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Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Digital Esthetics. He is also the author of 18 technology books, including the award-winning Green IT: Reduce Your Information System's Environmental Impact While Adding to the Bottom Line. As such, he’s particularly interested in the technological side of dentistry.
While most people tend to give up on their resolutions, here's how to keep up with your infection control efforts in 2019.
The new year has, customarily, been a time to improve oneself through resolutions. The perennial favorite is losing weight. Regrettably, many New Year’s resolutioners abandon their goals in less than two weeks. According to Strava, a social network for athletes, Jan. 12 is the auspicious day when most motivations begin to waver.
But that need not be the case. While the bulk of the populace may not be able to stick to their goals, that doesn’t mean that practices setting improvement goals can’t – especially when it comes to infection control. We have several resolutions that you should consider.
For instance, I resolve to…
“Too often, we forget to do our OSHA team training,” says consultant and speaker Leslie Canham, CDA, RDA. “This training is important when it comes to infection control because it is the foundation of infection prevention for employees. If you haven’t conducted OSHA training in the past 12 months, set a date to do it.”
Getting together with staff to talk about safety issues need not be an overly complicated, fussy affair. A regular monthly meeting is a good way to share information and keep safety in mind.
“It can be a topic while you eat your lunch,” says Joyce Moore, RDH, an infection control consultant and clinical instructor at Bristol Community College in Fall River, Massachusetts. “It can be something that is before hours in the morning huddle, it can be after hours, something a little bit more formal. But having a monthly meeting is really a great way to loop everybody into what you’re doing, keeping everybody on the same page. One of these topics might be how to properly load your sterilizer. Often you have many people in the practice that have either been taught at different schools and may approach things differently. Sometimes you have folks that don’t have a formal education. The biggest risk of sterilizer failure is improper loading, and it’s what’s people are doing, not what the actual machine is doing itself.”
Topics can run the gamut from something somewhat complex down to something basic.
“It could be a topic on how to keep your hands healthy because this part of the year is very dry. People are having a little bit more difficulty maintaining the integrity of their skin,” Moore observes. “Or it could be something like sterilizer use. There are a broad number of topics. It could be how to do stretching to help ergonomics.”
The meeting leader need not always be one of the dentists or the infection control coordinator. The routine and the topics can vary, depending on what kind of information there is and who wants to share it.
“It could be the manager. It could be somebody else that that works in the practice,” Moore says. “Maybe you have a staff member that teaches yoga and is an appropriate person to discuss ergonomics. So, it could be really could be whoever is the content expert.”
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Properly process instruments
While the OSHA-specific training is meant to protect employees, additional training should focus on issues germane to patient safety.
“For example, take a look at instrument processing,” Canham says. “Are you cleaning instruments well enough before packaging for sterilization? Here’s a good way to know: Do a spot check of your instrument pouches or cassettes. Look to see if there’s any debris left behind on the instruments. If debris is not removed, the instruments might not achieve sterilization because there could be viable microorganisms underneath that debris.”
Cleaning and sterilizing instruments is vitally important, but doing it properly also involves following the manufacturer’s directions for use of the sterilization equipment.
“Sometimes we go rogue on using our equipment because we either get in a hurry or we were never properly trained on how to operate that piece of equipment,” Canham continues. “Make sure you’re using the right package or wrap for your sterilizer and that you’re using the sterilizer the right way. Are you loading the sterilizer chamber properly? Are you using the right type of water? Most sterilizers that are autoclaves need distilled water. Make sure that you’re following the manufacturer’s directions on how to operate your sterilizer.”
The process would be simpler if everyone followed the exact same steps. However, each sterilizer has different usage instructions that are covered in the owner’s manual. But what if that manual is no longer handy?
“If you cannot locate the owner’s manual, contact the manufacturer and ask for copy,” Canham says. “Usually you can download it from their website. You can always call the manufacturer if the instructions for use are not clear or to ask specific questions.”
Two of the most common problems with instrument processing involve how they’re loaded into the sterilizer.
“One common error I see is overloading of sterilizers,” Canham says. “Another is improper placement of instrument pouches in the proper position. The manufacturer might recommend that the plastic side of an autoclave bag be placed up or down. Dental teams may have gone to a lecture and heard the lecturer say which way to place the pouches and thought, ‘Well, that must be the way it goes for my sterilizer. The manufacturer’s instructions for use always take precedence over what was heard at a lecture.”
Be sure to add verification to your instrument processing resolution too.
“In addition to weekly spore testing of the sterilizer, check to see if any of the sterile packages have holes or punctures. If so, the instruments are compromised and should not be used. They should be removed from the package or wrap, recleaned, rewrapped and resterilized. Also make certain you are using the right type of package or wrap for your sterilizer” Canham says.
It’s important to remember that proper equipment usage isn’t just limited to its day-to-day operation. Like a car or household appliances, routine maintenance is required. Again, that information can be found in the owner’s manual.
