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INFECTION CONTROL Ahana A.

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A brief pressentation about infection control measures to be followed in a dental office..

A brief pressentation about infection control measures to be followed in a dental office..

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INFECTION CONTROL Ahana A. Presentation Transcript

  • 1. AHANA
  • 2. AHANA
  • 3. AHANA
  • 4. • Deposition of organism inINFECTION tissues & their growth resulting in HOST REACTION.INFECTIVE • Number of organism required DOSEAHANA to cause an INFECTION.
  • 5. AHANA
  • 6. PATHOGENS AIR BLOOD BORNE BORNEAHANA
  • 7. AHANA
  • 8. AHANA
  • 9. AHANA
  • 10. AHANA
  • 11. AHANA
  • 12. AIR BORNE DIRECT INDIRECT CROSS CONTAMINATIONAHANA
  • 13. AIR BORNE CONTAMINATION Spatter (>50mm) MistsAerosols (>/= 50mm)(50ṷm-50mm) AHANA
  • 14. DIRECT INDIRECTCONTAMINATION CONTAMINATION Direct contact with body  Handling sterile fluids. equipments & areas with contaminated hands AHANA
  • 15. CROSSCONTAMINATIONPATIENT DOCTOR AHANA
  • 16. Elimination / reduction ofspread of infection from their hosts Removal of microorganisms from objects or surfaces AHANA
  • 17. AHANA
  • 18. STERILIZATIONIMMUNIZATION & DISINFECTION PERSONAL DENTAL BARRIER EQUIPMENT TECHNIQUE ASEPSIS SURGICAL PROCEDURAL ASEPSIS AHANA BARRIERS
  • 19. Vaccination plays animportant role Hepatitis B vaccine AHANA
  • 20. Hand Head washing cap Eyewear Facemask ProtectiveAHANA gown Gloves
  • 21. AHANA
  • 22. Primary source of infectiontransmissionAHANA
  • 23. HAND WASHING……….. AHANA
  • 24. HAND WASHING……….. Mild antiseptics : 3% P- chloro, meta- xylenol / chlorhexidine Control pathogens & suppress overgrowth of skin bacteria AHANA
  • 25. Head Cap ………… Hair is Hairrestrained should be away tiedfrom face properly AHANA
  • 26. Protective Eyewear……Protection against foreignbodies, splatter & aerosolsProtection against injury &microbesDo not touch with contaminatedhandsAHANA
  • 27. Face masks…… Should be changed regularly & b/w patients Do not touch the mask with gloved hands When wet should be changed To remove grasp only by strings AHANA
  • 28. GOWNSAHANA
  • 29. GOWNS…………. Protective over garments. Cotton or synthetic. Worn over dentists’ clothes. Protection against spatter from routine work. Only in clinic & should be laundered daily. AHANA
  • 30. GLOVES Prevents contamination of hands & control cross infection Should be changed btw patients Do not wash with detergents & thrAHANA should be no defects.
