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Dental Lab safety

Safety in Dental Labs (University of Griffith/ Australia)
Prof. Newell Johnson - Dean of Dentistry & Oral Health

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Dental Lab safety

  1. 1. Welcome to the World of Dental Technology Jane Evans: Program & Course Convenor Prof Newell Johnson: Dean of Dentistry & Oral Health
  2. 2. individualindividual
  3. 3. Hand washing Wash and dry hands before and after patient contact & between each case.Diagram courtesy Ansell Medical
  4. 4. Personal protective barriers Use personal protective barriers including gloves, masks, protective glasses, gowns and plastic aprons.Photo courtesy Ansell Medical
  5. 5. Safe handling and disposal of sharps Strategies to reduce the risk of a sharps injury must be practiced by all staff Photo courtesy Rexam Healthcare Packaging
  6. 6. Additional precautions Applied in additionApplied in addition to standardto standard precautionsprecautions Used for patients whoUsed for patients who are known to haveare known to have highly infectioushighly infectious diseasesdiseases
  7. 7. Personal hygiene A high standard of personal hygiene protects you, other staff and patients from infection
  8. 8. Personal hygiene includes Fingernails kept short and clean Hair short or tied away from face Clean uniforms Hand and wrist jewelry removed at start of day Hands washed before and after patient contact Hands washed before and after any activity likely to cause contamination.
  9. 9. Hand washing An important measure in preventing the spread of infection
  10. 10. Hands are washed and dried… Before starting work and after finishing work Before and after each patient/case Before and after going to the toilet Before working in a clean area Before and after a meal break.
  11. 11. Hands are also washed and dried After working in a ‘contaminated’ area Following any incident where hands are contaminated with blood or body fluids.
  12. 12. Hand wash at the start of the day Remove all jewelry Check hands for cuts, abrasions or sores Cover open cuts and abrasions with a waterproof dressing Clean fingernails with a plastic or wood stick Perform a routine hand wash.
  13. 13. A routine hand wash Lather hands with liquid soap and water for 10 to 15 seconds Rinse with cool water Dry hands with clean paper towels Use paper towel to turn off hand controlled taps.
  14. 14. Hand washing technique 1. Palm to palm 2. Palm over dorsum of hand Diagrams courtesy Ansell Medical
  15. 15. 3. Palm to palm with fingers interlaced 4. Back of fingers to opposing palms Diagrams courtesy Ansell Medical
  16. 16. 5. Rotate thumbs in palm 6. Rotate fingers in palm Diagrams courtesy Ansell Medical
  17. 17. Hand care The skin is a natural barrier to invading microorganisms
  18. 18. May cause dry cracked skin and dermatitis Frequent hand washing and wearing gloves
  19. 19. Dry cracked skinDry cracked skin gives disease causing microorganisms the opportunity to cause infection
  20. 20. Preventing dermatitis Remove all jewelry before washing hands Rinse hands thoroughly after washing Avoid using hot water for hand washing Dry hands completely after washing Handle irritant chemicals only while wearing gloves.
  21. 21. Personal protective barriers Lab Coats, Adequate Footwear Glasses, Gloves, & Mask
  22. 22. Personal protective barriers When worn properly provide a physical barrier between you and a risk. Protects feet from injury Protects feet from contact with sharp instruments that are accidentally dropped
  23. 23. Lab Coats Protect street clothes from aerosols and splatter contamination Are not worn outside the laboratory area Are changed/washed daily or more frequently if visibly soiled.
  24. 24. Facemask Provides a physical barrier by filtering microorganisms from the air Protects the wearers mouth from direct splash or splatter from the patient’s mouth.
  25. 25. Once a mask becomes damp Microorganisms are able to pass through and can then be inhaled.
  26. 26. Guidelines for wearing a mask Wear a mask to protect yourself from fumes or dust Wear a mask while assisting with all patient procedures Wear a new mask for each new patient Put on the mask before pulling on gloves While wearing a mask do not touch it with your hand.
  27. 27. Removing a mask Remove the mask after removing gloves by touching only the strings or loops Discard the mask with the general waste.
  28. 28. Protective glasses Protect eyes from sharp flying debris Protect eyes from blood and saliva splatter Protect patient’s eyes from accidentally dropped instruments Protect patient’s eyes from chemical splashes.
  29. 29. Guidelines for wearing glasses Wear protective glasses while cutting, trimming or polishing Wear protective glasses while assisting with all patient procedures Put on protective glasses and mask before pulling on gloves Wash glasses between patients with water and detergent Rinse glasses well after washing.
