Infection Control 8-7-2013

7/28/2019 Infection Control 8-7-2013

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Dr. Hisham Al-Shorman

Assistant professor of Periodontology

Department of Preventive Dentistry

JUST

Monday 8/7/2013


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INFECTION CONTROL

1.Personal Protective

Equipment:

a.Gowns

b.Gloves

c. Masks

d.Protective eyewear

2.Surfaces

3.Hand hygiene

4.Clinical wastes

5.Blood-BornePathogens

6.Food and drinks

7.Infections


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WHY IS IT IMPORTANT?

Both patients & dental health-care personnel areexposed to pathogens

Nature of profession i.e. contact with blood, oral

and respiratory secretions and contaminatedequipment

Hospital settingreferral institution for medically

compromised patients

Proper procedures can preventtransmission ofinfections


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MODES OF TRANSMISSION

Direct contact with blood or body fluids

Indirect contact with contaminatedinstruments or surfaces


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MODES OF TRANSMISSION

Contact of mucosa of the eyes, nose, ormouth with droplets or spatter

Inhalation of air-borne microorganisms


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Exposure To Blood & Body Fluids

Laceration (wax knife,scalpel, carvers,)

Needle stick (anesthesia,irrigation,)

Puncture with dentalinstruments (burs, ortho

wires,)


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Exposure To Blood & Body Fluids

Splash of blood or saliva to mucousmembranes of (mouth, nose or eyes) and tobroken areas of skin:

Handpieces, scalers,

Sneezing, coughing, gag reflexes,speaking,


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Chain of Infection

Pathogen

Source

ModeEntry

Susceptible Host


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Potential Routes of Transmissionof Blood-borne Pathogens

Patient Operator

Patient

Patient Patient

Operator


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STANDARD PRECAUTIONS

Standard PrecautionsA standard of caredesigned to protect health-care providersand patients from pathogens that canspread by blood and other body fluids

Apply these standard precautions to allpatients

ALL BLOOD AND BODY FLUIDS ARECONSIDERED TO BE INFECTIOUS


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PPE

Consider all patients as infectious

Wear personal protective equipment:

Gowns

GlovesMasks

Protective Eyewear

Should be removed when leaving treatmentareas


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GOWNS / WHITE COATS

Should cover operators clothesand protect them from splashesand aerosols:

High neck

Long sleevesKnee long

Design!!! Reduce folds, pockets

and any other areas thatfacilitates accumulation of soil oraeresoles

Change if visibly soiled


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Minimize the risk of crossinfection:

From patients to operators

From operators to patients

From one patient to another

Are NOT a substitute for handwashing!

GLOVES


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Disposable latex, vinyl, ornitrile gloves:

Non-surgical procedures

Sterile disposable gloves

All surgical procedures

GLOVES


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UTILITY GLOVES

Heavy duty utility glovesafter patient treatment

Must be washed withantimicrobial soap,

rinsed and dried

Stored in plastic bag inlocker


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RECOMMENDATIONS FORGLOVING

Wear gloves when contact with

blood, saliva, and mucous

membranes is possible

Remove gloves after patient care

New gloves for each patient


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If torn, cut or

puncturedreplace

them

Do NOT wash, disinfect

or sterilize gloves for

re-use

RECOMMENDATIONS FORGLOVING


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Masks to protect: Face

Oral and nasal mucosa

Must be changed if theybecome damp

Must be changed for eachnew patient, except for

short exams

If a face shield is worn itmust be worn at the same

time as a surgical mask

MASKS


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PROTECTIVE EYEWEAR

Protect from aerosol and spatter

Regular eyewear must have side shields - free

of vents or openings


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SEQUENCE OF PUTTING ON PPE

1. Hand hygiene - FIRST

2. Gownif sterile (Surgical)

3. Mask

4. Protective eyewear

5. Gloves - LAST


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SEQUENCE OF REMOVING PPE- Reverse

1. GlovesFirst (most contaminated)

2. Hand hygiene

3. Protective eyewear - handle by head band or ear

pieces

4. Gown

5. MaskBy elastics -Front of mask is contaminated

DO NOT TOUCH!

6. Hand hygiene


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SHARPS

Used needles, blades, burs, endo filesand reamers, anesthetic cartridges andall other sharps are to be discarded in:

SHARPS CONTAINERS


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Recap anesthetic needlesby using the needle re-capper

If unavailable, use the onehanded scoop technique

SHARPS


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FOOD AND DRINKS

Eating and drinking are prohibitedin all clinical areas


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Enjoy them outside!

