DA116 Infection Control Environmental Infection Control

1. DA116 Infection ControlEnvironmental Infection Control • 1935 TODAY

2. Direct Indirect Inhalation Direct contact with Through cross contamination Microorganisms inhaled lesion or microorganism Blood or saliva Countertops Handpieces Open lesion Equipment Ultrasonic cleaner Pens Charts Routes of Transmission in the Dental Office

3. Asepsis = free of pathogens Step One: wash and dry hands thoroughly each time you approach the dental chair use disposable towels to dry hands AND to turn off faucets unless foot pedals are used Maintaining asepsis

4. Clinical Asepsis • Clinical Contact Surfaces • OSHA BBP = contaminated work surfaces should be disinfected • CDC guidelines = may use barriers orpreclean/disinfect methods • High potential for direct contamination from spray or spatter or by contact with DHCP’s gloved hand • Include suction lines • Housekeeping guidelines • Basic cleanliness and neatness • Do not come into contact with patients or devices • Limited risk of disease transmission

5. Cleaning Clinical Contact Surfaces Risk of transmitting infections is greater than for housekeeping surfaces • Surface barriers can be used and changed between patients OR • Clean, then disinfect using an EPA-registered low- to intermediate-level hospital disinfectant • (HIV/HBV /Tuberculocidal claims)

6. Clinical Contact Surfaces • Touch = directly touched during procedure • Place barriers or clean/disinfect between patients Dental light handles and dental chair Unit controls and switches Chairside computers Pens, telephones Dental material containers Door and drawer handles

7. Clinical Contact Surfaces • Transfer = often touched by contaminated instruments or contaminated gloves • Place barriers or clean/disinfect between patients • Instrument trays • Handpiece holders • Stools

8. Clinical Contact Surfaces • Splash, Spatter, Droplet • No direct contact but potential for contamination • Clean at least once a day (or more often as needed) • Countertops

9. Barriers or Pre-clean/Disinfect?Doctor decides….

10. Surface Barriers “if a surface cannot be easily and thoroughly cleaned and disinfected, it should be covered with a barrier to prevent area from becoming contaminated” • Fluid resistant • Plastic bags or tape, aluminum foil • Various shapes to fit specific equipment • Wear PPE (utility gloves) to remove contaminated barriers • Remove before beginning surface disinfection • Discard in regular trash • No need to clean/disinfect areas IF underneath surfaces are not touched when barrier is removed • must clean/disinfect if area becomes contaminated Must clean/disinfect all surfaces at the beginning and end of the workday

11. Typical Barrier Surfaces • Dental Chair • Headrest • Control buttons • Light • Handles and switches • Dental Unit • a/w syringe handles • Control touch pads • Bracket table • Evacuator hoses and controls • Digital X-ray Sensors • Light-curing devices • Automatic mixing devices • Drawer handles • Adjustment handles • Operator and DA stools

12. Place Barriers…

13. Pre-clean/Disinfect **Pre-clean surfaces **Disinfect surfaces After pre-cleaning Kills most disease-causing microorganisms • Reduce number of microbes and remove bioburden **Use a product that both cleans and disinfects

14. Evacuation • The suction system is routinely exposed to large amounts of saliva, debris, and blood. Infection control experts recommend daily maintenance of the high-velocity evacuation system, including the use of cleaners

15. Evacuation Lines • Lines and hoses • Flushed, cleaned, sanitized • Keep systems free from organic waste • Nonfoaming • Biodegradable • Pleasant scent • Solutions prepared daily • Use EPA approved products • Solutions are aspirated into hoses between patients and at the end of the day • Failure to use = odors, clogging, no suction • Clean and replace screen traps regularly

16. Housekeeping • Floors, walls, sinks • Routine basis and when visibly soiled • Detergents or EPA-registered low-level disinfectants • Prepare daily, following manufacturer’s instructions • Use PPE • Clean mops and cloths after use; dry thoroughly • Avoid carpeting and cloth-covered furnishings in clinical area

17. All ready for your next patient…. Now that you have your sterile instruments ready and the operatory is prepared with barriers and new supplies…go get your patient!