Chapter 9:Preparing for Patient Safety and Occupational Health

Copyright © 2017, Elsevier Inc. All Rights Reserved.
Preparing for Patient Safety
and Occupational Health
Chapter 9
1

Learning Objectives
Lesson 9.1: Preparing for Patient
Safety and Occupational Health
1. Do the following related to safety culture:
• List some unsafe infection control practices.
• Describe steps in developing a safety culture.
• List examples of infection control elements that
can be evaluated.
2. List some “behind the scenes” activities that
facilitate patient and dental personnel safety.
3. List infection control benefits for patients as
well as for dental personnel.
2

Developing a Safety Culture
 The safety of dental patients and office
personnel is rooted in establishing a safety
culture
 Culture: set of behaviors and attitudes shared
by a group of interacting individuals
 Safety culture: prevention strategy based on
the shared environment of everyone in the
office toward ensuring safety of everyone
3

Developing a Safety Culture (Cont.)
4

Examples of Unsafe Practices
5

Examples of Unsafe Practices
 Unsafe infection-control practices can cause
injuries and microbial contamination that may
lead to illness in patients or dental personnel.
 You can determine the safety climate in the
office by having everyone take a survey
shown in Box 9.2 developed by the National
Institute for Occupational Safety and Health
(NIOSH).
 A score of 9 to 15 indicates a poor safety climate;
16-20 indicates a fair safety climate; 21-24
indicates a good safety climate.
6

Setting the Stage for Safety
 “Behind the scenes” activities that facilitate patient
and dental personnel safety include:
 Making sure office is up-to-date on infection-control and
hazardous materials regulations from OSHA and
recommendations from CDC
 Making sure required documents and records are up-to-
date
• exposure control plans and safety data sheets.
• employee medical records as well as training.
 Checking availability of supplies
 Making sure eyewash stations are operable; SDS sheets in
order
 Ensuring equipment maintenance is up-to-date
 Making sure sterilization monitoring data indicate that
processed instruments are safe for use 7

Setting the Stage for Safety (Cont.)
 “Behind the scenes” activities that facilitate
patient and dental personnel safety also
include:
 Making sure dental unit water procedures are in
place and effective
 Making sure staff has been properly immunized;
trained about infection control before making contact
with patients
 Making sure postexposure management procedures
are in place
 Making sure the staff is complying with infectious
disease work restrictions in place
8

 What are some other areas that need to be
addressed before patient treatment?
 Viewing patient records for any special patient needs;
 ensuring cleanliness and asepsis of the clinical,
laboratory, reception, restroom, and check-in areas;
 making sure cough etiquette supplies and signs are
present in reception area;
 ensuring the operatory has been properly prepared by
using surface barriers and performing cleanliness and
disinfection;
 distributing the necessary instruments, handpieces,
supplies, disposables, prostheses, and equipment;
 ensuring the availability of personal protective equipment,
hand hygiene supplies, and sharps containers
9

Examples of Infection Control
Elements That Can Be Evaluated
 Immunizations of the office staff
 Occupational exposure to infectious materials
 Postexposure management and follow-up
 Hand hygiene procedures
 Use of PPE
 Surface asepsis procedures
 Monitoring the sterilization process
 Evaluation of safety devices
10

Examples of Infection Control
Elements That Can Be Evaluated (Cont.)
 Microbial quality of dental unit water
 Use of disposables
 Sharps and injection safety
 Waste management
11

How Infection Control
Benefits Patients
 Vast majority of infection-prevention
procedures performed in dental offices relate
to patient safety
 Some procedures benefit both patients and
dental personnel (e.g., protective eyewear for
staff; aspects of waste disposal)
12

Benefits Patients (Cont.)
 Infection control recommendations from the
CDC
 Immunizations
 Hand hygiene
 Gloving
 Facemask
 Protective clothing
 Divided instrument processing areas
13

 Instrument/handpiece cleaning
 Instrument/handpiece packaging
 Instrument/handpiece sterilization
 Sterilization monitoring
 Examining wrapped packages of sterilized
instruments before opening
 Preprocedure mouth rinsing
 Use of mouth rinsing
 Use of disposables
14

 Unit dosing
 Aseptic retrieval of supplies
 Needle/sharps safety
 Using sharps containers
 Rubber dam
 Use of high-volume evacuator and saliva
ejector
 Telling patients not to close lips around saliva
ejector
 Aseptic use of parenteral medications
15

 Maintaining dental unit water quality
 Using sterile saline or water
 Surface cleaning and disinfection
 Surface barriers
 Housekeeping
 Disinfecting prosthodontic items before they
are taken to laboratory
 Perform/confirm disinfection of dental
prostheses before placement in patients’
mouths
16

 Disease prevention training of dental
personnel
 Maintenance of infection control equipment
 Office policy on infectious diseases work
restrictions and exclusions for dental
personnel
17

Benefits Dental Personnel
 Regulations and recommendations
 Bloodborne Pathogens Standard
 Hazard Communication Standard
 Infection control recommendations
 Education and training
 Employers provide training on bloodborne and
infectious diseases at time of initial employment
 Employers should also provide training whenever
new tasks or procedures affect the employee’s
potential for occupational exposure to infectious
agents.
18

Benefits Dental Personnel (Cont.)
 Written health program
 Recommended by CDC and should include:
• Medical conditions and work restriction
• Immunizations
 Immunizations against important diseases as described in Chapter
10 helps maintain worker health.
• Allergic reactions
• Postexposure management
 Having written protocols for proper management of
workers after being exposed to potentially infectious
materials is very important in preventing subsequent
infection.
19

Chapter 9:Preparing for Patient Safety and Occupational Health

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