“Follow the instructions for cleaning the chamber, changing gaskets, or having service maintenance,” Canham says. “Then set up a schedule to perform the tasks.”
Stay home if you’re sick
A great way to prevent the spread of infection is to eliminate contact with a contaminated source. An obvious way to avoid that contact is to stay home when one is sick.
“Nobody really wants to miss work or their appointments, so hopefully we can keep everybody healthy as healthy as possible, as things really start brew at this time of year,” Moore says.
She refers to a CDC map that tracks flu activity at: www.cdc.gov/flu/weekly/index.htm#ILIMap.
“As we see, the flu is starting to be really elevated down south,” she observes. “If you look at the CDC site, you can look at the weekly U.S. influenza surveillance report, and they’ve got a nice color map.”
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Do spring cleaning
The new year is a good time to take a look at the practice’s instruments to ensure that they are serviceable and not shabby-looking.
“Take a look at appearance of the instruments themselves,” Canham says. “Sometimes they become corroded or rusted. If your instruments are starting to break down, maybe it’s time to retire them.”
This is especially important because when instruments have compromised surfaces, they’re more difficult to clean.
“If you use a wrench, it doesn’t matter if the wrench has rust or corrosion on it. It’s not really going to harm anything that you’re using it for,” Canham says. “But if you have an instrument that’s corroded or rusting, the corrosion can affect other instruments that it is exposed to. Appearances are important when it comes to the patient perception. If patients see an instrument that has rust or corrosion on it, are they going to think that it’s blood?
That notion of spring cleaning shouldn’t be limited to just instruments. Rather, now is a good time to look at the whole environment.
“How about the appearance of the treatment room?” Canham adds. “Look everywhere – the over headlight light, the countertops, the flooring, the window shades, dental unit, patient chair or operator stool, particularly the upholstery.
Are there rips, tears, stains, or areas that could be addressed? What are the patients seeing, and what deduction do they make from the appearance of a treatment room about you?”
Staff must be certified to perform their dental work, and infection prevention is a component of that. However, there are efforts to create an infection prevention-specific certification called Certified in Dental Infection Prevention and Control (CDIPC).
“OSAP and Dental Auxiliary Learning and Education Foundation (the DALE Foundation), which is the dental assisting group, have been, for the past couple of years, working on a certification program,” Moore says. “Often people are saying, ‘Well, why would I want to do that?’ Certification is something that, in addition to really wanting to have an infection control coordinator in your practice, is a great way to elevate your knowledge and your confidence and your competence. But it’s also great for your dental practice because now you have someone here that you can say, ‘We’ve got a person that is certified, somebody that is going to lower our risk.’ And it’s great for overall public opinion. It’s great to promote that in your dental practice.”
CDIPC is comprised of four parts. The first two parts are available now, and the final two will be available later this year. The certification program can be found online at dentalinfectioncontrol.org.
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Buy OSAP’s “From Policy to Practice” book
The CDC gives very specific infection prevention rules and regulations. However, sometimes the information can be hard to understand. As such, OSAP has a guide for health practices to understand what CDC demands.
“This is such a great resource,” Moore says. “Often I hear staff, I hear employees say they need to know an answer. They don’t know where to find the answer and they are questioning how something is done. This is a self-study workbook, but it’s really practical. It gives you checklists, charts, photos, things that you can really help you drill down to do what you’re doing correctly. So, it’s great for every dental practice.”
“From Policy to Practice” is not only a good resource for the practice but staff members can also get continuing education credit for it. Beyond just buying the book, staff can pay a little bit extra and take a test that will grant credits.
“If you pass at 70 percent, you will receive 10 continuing education credits,” Moore says. “This is a great option at a low cost. As an RDH, I need 10 CEUs per year.”
The book can be purchased online at www.osap.org/store/ListProducts.aspx?catid=71943.
Appearances matter and staff members should have a professional look.
“As a member of staff and as an individual practitioner, look at what you’re wearing,” Moore says. “Do you have a cohesive staff look? At some offices, everybody will be wearing the same scrubs, so they look uniform. Are you looking sharp? Do you need to replace some of the things that you have? Impressions count.”
Unfortunately, if someone neglects his or her outward appearance – no matter how good he or she is at the job – that aura of unprofessionalism can reflect back on others.
“I worked in an office where an assistant had a T-shirt on; it was a nice-looking T-shirt, but she had a hole in it,” Moore says. “I said to the dentist, ‘Her appearance reflects on everyone in the practice and, frankly, I’m not okay with it.’ I went to school, took my tests, earned my degree. I want to be considered a professional, not only based on what I do, but how I look. So, I think you really have to fit the part. You have to look the part, and part of that is your appearance.”
New Year’s resolutions aren’t just limited to individuals. And while many fall by the wayside well before the month of January is even over, the practice can take this opportunity to improve its infection prevention efforts.