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.
- Minimising blood-borne virus transmission
- 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.
- 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.
- Records of these examinations will be held securely by the practice to ensure that confidentiality is maintained.
- 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
- 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.
- Decontamination of instruments and equipment
- 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.
- 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.
- 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).
- Contaminated instruments are first cleaned manually before ultrasonic cleaning.
- Contaminated instruments are then to be cleaned using the ultrasonic cleaner, unless this is incompatible with the instrument. Follow the manufacturer’s instructions for
- 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.
- 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.
- 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.
- Surgery work surfaces and equipment
- 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)
- 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
- 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.
- Cupboard doors, other exposed surfaces, and floor surfaces are to be cleaned daily.
- Impressions and laboratory work
- 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.
- Hand hygiene
- 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.
- Nails must be short, clean. Nails are to be cleaned using a blunt “orange” stick, not with a nailbrush.
- 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.
- 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.
- 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
- Clinical waste disposal
- The registered waste carriers appointed by the practice are Initial and North West Ambulance Service.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- All staff involved in handling clinical waste are to be vaccinated against hepatitis B.
- All relevant staff will be trained in the handling, segregation, and storage of all healthcare waste generated in the practice.
- Personal Protective Equipment
- 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
- PPE includes protective clothing, footwear, disposable gloves, heavy duty gloves for manual cleaning plastic disposable aprons, face masks, and eye protection.
- Footwear must be fully enclosed and in good order.
- 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.
- Clinical gloves are single-use items and must be disposed of as clinical waste.
- 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.
- 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.
- Plastic aprons are to be worn during all decontamination processes. Aprons are single use and should be disposed of as clinical waste.
- 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.
- 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.
- 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.
- 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.
- Blood spillage procedure
- 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.
- 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.
- 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.
- Environmental cleaning
- The non-clinical areas of the practice are cleaned in line with the practice policy, which can be provided by the Practice Manager.
- Cleaning equipment is stored outside patient care areas
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.