Cross Infection Control

Infection control is of prime importance at  Denpoint. Prior to undertaking clinical procedures every member of staff should  have received training in all aspects of infection control and the following  policy must be adhered to at all times.     It is essential to  the safety of our patients, families and staff. Every member of clinical staff should  be familiar with all aspects of infection control, including decontamination of  dental instruments and equipment, as part of their induction programme and thorough  regular update training. CPD requirements of the General Dental Council demand  regular training in infection control for registrants.    The following policy describes the routines  for the practice, which must be followed at all times. This policy should be  read in conjunction with the compliance, advice, guidance, and referenced  documentation contained within the “Denpoint  - Infection Control Audit”. This is found on the practice clinical  governance intranet. If there is any aspect that is not clear, please ask Sarah Duerden, the practice principals, or Claire Akrigg. Any of our patients might ask you  about the policy, so make sure you understand it. Additional guidance on the  procedures and protocols are available, and are referred to in this document.  These documents and links are generally available on the practice clinical  governance intranet site.

  1. Minimising blood-borne virus transmission
    1. All  staff must be immunised against hepatitis B; records of hepatitis B  seroconversion will be held securely by the practice manager to ensure that  confidentiality is maintained. For those who do not seroconvert or cannot be  immunised, advice will be sought on the appropriate course of action.
    2. Staff  identified as being at risk from exposure to blood borne viruses at work will  be required to undergo an occupational health examination. This will be provided  by the Occupational Health Provider. Tel: 01254 358070, Accrington  Victoria Community  Hospital, Haywood Road, Accrington, Lancashire, BB5    6AS.
    3. Records  of these examinations will be held securely by the practice to ensure that  confidentiality is maintained.
    4. In  the event of an inoculation (needlestick) injury, the wound should be allowed  to bleed, washed thoroughly under running water, and covered with a waterproof  dressing. The practice policy for dealing with inoculation injuries can be  found in the accident book, and also on file on the Clinical Governance  Intranet. Record the incident in the accident book.
    5. All  inoculation injuries must be reported to one of the principal dental surgeons  who will assess whether further action is needed (seeking advice as  appropriate) and maintain confidential records of these injuries, as required  under current health and safety legislation. Advice on post-exposure  prophylaxis can be obtained from the Occupational Health Provider. Tel:  01254 358070, Accrington  Victoria Community  Hospital, Haywood Road, Accrington, Lancashire, BB5    6AS.
  2. Decontamination of instruments and equipment
    1. Single  use instruments and equipment are to be identified and disposed of safely,  never reused. Re-usable instruments are to be decontaminated after use to  ensure they are safe for reuse. Gloves and eye protection are to be worn when  handling and cleaning contaminated instruments.
    2. Before  being used, all new dental instruments are to be decontaminated fully according  to the manufacturer’s instructions. Those that require manual cleaning are to  be identified. Wherever possible, the practice will purchase instruments that  can withstand cleaning in an ultrasonic cleaner.
    3. At  the end of each patient treatment, contaminated instruments are to be safely transferred  to the decontamination area for reprocessing according to the Safe Transference  of Contaminated Instruments Policy (see clinical governance intranet).
  3. Cleaning
    1. Contaminated  instruments are first cleaned manually before ultrasonic cleaning.
    2. Contaminated  instruments are then to be cleaned using the ultrasonic cleaner, unless this is  incompatible with the instrument. Follow the manufacturer’s instructions for  use.
    3. Instruments  cleaned in an ultrasonic cleaner or manually are to be thoroughly rinsed by immersion  in tap water in the designated stainless steel tank before proceeding.
    4. After  cleaning, instruments are to be inspected for residual debris and checked for  wear or damage. If residual debris is present instruments are to be reprocessed  in the ultrasonic cleaner for another cycle. Damaged instruments are to be  removed from use.
  4. Sterilisation
