PIC HOMEPAGE

The goal of an Infection Control program is to eliminate the transfer of micro-organisms by taking the necessary steps to prevent the spread of infectious agents.

1. Annual assessment of all infection control policies and procedures insures ongoing staff infection control training, review, and evaluation of all aseptic, isolation, and sanitation techniques. To insure compliance of policies and procedures, quarterly assessment by scheduled and random inspections is required. Infection control is a top priority in an overall quality assurance program addressing occupational health and safety.

2. All clinical personnel subject to occupational exposure must be offered HBV vaccination. Personnel records should include written verification of HBV vaccination, immunity, or waiver of offered vaccination with statement of understanding of risks.

3. A Bloodborne Pathogen Exposure protocol must be established to manage percutaneous exposure to potentially infectious agents. This should include proper triage, treatment, and follow-up care of both the injured and source individuals. Documentation of all pertinent circumstances permits review, evaluation, and modification of policies and procedures.

4. All patients shall be treated under the concept of "universal precautions", an approach to infection control to which all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV and other blood-borne pathogens.

5. The prevention of cross-contamination, whether between dental health care worker (DHCW) and patient or between patients, is paramount. This principle underscores the establishment of all policies and procedures. For example, materials and supplies required to treat an individual patient should be issued as a unit dose whenever practical.

6. The use of disposable, impervious barriers is applied wherever practical, and especially where adequate cleaning and disinfection is difficult or impractical. Otherwise, an acceptable method of cleaning and disinfecting is by the spray-wipe-spray technique. An agent which has the Environmental Protection Agency (EPA) registration, American Dental Association (ADA) acceptance, and cleans and disinfects in one step is ideal. Cleaning as a separate step from disinfection and sterilization is of high priority and cannot be overemphasized.

7. A waste management system, including collection, transfer, and final disposal of general and infectious waste must be established to meet federal, state and local requirements.

8. A written protocol shall be developed for proper instrument processing, operatory cleanliness and management of injuries.

Based on the pathways through which cross contamination may occur, dental items are classified as critical, semi-critical or non-critical.

A. Critical Items:Materials and instruments that penetrate the soft tissue or bone. These items must be sterilized. Examples include: surgical instruments, suture needles, hand instruments, burs, endodontic files, etc.
Surgical procedures are entries into normally sterile areas of the body.

B. Semi-critical Items: Equipment, instruments or materials that are not used to penetrate soft tissue or bone but contact oral tissues. These items require sterilization or high level disinfection. Examples are plastic impression trays, mouth mirrors, etc..

C. Non-critical Items: Equipment, devices or instruments that contact intact skin. They may be exposed to aerosol sprays, spatter, or splashing of blood or touched by contaminated hands. An intermediate level or low level disinfection is required. Examples include the dental chair, unit and x-ray heads.

A. All new dental health care workers should receive initial training with annual update training thereafter. Infection control training should include and explain:

1. Epidemiology of bloodborne diseases and symptoms.

2. Modes of transmission of infectious diseases and bloodborne pathogens.

3. The use and limitations of infection control practices that will reduce or prevent exposure.

4. All Central Service Room (CSR) personnel or surgical assistants will receive additional documented training in sterilization and aseptic techniques.

5. All infection control training sessions will be documented with names and signatures of persons in attendance with the presenter names, dates, and content summaries; maintain records for five years.

6. Dental health care workers (DHCW) shall refrain from direct patient care if there are open skin lesions on the hands, face or upper extremities until such conditions are resolved. DHCW who have exudative lesions or weeping dermatitis shall refrain from all direct patient care and from handling patient care equipment until the condition resolves.

7. Pregnant dental health care workers are to be educated and made aware that bloodborne pathogens can be transmitted to their unborn.

8. Obvious illness (i.e. fever, severe colds, flu, etc.) of dental health care workers are cause for absence from work.

9. Eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses are prohibited in work area where there is a reasonable likelihood of occupational exposure. Food and drink shall not be kept in refrigerators, freezers, shelves, cabinets or on countertops or bench tops where blood or other potentially infectious materials are present.

10. Facilities and/or licensees with one or more employees shall comply with infection control precautions mandated by the California Occupational Safety and Health Administration.

11. A copy of the California Board of Dental Examiners Infection Control Regulations shall be conspicuously posted in each dental office/facility.

PERIODONTICS INFORMATION CENTER