Why spring is a great time for yearly infection control maintenance

April 12, 2019

As you conduct spring cleaning in your home, here’s why you should also apply the concept to your dental practice.

The practice of spring cleaning is a customary annual activity when one can open up the windows, let in some fresh air and give the environment the deep cleaning it needs-especially after a long winter. In fact, some researchers even trace the custom of spring cleaning to the Iranian Nowruz, or the Persian New Year, which falls on the first day of spring. The Iranian practice of “khooneh tekouni” means “shaking the house.”

Spring cleaning can, certainly, be literally applied in the dental practice. But it’s also a good opportunity to pay special attention to some important infection control responsibilities.

Training

Spring is a great time to get in front of the practice’s training schedule. While there are some trainings that can be delivered at any time, spring is a great opportunity just to get them off the schedule. Other trainings are required to be performed annually, and this is an opportunity to get them out of the way.

“How about moving the office’s annual OSHA and infection control training to earlier in the year?” asks Karen Daw, a speaker and consultant also known as “The OSHA Lady.” “This way the office isn’t caught by surprise when they realize the anniversary for the training is quickly approaching or-gasp-has passed. For the offices that hire me to do their annual training later in the year, I automatically schedule their anniversary 10 to 11 months from that date instead of the full 12. What I’ve discovered, after having done this for many years, is that for one reason or another the training has been pushed ever so slightly further back each year. One year it might be by a week or two, and sometimes they discover it’s December and they haven’t scheduled any of the required training. Then everyone is scrambling during the holidays to complete this requirement.”

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Annual trainings aren’t required to be conducted on the same day every year, but reasonable attempts should be made to perform those trainings as regularly as possible.

“From OSHA, they interpret ‘at least annually’ to mean ‘Employees must be provided re-training at least once every 12 months’ (i.e., within a time period not exceeding 365 days),” Daw says. “This annual training need not be performed on the exact anniversary date of the preceding training but should be provided on a date reasonably close to the anniversary date, taking into consideration the company’s and the employees’ convenience in scheduling. If the annual training cannot be completed by the anniversary date, the employer should maintain a record indicating why the training has been delayed and when the training will be provided.”

Scheduling that training should be done as far in advance as possible so that schedules and calendars can be accommodated.

“Employers sometimes find it difficult to get the team together for training,” Daw says. “As soon as a potential date is announced, the vacation requests seem to come flying in. Make it easier on the team by setting the date way in advance. My dental hygiene appointment is automatically scheduled six months out, while I’m still in the dental chair. Scheduling OSHA Bloodborne Pathogen (BBP) training should be just as easy.”

Up next: Requirement review

 

Requirement review

Depending on the state in which the office practices, there may be a number of governing bodies, each with its own requirements. During your spring cleaning exercises might be a good time to review those rules and regulations. At the very least, OSHA rules should be routinely reexamined.

“Take this time to review the OSHA manual for the practice,” Daw advises. “The Exposure Control Plan (ECP) is the heart of the OSHA manual. In it, it describes how the practice is committed to a safe and healthful work environment. An ECP describes how exposure to bloodborne pathogens is eliminated or minimized in accordance with OSHA’s BBP standard.”

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At a minimum, Daw says the ECP must include the following:

  • Determination of employee exposure

  • Implementation of various methods of exposure control, including universal precautions, engineering and work practice control, personal protective equipment and housekeeping

  • Hepatitis B vaccination

  • Post-exposure evaluation and follow-up

  • Communication of hazards to employees and training

  • Recordkeeping

The ECP contains standard safety information for every practice, but it’s not a cookie-cutter document. It must be tailored to each location and its specific circumstances.

“In addition, the ECP must meet a few criteria, including being customized specifically to the location and reviewed and updated at least yearly,” Daw says. “This is so that any changes, such as new positions or procedures, can be included. What if this year an extra set of eyes joined the infection control coordinator for the review? A fresh perspective is sometimes exactly what is needed to breathe life into stale operating procedures or outdated processes.”

Up next: Perform a systems check

 

Perform a systems check

The saying “If it ain’t broke, don’t fix it” is a nice bit of homespun wisdom, but it’s not universally true. Just because the practice hasn’t had problems with infection control issues, doesn’t mean that they don’t require study or attention.

“Conduct an internal infection control audit,” Daw recommends. “The Centers for Disease Control and Prevention (CDC) gave us a great checklist to do exactly that. It’s a wonderful self-assessment and is kind of where ‘the rubber meets the road.’ In other words, it asks, ‘Is our practice doing what we say we’re doing?’”

The CDC’s checklist can help practices perform effective, thorough infection control audits.

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“The CDC’s summary is broken into two sections: one is on administrative polices and the other is based on observation,” Daw says. “I love this tool because it is an eye-opener for many offices under the impression they’ve been doing OK. Many realize after the checklist opportunity still exists to enhance infection control within the practice. It could take a few hours to complete from beginning to end but is oh so worth it! What better way to ‘spring clean’ infection control practices than with an honest-to-goodness evaluation with the help of the CDC?”

If a practice is busy, and especially if nothing has gone wrong,  it’s easy to let infection control evaluations slide, but there are things that should be routinely revisited.

“In a typical, thriving practice, it’s easy to gloss over or completely be oblivious to infection control and safety in the office,” Daw says. “Some days we barely have enough ‘me’ time, let alone the extra time needed to really peel back the layers and see if we continuously meet the basic expectations for safe care.”

These infection control initiatives can be performed anytime during the year, of course, but while performing your own “khooneh tekouni,” why not use it as an opportunity to keep on top of infection control chores?