Dental Post Needle Stick Exposure Education

1. Dental Post Needle Stick Exposure Education WellOne Primary Medical and Dental

2. Bloodborne Pathogens Standard • The Bloodborne Pathogens Standard applies to all employers with any employees who are exposed to blood or other potentially infectious materials in the office. • Designed to protect health care workers from exposure to bloodborne pathogens such as HIV, hepatitis B virus (HBV) and hepatitis C (HCV). • Bloodborne viruses may be found in human blood, saliva and certain other bodily fluids that have become infected.

3. Types of Occupational Exposure • OSHA defines occupational exposure as, “reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee’s duties.”

4. Types of Occupational Exposure cont. Occupational exposure to blood and saliva may occur in several ways: • Parenteral exposure (exposure occurring as a result of piercing the skin barrier, e.g. needlestick or cut with a sharp instrument.) • Contact with mucous membranes, such as the eyes. • Contact with skin. • *Parenteral exposure poses a greater risk of infection than does exposure through mucous membranes or nonintact skin.

5. Sources of Occupational Exposure • Needles • Burs and suture needles • Scalers and other dental instruments • Scalpel blades • Air-water syringe • Saliva ejector • High-speed evacuator • Surfaces of water lines • Radiographs • Chairbacks • Countertops • Drawer handles • Light and equipment switches • Disposables used in patient care

6. Standard Precautions • Standard precautions is an approach to infection control in which all human blood and certain body fluids (saliva in dental procedures) from all patients are treated as if they were infectious for HIV, HBV and other bloodborne pathogens. • Application of standard precautions reduces the risk of transmission of bloodborne pathogens. • Frequent hand washing, proper handling and disposal of contaminated needles, and the use of gloves and other personal protective equipment greatly reduces risk of transmission.

7. Handling Contaminated Needles and Other Sharps • According to the Bloodborne Pathogens Standard, contaminated sharps include any object exposed to blood or saliva that can penetrate the skin including needles, scalpels, broken glass, broken capillary tubes and exposed ends of dental wires.

8. Handle Contaminated Sharps as Follows: • Contaminated needles and other sharps must not be bent, recapped or removed by hand. • Shearing or breaking of contaminated sharps is never permitted. • Recapping/removal may be permitted for the procedures listed below if there is no other alternative or recapping/removal is required by the specific dental procedure (e.g. administering multiple doses of an anesthetic to the same patient.) • In cases where recapping/removal of contaminated sharps is permitted, employees must use a mechanical device or one-handed technique.

9. One-Handed Recapping Technique (Video) http://www.youtube.com/watch?feature=player_detailpage&v=JLxvnmz5zhA

10. Sharps Injury Prevention • About half of all percutaneous injuries are preventable. • Properly following workplace controls is the most important way to prevent these incidents from occurring. • In the dental department we are exposed to many different kinds of sharps and must always practice safe workplace controls to protect ourselves and others. • Some of the sharps that we encounter are contaminated burs, patient anesthetic syringes, scalpels and suture needles.

11. Contaminated Burs • They are a part of every procedure where a dental handpiece is used. • While the operator is using the bur it is important to only retract the patient’s mucosa using an acceptable retraction tool. (i.e. Mirror, suction tip, Minnesota retractor) • Once the procedure is finished and the handpieces are no longer needed, the operator must carefully remove the contaminated burs and place in the disposable medicine cup on the doctor’s bracket tray. This makes carrying the burs into the sterilization area a safe practice.

12. Patient Anesthetic Syringe • It is important that caution is always taken when handling a contaminated patient anesthetic syringe. Whether you are the operator or the assistant, full attention must be paid to the task at hand. • As the operator, only retract the patient’s mucosa with an acceptable retraction tool. (I.e. Mirror, suction tip, Minnesota retractor) Use a mechanical device or the one-handed scoop technique when recapping the needle. • When disassembling a patient syringe, only start to disassemble the syringe while you are directly in front of the sharps container. Do not bend the needle when you are disassembling the syringe, this is not a safe practice. It is essential that while performing this task full attention is being paid. Do not rush, this is how accidents happen. • If the syringe hub comes loose while you are trying to remove the needle, dispose the entire syringe into the sharps container. * Your safety comes first and the syringe can be replaced!

13. Scalpels • Never pass a contaminated scalpel between operator and assistant. • While using a scalpel only retract the patient’s mucosa using an acceptable retraction tool. (i.e. Mirror, suction tip, Minnesota retractor) • Place the contaminated scalpel carefully on the bracket tray. • When disposing of a contaminated scalpel, take extreme caution.

14. Suture Needles • Never pass a contaminated suture needle between operator and assistant. • While using a suture needle, only retract the Patient’s mucosa while using and acceptable retraction tool. (i.e. Mirror, suction tip, Minnesota retractor) • Place the contaminated suture needle carefully on the bracket tray. • When disposing of a suture needle, while using cotton pliers, carefully place the suture needle into a disposable cup. • Carry the cup to the sharps container and carefully dispose the suture needle into the sharps container.

15. Sharps Safety • There are many other sharp instruments that we are exposed to in the dental department. All loose instruments should be placed in an instrument basket before being placed in the ultrasonic cleaner. • Utility gloves should be worn while transferring contaminated instruments in and out of the ultrasonic cleaner. • We are all responsible for continuing to make improvements to keep our dental department injury free and a safe working atmosphere. If you observe a work practice that is not safe, it is your responsibility to report it to the Dental Office Manager. We then can take a focused look at the observation and improvements can be made to prevent injuries from occurring.

16. Sharps Disposal • Immediately after use contaminated reusable sharps (such as scaler or explorer) must be placed in appropriate containers until they are processed. • Containers must be puncture resistant, marked with biohazard label or colored red, leak proof and designed so that employees do not need to reach by hand into the containers.

17. If a Needle Stick Should Occur… • Immediately wash the area thoroughly with soap and water. • Report incident to Dental Office Manager and notify Cathy Haringa (ext 197) so that she can notify Beacon Insurance to file a claim (must be done within 24 hours of injury.) • Report incident to Wellness Coordinator. • Following a report of an exposure incident, a confidential medical evaluation and follow-up will be available to the employee at no cost to the employee. • All exposure incidents will be reported to WellOne’s Worker’s Compensation Insurance Carrier. • Medical records will be kept in accordance with OSHA, HIPPA, and Rhode Island Rules and Regulations.

18. For More Information: • Please consult the WellOne Exposure Control Policy and Procedure Manual located on your computer desk top. • Visit http://www.osha.gov/SLTC/bloodbornepathogens/index.html

19. Resources • ISIPS | ISIPS | International Sharps Injury Prevention Society. (n.d.). ISIPS | ISIPS | International Sharps Injury Prevention Society. Retrieved November 9, 2012, from http://www.isips.org/ • OSHA training for dental professionals. (2007). Chicago, Ill.: American Dental Association. • Safety and Health Topics | Bloodborne Pathogens and Needlestick Prevention. (n.d.). Occupational Safety and Health Administration - Home. Retrieved November 9, 2012, from http://www.osha.gov/SLTC/bloodbornepathogens/index.html

20. You have reached the end of this program… Once you are confident that you are comfortable with all the materials presented, proceed to the Sharps Injury Education post test at http://www.classmarker.com/professional Your username is the first initial of your first name followed by your full last name. Your password is= nwhealth