  30. 30. Gloves Worn whenever there is a potential for contacting blood and saliva Cannot protect hands from a sharps injury.
  31. 31. Non-sterile examination gloves Used in all non- surgical procedures Fit both hands and come in small, medium and large sizes Gloves are single- use and must never be washed or reused.Photo courtesy Ansell Medical
  32. 32. General purpose utility gloves More resistant to puncture Worn when handling contaminated instruments Worn during clean-up Washed in detergent and reused Stored dry Replaced when torn or cracked.PhotoPhoto HuHu--FriedyFriedy DentalDental
  33. 33. Guidelines for using non-sterile examination gloves Remove rings and watches Cover cuts and abrasions with waterproof dressing Wash, rinse and dry hands Choose a glove size that fits well Remove gloves that are torn, cut or punctured Discard gloves with general waste Wash hands thoroughly after removing gloves.
  34. 34. Aerosols A fine mist of tiny air- borne particles that may contain bacteria, viruses and fungi Splatter Larger particles of blood and saliva contaminated debris
  35. 35. Sharps injury All dental practices should have a written procedure for a sharps injury that involves exposure to blood or body fluids
  36. 36. Reducing the risk of sharps injury Strategies to reduce the risk of a sharps injury must be practiced by all staff An injury caused by contaminated sharps is potentially very serious.
  37. 37. A sharps injury is most likely to occur DuringDuring proceduresprocedures using bursusing burs During transferDuring transfer and disposal ofand disposal of sharpssharps While workingWhile working in confinedin confined areasareas
  38. 38. Procedures using burs The operator is responsible for removing the bur from the handpiece after use Slow speed burs are discarded into the sharps container High speed burs are cleaned and sterilized.
  39. 39. Managing a sharps injury Immediately wash the injured area of skin with soap and water Cover the injury with waterproof tape Report the sharps injury immediately to the person in charge of the surgery Complete an accident report form.
  40. 40. The accident report form records The date of the injury The time of the injury How the injury occurred The name of the person whose body fluid was involved.
  41. 41. Dispose of Dental Waste Safely
  42. 42. PackagedPackaged According to legislative requirements WasteWaste must bemust be LabeledLabeled StoredStored TransportedTransported
  43. 43. Waste generated from a dental practice includes Clinical waste Related waste General waste
  44. 44. Clinical Waste Waste that has the potential to cause sharps injury, infection or public offence
  45. 45. Clinical waste includes Discarded sharps Human tissues including materials or solutions that contain free-flowing or expressible blood Laboratory and associated waste.
  46. 46. Discarded sharps Wear personal protective equipment Discard all sharps into a clearly labeled sharps container Keep the sharps container out of the reach of children Replace the container when three-quarters full The operator who generated the sharp is the person responsible for their safe disposal.
  47. 47. Sharps include Needles Disposable syringes Scalpel blades Slow speed burs Endodontic files
  48. 48. Sharps container A clearly labeled yellow rigid sharps container Located close to where waste is generated Collected by a licensed medical waste contractor. Photo courtesyPhoto courtesy RexamRexam MedicalMedical PackagingPackaging
  49. 49. Human tissues Pathological specimens Biopsy specimens Tissue taken during surgery Free flowing or expressible blood Other body fluids removed during surgery
  50. 50. Laboratory and associated waste This category includes All specimens used for laboratory testing Cultures of microorganisms used in biological indicators
  51. 51. Disposal of clinical waste Yellow leak proof bag marked with biological hazard symbol Located close to where waste is generated Collected by a licensed medical waste contractor.
  52. 52. During waste disposal PracticeUse Personal protective equipment + Personal hygiene
  53. 53. Related Waste Wastes that are contaminated with chemicals or pharmaceuticals
  54. 54. Related wastes include Amalgam waste Radiographic waste
  55. 55. Radiographic waste Used fixer and developer solutions should be stored in secure, plastic, leak proof containers Containers must be labeled with the contents and safety instructions Processing chemicals are highly corrosive and must not be tipped down the sink Personal protective equipment must be worn when handling chemicals Processing chemicals should be collected by an approved recycling company
  56. 56. Stored in a small box in the developing area LeadLead foilfoil Collected by a metal recycling company Or disposed of by a licensed contractor Cannot be disposed of into the general waste OldOld filmfilm
  57. 57. Disposal Lead foil Stored in a small box in the developing area Collected by a metal recycling company or disposed of by a licensed contractor Old films Collected by an approved recycling company or disposed of by a licensed contractor.