    1. The  practice uses non-vacuum autoclaves: Instruments are loaded to allow steam to  contact with all surfaces, without overloading the autoclave, and following  manufacturer’s instructions for use. Where instruments are to be stored for use  at a later date, they are to be wrapped or bagged, labelled with date of sterilisation  and date for reprocessing, to allow easy identification. Storage must not  exceed 21 days; after this time instruments are to be reprocessed. Instruments  for same-day use do not require wrapping.
  5. Surgery work surfaces and equipment
    1. The  patient treatment area are to be cleaned after every session, even if the area  appears uncontaminated, using surface decontamination agents (spray and/or  wipes) provided.
    2. Between  patient treatments, the local working area and items of equipment are to be cleaned  using spray or wipes provided in all surgeries. This will include work  surfaces, inspection light and handles, hand controls, delivery units,  aspirators and, if used, x-ray units and controls. Other equipment that may  have become contaminated is also to be cleaned.
    3. Dental  chairs all to be decontaminated with the antibacterial wipes specifically  designated for this purpose. All other cleaners will result in chair material  cracking over time, and must not be used.
    4. Cupboard  doors, other exposed surfaces, and floor surfaces are to be cleaned daily.
  6. Impressions and laboratory work
    1. Dental  impressions are to be rinsed until visibly clean and disinfected by immersion  for 10 minutes using Perform (as recommended by the manufacturer). Label the  work as 'disinfected' before sending to the laboratory. Other technical work  being returned to the laboratory is also to be disinfected and labelled before  despatch. The practice procedure for decontamination and management of  technical work is to be found on the clinical governance intranet.
  7. Hand hygiene
    1. The  practice policy on hand hygiene is to be followed routinely. The full policy is  on the clinical governance intranet, and diagrams showing the recommended  procedure are displayed by all sinks. A summary is included here.
    2. Nails  must be short, clean. Nails are to be cleaned using a blunt “orange” stick, not  with a nailbrush.
    3. Wash  hands using liquid soap at the beginning and end of each session, using the recommended  protocol, before donning and after removal of gloves. Follow the handwashing  techniques displayed at each hand wash sink. Scrub or nailbrushes are not to be  used; they can cause abrasion of the skin where microorganisms can reside.  Ensure that paper towels and drying techniques do not damage the skin.
    4. Antibacterial-based  hand-rubs/gels are to be used rather than hand washing between patients during  surgery sessions if the hands appear visibly clean. It should be applied using the  same techniques as for handwashing. The product recommendations for the maximum  number of applications should not be exceeded. If hands become “sticky,” they  must be washed using liquid soap.
    5. At  the end of each session and following handwashing, apply the hand cream  provided to counteract dryness. Do not use hand cream under gloves; it  encourages the growth of microorganisms.
  8. Clinical waste disposal
    1. The  registered waste carriers appointed by the practice are Initial and North West  Ambulance Service.
    2. All  clinical waste is classified as ‘hazardous’ waste and placed in yellow sacks  for collection. These should be stored in the lockable designated bins until  collection by the registered waste carrier.
    3. Clinical  waste sacks must be no more than three-quarters full, have the air gently  squeezed out to avoid bursting when handled by others, labelled according to  the type of waste and tied at the neck, not knotted. Full sacks are to be  placed in the lockable container at the back of the premises.
    4. Sharps  waste (needles, burs, scalpel blades etc) are to be disposed of in UN type  approved puncture-proof containers (to BS 7320), and labelled to indicate the  type of waste. When two-thirds full, sharps containers must be locked and  stored securely for collection and disposal by the registered waste carrier  appointed by the practice.
    5. Clinical  waste and sharps waste are to be stored securely in the areas provided before collection  for final disposal by the registered waste carrier appointed by the practice.  The waste carrier holds a certificate of registration with the Environment  Agency.
    6. Dental  amalgam wastes, and spent developer and fixer solutions, are to be disposed of  as hazardous waste by the registered waste carrier appointed by the practice.
    7. At  each collection of waste, the waste carrier issues a consignment note, which is  retained by the practice for 3 years. Consignment notes are to be filed away.
