Sterilization and infection control is a vital and comprehensive part of every dental practice. OSHA, as well as state dental boards, set forth regulations, requirements and recommendations for the safety of both the staff as well as the patient. With all of the breaches in sterilization and infection control procedures that have been in the news recently, this should be a wake-up call to all of us in the dental industry to do a better job. In the past, patients tended to judge your sterilization techniques by the cleanliness of the restrooms. Not anymore! They are a lot more in tune as to what is being done, or not being done, with regards to sterilization of items that will be used on them and their families. Patients entrust their health to their dental professionals every day. What can we do to ensure the safety of our patients as well as ourselves?
Sterilization Area - Does the state-of-the-art technology in the rest of the practice match that of the sterilization area? When was the last time you walked through your sterilization area and really looked at how the workflow is laid out? Can you tell right away where the dirty and cleans sides are? Are there areas that can be identified as potential sources of cross-contamination?
The Centers for Disease Control (CDC) recommends dividing the area for instrument processing into four areas: Receiving, Cleaning and Decontamination; Preparation and Packaging; Sterilization and Storage. Identifying each of these areas so that things flow from beginning to end in the proper sequence will reduce the incidence of cross-contamination. Look at the equipment. Is it functioning correctly? Proper regular maintenance can certainly extend the life of equipment, but remember that equipment is not designed to last forever. The average life expectancy for a steam autoclave is seven to 10 years; for an ultrasonic cleaner, life expectancy is about six years, depending on the manufacturer and model.
Review of Procedures – An important aspect of a self-audit is a review of the procedures and protocols for sterilization and infection control. Although each state dental board will mandate regulations that must be adhered to, the CDC Guidelines for Infection Control in Dental Health-Care Settings, 2003 is a resource that should be utilized in every dental practice. How often is the ultrasonic cleaner being drained and cleaned? Is a biological indicator spore test being run weekly in each steam sterilizer in the office? Are there written protocols for sterilization and infection control? Are there written cleaning schedules for clinical contact surfaces as well as housekeeping surfaces? Are they being adhered to?
Operatories – What do the counters look like? Are they cluttered? Are instruments stored unwrapped in drawers or on the counters? Cassette systems, along with procedure tubs such as Hu-Friedy’s IMS System, are modern, effective and safe ways to transport contaminated instruments from operatory to sterilization according the OSHA Bloodborne Pathogens Standard, as well as clean, sterilize and store instruments to protect patients, staff and instruments. Procedure tubs are an efficient way to organize materials and consumable products to be used chairside.
Engineering Controls – These are devices that isolate or remove the bloodborne pathogens hazard from the workplace. If used properly, they can actually eliminate the potential for a sharps related injury. The OSHA Needlestick Safety and Prevention Act of 2000 require employers to identify, evaluate, and implement safer medical devices. These devices include those that are needleless or have built-in protection to guard workers against contact with the contaminated sharp. Devices such as self-sheathing needles, needle re-capping devices and blade removers are all examples of engineering controls that not only reduce the potential risk of exposure but also are safer and more state-of–the–art than the old pair of hemostats that may be used to remove the scalpel blade!
There are many options when it comes to adding technology and state-of-the-art equipment and systems for sterilization and infection control. A self-audit should include a conversation that includes the dentist and staff. Look at ways to improve the technology as it applies to both your sterilization area and operatories but don’t overlook your lab and any other places where you can improve and update. Enlist the assistance of your dental dealer and manufacturer reps. They often have tools and resources to help you accomplish this important and critical update. Following recommended guidelines for sterilization and infection control will not only keep staff and patients protected, but will also help the dental practice to run more efficiently. Maintaining infection control practices in your office can save time and money in today’s fast-paced world. Become more techno-savvy in protection for yourself, staff, and especially your patients.