  58. 58. Amalgam waste Stored in a tightly closed container under radiographic fixer solution Storage of amalgam waste must protect staff from mercury vapour Container should be labeled with the contents and safety instructions Collected by a metal recycling company or by a licensed contractor
  59. 59. General waste Waste that is not classified as being within any of the categories of the clinical and related waste streams
  60. 60. General waste General waste bag is coloured black, buff, green or white Collected by the community waste contractor Includes gloves, mask, rubber dam, single-use cups and protective coverings Handled using heavy duty gloves.
  61. 61. Instruments that cannot be cleaned and sterilized after use must be discarded
  62. 62. Disposables include Anaesthetic cartridges and needles Prophylaxis cups and brushes Mouthwash cups Saliva ejector tips Patient bib Gloves and mask.
  63. 63. Undertake necessary measures to ensure prevention of transmission of infection
  64. 64. ContaminatedContaminated instruments andinstruments and equipmentequipment Should be confined to a well designated zone
  65. 65. Limiting contamination Clearly defines the contaminated and clean zone in the surgery Means that surgery clean-up is easier and faster Reduces the chances of cross- contamination.
  66. 66. Clean zone Must never become contaminated with items used during patient treatment Stores sterile instruments, equipment, materials and medicaments Includes the interior of drawers and cupboards which must never become contaminated during patient treatment.
  67. 67. Retrieve instruments and equipment if needed by one of the following techniques • Remove gloves and wash hands • Retrieve instruments / dispense materials • Re-glove before returning to assist ‘Overglove’ with a food handlers glove Use transfer tweezers
  68. 68. Contaminated zone Contains contaminated material from the current patient All surfaces in the contaminated zone must be cleaned and dried between patients Single-use coverings are used to reduce surface contamination.
  69. 69. Contaminated zone •Receiving area for contaminated items •Sinks and instrument washer Clean zone •Packaging area •Items awaiting sterilization Sterile zone •Cooling area for sterilized items •Storage area for sterile packs
  70. 70. Blood and/or body fluid spills Managing a spill is always easier when the cleaning items needed to remove the spill are readily available
  71. 71. Disposable spills kit A large reusable plastic container, with a fitted lid, containing the following Leak proof bags for disposal of waste material A disposable scraper and pan for spills Disposable rubber gloves for cleaning Protective glasses and a plastic apron.
  72. 72. Removing a small spill Wear heavy duty gloves, mask, protective glasses and a plastic apron Wipe up the spill immediately using paper towel Discard contaminated material in to a plastic bag for disposal Clean the area with warm water and detergent solution Remove gloves and mask and wash hands Clean and dry protective glasses before re- use.
  73. 73. After removing the spill Ensure the area is clean and dry Replace disposable items in the spill kit
  74. 74. Summary - it is your responsibility to collate and maintain evidence to demonstrate Knowledge of how infection is spread Knowledge of infection risks in a health environment Compliance with NHMRC infection control guidelines Compliance with Australian Standards.
  75. 75. Summary cont…. Safe waste handling and management procedures Knowledge of personal hygiene practices Knowledge of personal protection Selection and use of appropriate cleaning agents Selection of the correct sterilization method.
  76. 76. YOUR responsibilities 1. Comply with instructions given for workplace health and safety. 2. Use personal protective equipment. 3. Do not wilfully misuse anything provided for workplace health and safety. 4. Do not wilfully place at risk the health and safety of others. 5. Do not wilfully injury yourself.
  77. 77. Hazard Identification & Risk Control The hazards in the laboratory need to be identified and the risks assessed and controlled, so the laboratory is as safe as possible. Types of Hazards: Biological: Disease, micro-organisms Chemical: Solvents, acid, dust, (silica) resins Electrical: Leads, equipment Ergonomic: Position while working Physical: Noise, lighting, hot/cold, radiation Stressors: Discrimination, harassment, production pressure
  78. 78. Risk Management Procedures: It is essential to either eliminate the risk or control the risk. 1. Identify the hazard 2. Minimise the risk by using the hierarchy of hazard control: • Design • Substitute • Redesign • Separation • Administration • Personal Protective Equip.
  79. 79. Risk Management & You… Hazard Risk Control Hand contamination Gloves Eye contamination Eye protection Aerosols / Dust Mask, Dust extraction Eye protection, Sharps injury Good technique, Safe disposal Contaminated waste Safe disposal of waste
  80. 80. Handpiece… Following Operating Instructions when using equipment