  • 31. GLOVES AHANA
  • 32. Lowest possibility of manufacturing defectsWell fittingGood tactile sensitivityDo not cause hypersensitivity.Conducive to glove powder.Non offensive taste & odour.Reasonable cost. AHANA
  • 33. LATEXHEAVY STERILEUTILITY GLOVES SURGICAL VINYL AHANA
  • 34. High qualityMaximumprotection Expensive AHANA
  • 35. Commonly used in dentistry Adversely affected by alcohols & detergentsBecomes tacky / sticky when AHANA wet
  • 36. Over gloves When intraoral procedures are to be interrupted Slipped over gloved hands.AHANA
  • 37. Wear resistantNITRITE TYPE can bewashed, sterilized,disinfectedDouble gloves – Herpes, HIV, HBVBoxes of gloves: stored away from sunlight intightly closed, heavy plastic bags__ minimize AHANAoxidation
  • 38. Surgical staff preparationSurgical site preparation AHANA Draping the patient
  • 39. Personal barrier protection Surgeon is helped into sterile gown by properly gowned & gloved assistantAHANA Last step- wear gloves
  • 40. SURGICAL SITE PREPARATIONReduces postoperative infections.Lubricating oil is applied patient’s eyes &taped shut.Removal of hair in surgical siteWhole area is scrubbed with iodophoresolutionSkin preparation should take only about5 min. AHANA
  • 41. DRAPING THE PATIENTIsolate surgical areaSecured with towel clipsWaterproof drapes will be more beneficial AHANA
  • 42. RUBBER DAM Prevents aerosol formation of saliva SALIVA Minimize contact EJECTOR with aerosols & spatter Rinsing mouthANTIMICROBIAL SOLUTION reduces amount of bacteria AHANA
  • 43. SALIVA RUBBER ANTIMICROBIALEJECTOR DAM SOLUTION AHANA
  • 44. Clean & disinfect 2Approaches Prevention of contamination AHANA
  • 45. DISPOSABLE, SINGLE-USEINFECTION CONTROL BARRIER AHANA
  • 46. PLASTIC FILM Al FOIL BAGS TREATED AHANA FABRIC
  • 47. DELIVERY SYSTEMSurfaces should be cleaned & disinfected b/w each patientClean the surface by vigorous wiping, reapply the agent to disinfect& keep the surface moist for 10 min.Simple & most cost effective method is by use of single use barriermaterials AHANA
  • 48. DENTAL CHAIR Should be smooth with minimum accessories Upholstery should be removable for cleaning Plastic sheets should cover switches Head rests & arm slingsAHANA should also be disinfected
  • 49. OPERATOR STOOLCovering thelever withplasticSheet materialshould be ofvinyl plastic AHANA
  • 50. DENTAL CABINETRYAHANA
  • 51. Materials & instruments should bestored out of treatment room Cabinets should be made of materials that can be cleaned & disinfected regularly Avoid organic materials in AHANA construction
  • 52. UTILITY ITEMSSupply of water, compressed air, suction etc. Excellent circulation of air with an exhaust to outside Prevent clogging of water passages by using water sediment filter & deionizing the incoming water Suction pumps should have smooth flow of water & air Sediment trap should be disassembled & cleaned regularlyThe air compressor tank must be drained daily to avoid AHANAmicrobial contamination
  • 53. DENTAL UNIT WATER LINES AHANA
  • 54. Dental unit water lines……. Bacterial biofilm is formed ADA - <200 CFU/ml Dental waterlines should be flushed at the beginning of the day. Chemical germicides should be used to flush the waterline Antiretraction valves can also be used AHANA
  • 55. PRESOAKING CLEANING PACKAGING RINSE & DRY SEALING STERILIZATION CLINICAL AHANA STORAGE USE
  • 56. Prevents debris from dryingPlace instruments in a perforatedbasket & then place it in holdingsolution (neutral pHdetergents, water, Enzyme soln)Do not soak for too long AHANA
  • 57. PRESOAKING…………… AHANA
  • 58. Reduces the bio burden MANUALSCRUBBING ULTRASONIC CLEANINGMECHANICALINSTRUMENT WASHERAHANA
  • 59. Removes debris but directcontamination risks are high. AHANA