    8. All  staff involved in handling clinical waste are to be vaccinated against  hepatitis B.
    9. All  relevant staff will be trained in the handling, segregation, and storage of all  healthcare waste generated in the practice.
  9. Personal Protective Equipment
    1. Training  in the correct use of PPE is included in the staff induction programmes, The practice  policy and protocols for the correct use of PPE is available on the clinical  governance intranet.
    2. PPE  includes protective clothing, footwear, disposable gloves, heavy duty gloves  for manual cleaning plastic disposable aprons, face masks, and eye protection.
    3. Footwear  must be fully enclosed and in good order.
    4. The  disposable clinical gloves used in the practice are non-latex, CE-marked and  low in extractable proteins (<50 μg/g), low in residual chemicals and  powder-free. Anyone developing a reaction to protective gloves or a chemical is  to inform the infection control supervisor immediately.
    5. Clinical  gloves are single-use items and must be disposed of as clinical waste.
    6. Long  or false nails may damage clinical gloves, so nails are to be kept short.  Alcohol rubs/gels are not be used on gloved hands, nor should gloves be washed.
    7. Heavy  duty gloves are to be worn for all decontamination procedures in the decontamination  unit, After each use, they should be washed with detergent and hot water to  remove visible soil and left to dry. These gloves should be replaced if worn or  torn or it becomes difficult to remove soil.
    8. Plastic  aprons are to be worn during all decontamination processes. Aprons are single  use and should be disposed of as clinical waste.
    9. Face  and eye protection are to be worn during all operative procedures. Tie face  masks are removed by breaking the ties. Face masks are single use items and are  to be disposed of as clinical waste.
    10. A  visor, face shield or protective goggles should be worn to protect the eyes;  ordinary glasses do not provide sufficient protection. Disposable masks are to  be worn with visors, as visors alone do not protect against aerosols. In  particular, masks are to be used when air abrasion is being used. Eye  protection should be cleaned according to the manufacturer’s instructions when  it becomes visibly dirty and/or at the end of each session. Disposable visors  should be used wherever possible and changed when damaged.
    11. Protective  clothing worn in the surgery is not be worn outside the practice premises. Adequate  changing and storage facilities are provided in the staff cloakroom.
    12. Protective  clothing becomes contaminated during operative and decontamination procedures.  Surgery clothing is to be clean at all times and freshly laundered clothing  worn every day. Machine washing at 60oC with a suitable detergent is advised.
  10. Blood spillage procedure
    1. If  a surface becomes grossly contamination with blood or blood/saliva, the area is  to be saturated with 1% sodium hypochlorite with a yield of at least 1000-ppm  free chlorine. Household bleach is used for this purpose. The cloths used for  cleaning are to be disposed of as clinical waste.
    2. If  blood is spilled as a result of an operative procedure, the spillage is to be  dealt with as soon as possible. The spilled blood is to be completely covered  by disposable towels, which are then treated with sodium hypochlorite solution  producing 10,000 ppm chlorine. Good ventilation is essential. At least 5  minutes must elapse before the towels are cleared and disposed of as clinical  waste.
    3. Heavy  duty gloves, protective eyewear and a disposable apron must be worn when  dealing with a spillage of blood Care is to be taken to avoid unnecessary  contact with metal fittings, which can corrode in the presence of sodium  hypochlorite. The use of alcohol in the same decontamination process is to be  avoided.
  11. Environmental cleaning
    1. The  non-clinical areas of the practice are cleaned in line with the practice  policy, which can be provided by the Practice Manager.
    2. Cleaning equipment is stored outside patient care areas

Review

This policy and the  policies referred to within it, will be reviewed at regular intervals to ensure  their currency, and amended as required by changes within the practice and  legal and professional requirements.

For Appointments:

Tel: 01706 835 800

E-mail: info@denpoint.com

 

Our Address:

Denpoint Dental Care
9-11 Bacup Road
Rawtenstall
Rossendale
BB4 7NG

 

You can also use our contact form.

 

Opening hours:

Monday       : 8.00am - 5.30pm

Tuesday      : 8.00am - 7.00pm

Wednesday : 9.00am - 5.30pm

Thursday     : 8.00am - 5.30pm

Friday          : 8.00am - 5.30pm

Closed Bank Holidays 

 

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