FOOD AND DRINKS


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HAND HYGIENE

Plain soap and water

Antiseptic hand wash -

washing hands with water

and soap or other detergents

containing an antiseptic

agent


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HAND HYGIENE

Alcohol-based hand rub

Surgical scrub


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ALCOHOL-BASED PREPARATIONS

Rapid and effective

antimicrobial action Improved skin

condition

More accessible

than sinks

Cannot be used ifhands are visiblysoiled

Store away from hightemperatures or

flames Hand softeners and

glove powders maybuild-up

Benefits Limitations


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Efficacy of Hand Hygiene Preparations inReduction of Bacteria

Good Better Best

PlainSoap

Antimicrobialsoap

Alcohol-basedhandrub

http://www.cdc.gov/handhygiene/materials.htm


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Long fingernails

Colored nail polish

False fingernails

PROHIBITED!

SPECIAL HAND HYGIENECONSIDERATIONS


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Avoid hand jewelry that may tear gloves

SPECIAL HAND HYGIENECONSIDERATIONS


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HANDS NEED TO BE CLEANED

When visibly dirty

After touching contaminated

objects with bare hands

Before and after patient

treatment (before glove

placement and after glove

removal)


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BEST

Taps with sensors or foot

control to avoid hand contact

TAP DESIGN

AT LEAST

Taps with lever Use arm or back of your hand

to activate it


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TAP DESIGN

AVOID TAPS WITH KNOB


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HAIR

Hair should be short and well-managed

Long hair should be pulled back orcompletely covered with a surgical capto minimize the possibility ofcontamination


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HOUSEKEEPING

Worksite must be maintained in a clean

and sanitary condition

Equipment and work surfaces must becleaned and decontaminated after contact

with blood and other infectious materials

Protective coverings must be used tocover equipment and work surfaces


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CATEGORIES OF ENVIRONMENTALSURFACES

CLINICAL CONTACT SURFACES

High potential for direct contamination

from spray or spatter or by contact withgloved hand

HOUSEKEEPING SURFACES

Do not come into contact with patientsor devices

Limited risk of disease transmission



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CLINICAL CONTACT SURFACES


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CLEANING CLINICAL CONTACTSURFACES

Risk of transmittinginfections greater than forhousekeeping surfaces

Clean and disinfectsurfaces

Apply barriers


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SURFACE COVERS

Handles, handpieces or similar surfacesthat may be contaminated by blood orsaliva - wrap with clear plastic wrap.

Head rest cover


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GENERAL CLEANINGRECOMMENDATIONS

Use barrier precautions (e.g. heavy-dutyutility gloves, masks, protective eyewear)when cleaning and disinfectingenvironmental surfaces

Physical removal of microorganisms bycleaning is as important as the disinfection

process

Do not use sterilant/high-level disinfectantson environmental surfaces


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CLEANING CLINICAL CONTACTSURFACES

Surface barriers can be used and changedbetween patients

OR Clean then disinfect with hospital disinfectant


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CLEANING HOUSEKEEPINGSURFACES

Routinely clean with soap and water orhospital disinfectant

Clean mops and cloths and allow to drythoroughly before re-using

Prepare fresh cleaning and disinfectingsolutions daily and per manufacturerrecommendations


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WASTE DISPOSAL

Regular House Waste

Contaminated Medical Waste

Sharps

Human Tissues


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PREVENTION OF INJURIES

1. Remove burs fromhandpiece immediatelyafter completion ofdental procedure

2. Recap anestheticneedles


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PREVENTION OF INJURIES

3. Restrict use of fingers in tissue retractionor palpation during suturing oradministration of anesthesia

4. Avoid uncontrolled movements of dentalinstruments. THINK BEFORE MOVING ANINSTRUMENT.

h i i k


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Who is at risk?

Everybody!

Elderly pts

Children (lower resistance, Cystic fibrosis,)

Cardiac pts (e.g. valvular disease)

Respiratory disease pts (for air-borne infections)

Impaired healing functions

Immuno-deficient patients (e.g. auto-immune pts)

Other immuno-suppressants (e.g. transplant pts)

Cancer pts

Pts on steroids

Diabetics


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TAKE-HOME MESSAGE

Infection control regulations aremandatory to ALL

Violations of these regulations will

be taken seriouslyIt is better to play safe

Clinical assessment will consider

infection control practiceIf not sure, ASK!


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Infection Control 8-7-2013

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