  • 60. Produces billions of tinybubbles which furthercollapses & create highturbulence thatdislodges debrisSafer & more effective: 4– 16 minDiscard the solution daily AHANA
  • 61. Used mainly in hospitals Reduces directAHANA handling
  • 62. Always keep the instruments dry.Use hot air oven sterilization forcorrosion prone instrumentsSpray rust inhibitor( sodiumnitrite)AHANA
  • 63. Maintains sterility of instrumentsSelf sealing, paper plastic & peelpouchesInstruments will be kept wrappeduntil usedReduce the risk of contamination AHANA
  • 64. PACKAGING……..AHANA
  • 65. AHANA
  • 66. Sunlight FlamingPHYSICAL Incineration AHANA Hot air oven
  • 67. Alcohols Aldehydes HalogensCHEMICAL Phenols Metallic salt gases AHANA Surface active agents
  • 68. • Process by which an article , surface or medium is freed of allSTERILIZATION microorganisms either in vegetative or spore state • Removal or destruction ofDISINFECTION any microorganism capable of causing infection • Measure used to preventANTISEPSIS/ infection by inhibiting ASEPSIS AHANA growth of microbes on living surfaces
  • 69. MOIST DRY HEAT HEAT METHODSCHEMICAL ETHYLENE VAPOUR OXIDEPRESSURE AHANA
  • 70. AHANA
  • 71. AUTOCLAVE……… Most efficient & reliable method. 3 main phases; • Vacuum created followed byPretreatment induction of steam Phase • Saturated steam affects all instruments • Temperature rises to peakSterilization point Phase • Holding time Post • Steam removed by vacuum treatment AHANA • Ensure instruments are dried Phase
  • 72. TEMPERATURE TIME 121˚C 15 minutes 126˚C 10 minutes 134˚C 3 minutes 15 lbs PRESSURE AHANA
  • 73. ADVANTAGESTime efficientGood penetrationConsistently good & reliableresultsInstruments can be wrappedprior to sterilizationAHANA
  • 74. DISADVANTAGES Blunting & corrosion of sharp instruments Damage to rubber goods AHANA
  • 75. AHANA
  • 76. Hot air oven…….Utilizes radiating heat: long periods of exposure Packaging materials Paper & Wrapped Nylon plastic Al foil plastic bags cassettes tubing AHANA
  • 77. TEMPERATURE TIME 141˚C 3hr 149˚C 2.5hr 160˚C 2hr 170˚C 1 hr 180˚C 30 minutes AHANA
  • 78. ADVANTAGESNo corrosion & bluntingLow cost of equipmentInstruments are dry after cycleRapid cycles are possible athigher temperatureAHANA
  • 79. DISADVANTAGES Poor penetrating capacity High temperature may damage heat sensitive itemsInaccurate calibration & lack of attention to proper settings lead to errors Not suitable for hand pieces May discolour fabrics AHANA
  • 80. AHANA
  • 81. Chemical vapour sterilization…… HEATED INCHEMICAL HOT CLOSED CHEMICALSOLUTION CHAMBER VAPOURS Pressure Kill microbes AHANA
  • 82. ACTIVE INGREDIENTS 0.23% FormaldehydeOTHERS 72.38 % Ethanol + Acetone + water + Other Alcohols AHANA
  • 83. MODES COAGULATION OF CELL MEMBRANEO PROTEIN DISRUPTIONFACTIO REMOVAL OF FREE SUBSTRATEN SULFHYDRYL AHANA COMPETITION GROUP
  • 84. TEMPERATURE PRESSURE TIME 132˚C 20lb 30min AHANA
  • 85. Eliminates corrosion of carbonsteel instruments, burs & pliers AHANA
  • 86. DISADVANTAGES Items sensitive to elevated temperature are damagedSterilization of liner, textiles, fabric or paper towels not recommended Instruments should be dry when AHANA loaded
  • 87. AHANA
  • 88. ETOX………….. Best method for sterilizing complex instruments ETOX is highly penetrative, noncorrosive gas above 10.8˚C Cidal action against bacteria, spores & viruses. Suited for electric equipments, flexible fiber endoscopes & photographic AHANA equipment
  • 89. ADVANTAGES Leaves no residue Deodorizer Good penetration Suited for heat sensitive articlesAHANA
  • 90. DISADVANTAGES High cost Toxic, irritant, mutagenic, carcinogenic Explosive & highly inflammableAHANA
  • 91. AHANA
  • 92. AHANA
  • 93. BOILING WATER……………..100˚C at normal atmosphericpressure10 min exposure kills almost allbacteria & some virusesNot suggested for tissuepenetrating instruments.AHANA
  • 94. AHANA
