donning is putting PPE on and doffing it taking PPE off
Order of removal of protective equipment
Gloves, gown, goggles, mask, wash hands
When should clinical unit surfaces be wiped?
Clear unit at start of session, between patients and end of session.
Dual action wipes
Detergent and disinfectant combined in the wipe
When should gloves be removed?
When touching common equipment materials and non-clinical activity like typing notes and using phones.
What happens if the waterlines are not clean?
Biofilm will be produced
Water flushing protocol
4 mins Monday AM, 2 mins tues-fri AM
2 min at start of AM and PM session
20 seconds between patients
2 minutes at end of day
Decontamination cycle
Disinfection, inspection, packaging, sterilisation, transport, storage, use, transport, cleaning etc
Inspect instruments after use
All cement and dental materials must be removed from instruments before return to decontamination centre
Disinfection of appliances for mouth
Disinfect before and after lab by 1 min in 10% hypochlorite and rinse under water. For sending to lab ensure thoroughly dry before placed in plastic bag.
Sharps handling and disposal
Sharps disposal (yellow bin yellow lid) Pharmaceutical waste (yellow bin blue lid)
Disposal of waste
Clinical waste separate to domestic waste
Extracted teeth containing amalgam separate
Sharps handling
Always stay behind the needle
Ensure safety feature activated every time
Double-click lock before disposal
Hold cartridge end for disposal
Remove burs/files/tips from hand piece when not in use (common inoculation injury)
Ensure sharps instruments are seated horizontally in the tray
Use mirror for injections for tissue retraction
Never pass or receive an unsheathed needle
Never bend the needle
Operator removes and disposes of sharps
Ensure sharps bins are close during venepuncture
Never fill sharps container above black line
Operator should hold sponge ring holds and gauze and wipe
Inoculation injuries sero-conversion risk
Hepatitis B (1 in 3) Hepatitis C (1 in 30) HIV (1 in 300)
What to do in the case of an inoculation injury
- stop and encourage wound to bleed under running water
- wash with soap
- tell another clinician on the department that they have had an inoculation injury (deal with managing process)
- managing clinician will tell patient what has happened and ask they have a blood test
- source patient and recipient of injury have blood taken
- telephone occupational health and give full details of injury
- complete a Datix form
- student checklist form for school office
