Download Chapter 11 - Infection Control

Infection Control
Chapter 11
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Rationales of Infection Control
• Observe universal precautions
• Practice standard precautions
• Maintain chain of asepsis
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Regulators of Infection Control
• ADA
• Centers for Disease Control (CDC)
• Occupational Safety and Health
Administration (OSHA)
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Regulators of Infection Control
• Federal Drug Administration (FDA)
• Environmental Protection Agency (EPA)
• Organization for Safety and Asepsis
Procedures (OSAP)
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OSHA
• 1991 Bloodborne Pathogens Standard
– Determine exposure risk
– Prepare written exposure control plan
– Train initially and annually
– Provide PPE
– Establish standard operating procedure (SOP)
– Office hepatitis B vaccinations
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OSHA
• Needlestick Safety and Prevention Act
– Passed in 2001
– Addresses use of newer, safer medical
devices
– Maintain sharps injury log
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OSHA Compliance
• Dental office will be investigated for
compliance if:
– Complaint has been filed
– Office has eleven or more employees
– Invited by office
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Dental Check
• Under what category of occupational
exposure risk to bloodborne pathogens
does the DA fall?
– Category 1 – exposure to blood, body fluids,
saliva, and body tissues
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Cross-Contamination Pathways
• From DA to patient
• From patient to DA
• Can go on to infect families and friends
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Chain of Infection
• Agent:
– Biological
• Bacteria, virus, fungi, or protozoa
– Chemical
• Pesticides, food additives, or medications
– Physical
• Heat, light, noise, or radiation
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Chain of Infection
• Reservoir:
– Colonization
– Reproduction
• Portal of exit:
– Body secretions
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Chain of Infection
• Mode of transmission:
– Contact
– Airborne
– Vehicle
– Vector-borne
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Chain of Infection
• Portal of entry:
– Integumentary system
– Respiratory system
– Genitourinary tract
– Gastrointestinal tract
– Circulatory system
– Transplacental
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Chain of Infection
• Host:
– Age
– Concurrent disease
– Stress
– Immunization
– Lifestyle
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Chain of Infection
• Host:
– Occupation
– Nutritional status
– Heredity
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Breaking the Chain of Infection
• Between agent and reservoir
– Cleansing
– Disinfecting
– Sterilizing
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Breaking the Chain of Infection
• Between reservoir and portal of exit
– Having proper hygiene
– Cleaning equipment
– Cleaning dressings
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Breaking the Chain of Infection
• Between portal of exit and mode of
transmission
– Blocking exits
– Cleaning dressing
– Wearing gloves
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Breaking the Chain of Infection
• Between mode of transmission and portal
of entry
– Having proper hand hygiene
– Using barrier protection
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Breaking the Chain of Infection
• Between portal of entry and host
– Maintaining skin integrity
– Using sterile technique
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Breaking the Chain of Infection
• Between host and agent
– Having proper nutrition
– Exercising
– Updating immunizations
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Dental Check
• Handwashing and wearing PPE break the
chain of infection between what parts of
the chain?
– Mode of transmission and portal of entry to
the host
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Routes of Transmission in the
Dental Office
Direct
Indirect
Direct contact with
lesion or
microorganism
Blood or saliva
Through crosscontamination
Inhalation
Microorganism
inhaled
Countertops
Equipment
Handpieces
Pens
Open lesion
Ultrasonic cleaner
Charts
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Infection Control Techniques
•
•
•
•
Immunizations
Medical history
Handwashing
Alcohol-based hand
rubs
• Lotions
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
PPE
•
•
•
•
•
Eyewear
Gloves
Masks
Protective clothing
Barriers
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Disinfection
• Cleaning
• Disinfection
– Physical removal of
matter
• Sanitization
– Decontaminated, but
not free of microbes
– Destruction of some
microorganisms
• Sterilization
– Destruction of all
microorganisms
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Chemical Disinfectants
• Chlorine dioxide
• Glutaraldehyde
• Sodium hypochlorite
• Iodophor
• Phenolics
• Alcohol
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Disinfection Technique
• Spray-wipe-spray-wipe
1.
2.
3.
4.
5.
Spray
Wipe to eliminate surface debris
Spray
Let sit approximately 10 minutes
Wipe
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Ultrasonic Cleaning
•
•
•
•
Holding bath
3- to 10-minute cleaning cycles
Sound waves used
Cavitation process
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Dishwasher-Disinfector Device
• Provides high-level disinfection
• Has thermal disinfector
• Washes, cleans, disinfects, and dries
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Sterilization Methods
• Liquid chemical
disinfectant
• Ethylene oxide
• Dry heat
• Chemical vapor
• Steam under
pressure
• Steam autoclave
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Sterilization
• Equipment maintenance
– Necessary for proper function
– Ensure correct solution is used in appropriate
machine
• Handpiece sterilization
• Packaging and loading sterilizer
• Instrument storage
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Sterilization Monitoring
• Biological monitors
• Process indicators
• Dosage indicators
© Cengage Learning 2013
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Infection Control Techniques
•
•
•
•
Pre-procedure antiseptic mouth rinses
High-volume evacuation
Dental dam usage
Disposable items
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Dental Check
• Explain why hand hygiene is so important.
– It prevents the spread of infection from the DA
to the patient and from the patient to the DA
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Clinical Asepsis
• Asepsis
– Environment free of pathogens
• Housekeeping standards
• Government guidelines
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Treatment Room Preparation
•
•
•
•
•
Wash hands
Review chart
Place new barriers
Prepare instrument tray
Put on PPE
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Completion of Dental Treatment
• Move tools back to treatment tray
• Document information on chart or
computer with overgloves on
• Remove patient napkin and dismiss
• Remove all barriers with gloves on
• Remove gloves and wash hands
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Final Cleaning
• Put on utility gloves
• Employ spray-wipe-spray-wipe technique
• Set routine
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Dental Unit Water Lines
• Small tubes that connect water line to
instruments
• Biofilms
– Thin layer of bacteria that lines tubes
• Flush at start of day and between patients
• Install retraction devices
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Dental Radiography and
Equipment Rom
• Often missed
• Preparation similar to treatment room
• Disinfect once completed
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Dental Laboratory
• Disinfect in same manner as other rooms
• Clean and disinfect after working
• Clean and disinfect appliances created
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Dental Check
• What is the disinfection technique used to
prepare the treatment room?
– Spray-wipe-spray-wipe
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.