  • 95. Glass bead sterilizer….. Rapid , chair side method of sterilization Usually uses table salt which consists of ~ 1 % sodium silico aluminate & sodium carbonate Salt can be replaced by glass beads if < 1 mm in diameter because , larger beads are not efficient in transferring heat to endodontic instruments 5- 15 sec at 260° C AHANA
  • 96. AHANA
  • 97. IRRADIATION….2 TYPES IONIZING NON IONIZING AHANA
  • 98. X rays, Gamma rays, High speed electrons Effective- heat labileitems; needles, syringes, culture tray, cannula…High energy gamma rays from Cobalt 60 AHANA
  • 99. UV LIGHT • Absorbed by proteins & nucleic acids & kill microbes • Purification of air INFRA RED • To sterilize large number of syringes sealed in metal container.AHANA • Has no penetrating ability
  • 100. AUTOCLAVE TAPE THERMOCOUPLE CHEMICALAHANA MICROBIAL TESTS INDICATORS
  • 101. CRITICAL SEMI- CRITICAL NON CRITICALCurettes, burs, Amalgam Light switches,files, scalpels condensers, counter tops, mouth mirror, drawer pulls or saliva ejectors cabinets•Touch sterile • Touch mucous •Do not come inareas of body / membrane contact with oralpenetrate tissues without mucosa& enter vascular penetrating •Touched handssystem tissues. contaminated•Sterilized & •Should be with saliva/ bloodstored in AHANA sterilized /packages disinfected.
  • 102. INSTRUMENT STERILIZATION CATEGORY METHOD CRITICAL HEAT STERILIZED & Stored in packagesSEMI CRITICAL HEAT STERILIZED / Treated with high level disinfectants after cleaningNON CRITICAL Treated with intermediate to low disinfectant after cleaningAHANA
  • 103. Constant contact with oral fluids result information of biofilm within the handpiece.This holds potential to infect a healthy patient.Tween 80 & Ponceau 4R3% hydrogen peroxideBut cannot replace autoclaving. AHANA
  • 104. Handpiece sterilization……Autoclave sterilizationProper cleaning & lubricatingprocedures should be doneCleaning with disinfectantsChemical vapour pressure & ETOXsterilization can be done AHANA
  • 105. STERILIZATION OF BURS Critical itemAutoclaving can be done but may result in rusting. ETOX sterilization. AHANA
  • 106. INFECTION CONTROL FOR IMPRESSIONSThoroughly wash under runningwater2% gluteraldehyde for 10 minAlginate impressions – Spray aniodophorStore items in separate sealed bags. AHANA
  • 107. DISINFECTION LEVEL COMPOUND LOW ETHANOL & • Antibacterial activity ISOPROPYL • Denature proteins ALCOHOLS • Maximum 10 min contactINTERMEDIATE PHENOLS • In high concentration protoplasmic poison • Precipitate proteins & destroy cell wall HIGH FORMALDEHYDE & • Toxic & irritant GLUTERALDEHYDE • Active against most vegetative forms & spores • 2 % soln requires 20min for disinfection & AHANA 6 to 10 hrs for sterilization.
  • 108. AHANA
  • 109. 1. Employers must provide HB immunization to employees without charge within 10 days of employment.2. Universal precautions should be observed to prevent contact with blood & other potentially infectious materials.3. Employers must implement control systems to reduce production of contaminated spatter, aerosols etc.4. Safe handling of needles & other sharps.5. Disposal of single use needles, wires , sharps etc. in hard walled, leak proof containers from which needles cant be easily spilled.6. Proper hand washing7. Providing proper personal protective barriers to employees.8. Proper sterilization & disinfection system9. Regular laundry services should be arranged. AHANA
  • 110. BIO HAZARDOUS WASTEBIOMEDICAL WASTE MEDICAL SOLID WASTE AHANA
  • 111. BIO HAZARDOUS WASTE Laboratory waste Fluid blood elements SharpsHuman body parts, tissues etc. AHANA
  • 112. Empty specimen containersBandages & dressingsSurgical glovesDecontaminated bio hazardouswastes. AHANA
  • 113. DISPOSAL BAGSAHANA
  • 114. DISPOSAL METHODS AHANA
  • 115. AHANA
  • 116. AHANA
  • 117. AHANA
  • 118. AHANA