2. Malawi Ministry of Health National Infection Prevention Standards: Assessment Tool
Facility:
Date:
Assessor:
AREA: DENTAL DEPARTMENT
OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A1
COMMENTS
1. There are written guidelines
for IPC practices.
Verify with the responsible person in the dental
department if:
• There are written guidelines for IPC
practices in this area including:
- Traffic flow and activity pattern
- Dental water delivery system
- Processing of instruments and other
articles, including decontamination,
cleaning, HLD and sterilization
- Storage of clean, sterile and high-level
disinfected instruments and other items
- Housekeeping, including cleaning
schedule
- Use of PPEs
- Waste management
• The guidelines are physically placed in this
unit (posted or in a procedure manual)
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1
Y = Yes; N = No; N/A = Not Applicable
Dental Department, November 2008 7- 2
3. OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A COMMENTS
2. The physical plant and
furniture/equipment provide
a safe environment.
Verify in the dental department if:
• There are working toilets for clients
• There is a receiving/clean-up area separated
with a physical barrier from the processing
area
• The receiving/clean-up area has:
- A receiving counter
- At least one sink with running water
- A counter for drying the instruments dry
• There is a clean work area for
wrapping/packing with:
- A work table or counter
- Shelves for holding clean items
• There is an area for sterilization and/or
high-level disinfection with at least one
sterilizer
• There is an area to store sterile supplies
and/or high-level disinfected instruments
and equipment with:
- Limited access to the storage area; in
closed cabinets/shelves
- Office desk for record keeping
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3. The dental office (s) is (are)
properly equipped.
Observe if each dental office has:
• Dental unit with:
- Dental chair
- Suction machine
- Spittoon if central hospital
- Light
- Lacket table
• Plastic container with 0.1% chlorine
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Dental Department, November 2008 7- 3
4. OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A COMMENTS
solution for decontamination
• Puncture-resistant containers to dispose
sharps
• Containers with a leak proof plastic bag for
medical waste
______
______
4. The dental department is
clean.
Observe in the dental department the absence of
blood, dust, soil, trash, insects and spider webs
in the following sites:
• Floors
• Walls
• Countertops
• Dental unit surfaces:
- Dental chair
- Suction machine
- Spittoon if central hospital
- Lacket table
- Light
• Receiving/clean-up area
• Work area for wrapping/packing
• Sterilization area
• Storage area
• Toilets
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5. The decontamination of
instruments and other articles
(immediately after use and
before cleaning) is
performed according to the
standards.
Observe in the dental department if:
• The concentration of chlorine solution is
labeled
− Liquid chlorine:
- if using JIK (3.5%), 1 part of bleach for
34 parts of boiled or bottled water ______
Dental Department, November 2008 7- 4
5. OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A COMMENTS
- if using a concentration of 5% chlorine,
1 part bleach for 49 parts of boiled or
bottled water, or
− Powder chlorine:
- if using calcium hypochlorite (35%), 2.8
grams bleach powder for 1 liter boiled
water, or
- if using 70 % chlorine powder 1.4 gram
bleach powder for 1 liter boiled water
• A new chlorine solution is prepared at the
beginning of each day, or sooner if
necessary
• Delicate instruments are soaked in the 0.1%
chlorine solution with boiled water for 10
minutes
• After 10 minutes, instruments and other
items are removed from the chlorine
solution; washed in soapy water and then
rinsed with clean water
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Tooth extraction and filling (criteria 6- 11 must be observed in sequence with the same client)
Dental Department, November 2008 7- 5
6. OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A COMMENTS
6. The provider prepares for the
procedure.
Observe during 2 procedures (one tooth
extraction and one filling) if the dental
therapist:
• Prepares instruments, materials, antiseptics
and equipment.
• Explains the procedure to the client
• Wears personal protective equipment (PPE)
and attire during the procedure:
- Dust coat
- Plastic apron
- Protective eyewear
- Face masks covering mouth and
nose
Extrac
t
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Filling
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7. Hand hygiene is performed
before the procedure.
• Hand hygiene is performed before the
procedure:
- Washes hands with running water and
soap for 10–15 seconds and dry with an
individual clean towel, paper towel or
allows hands to air-dry _____ _____
Dental Department, November 2008 7- 6
7. OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A COMMENTS
8. The provider performs the
procedure using IPC
practices to avoid injuries
and cross-contamination.
• Puts on clean examination gloves
• Working area (in the mouth) is kept isolated
by:
- Using clean cotton rolls
- Avoiding touching any other area while
working/operating
• For local anesthesia, if needed:
- Uses sterile needle and syringe
- Recaps the needle using the one-handed
“scoop” technique
- Places the syringe with anesthesia in a
receiver
• During the procedure, uses paper towels,
gauze or tape for adjusting the light without
removing the gloves, and avoiding
contamination of the light
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9. The provider properly
disposes of the instruments
and medical waste after the
procedure to avoid injuries
and contamination.
• Removes all the used instruments and
places them in 0.5% chlorine solution for
10 minutes
• Disposes of needle and syringe in a
puncture-proof container, without
removing, recapping or breaking the needle,
if using disposable syringes
• Disposes of other medical waste (e.g.,
cotton wool) in a container with a leak
proof plastic bag
• Removes gloves, after being immersed in a
0.5% chlorine solution, and places them in a
container with a leak proof plastic bag
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Dental Department, November 2008 7- 7
8. OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A COMMENTS
10. Hand hygiene is performed
after the procedure.
• Hand hygiene is performed after the
procedure:
- Washes hands with running water and
soap for 10––15 seconds and dry with an
individual clean towel, paper towel or
allow hands to air-dry _____ _____
Dental Department, November 2008 7- 8
9. OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A COMMENTS
11. The process of cleaning
instruments and other items
is performed properly.
Observe if the person cleaning the instruments
complies with the following steps and
recommendations:
• Wears:
- Utility gloves
- Mask and eyewear protection or face
shield
- Plastic apron
- Head cover
- Gumboots or enclosed shoes
• Utilizes:
- Soft brush
- Detergent (liquid or powder)
• Scrubs instruments and other items under
the surface of water, completely removing
all blood and other foreign matter
• Disassembles instruments and other items
with multiple parts and cleans in the
grooves, teeth and joints with a brush
• Rinses the instruments and other items
thoroughly with clean water
• Allows instruments and other items to air-
dry, or dries with a clean towel
• Washes hands after removing gloves:
- Washes hands with running water and
soap for 10–15 seconds and dry with an
individual clean towel, paper towel or
allows hands to air-dry
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12.A disinfectant cleaning
solution is prepared properly
Verify if the disinfectant cleaning solution is
prepared as follows:
Dental Department, November 2008 7- 9
10. OBSERVED CRITERIA VERIFICATION MEANS Y, N OR N/A COMMENTS
• A 0.5% chlorine solution is prepared
• Detergent without an acid, ammonia or
ammonium is added to the 0.5% chlorine
solution until a mild soapy cleaning
solution is made
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13. The cleaning equipment is
decontaminated, cleaned and
dried before reuse or storage.
Observe if the mops, buckets, brushes and
cleaning cloths are:
• Decontaminated by soaking for 10 minutes
in 0.5% chlorine solution or other approved
disinfectant
• Washed in detergent and water
• Rinsed in clean water
• Dried completely before reuse or storage
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14. The collection of medical
waste is performed properly to
prevent injuries and
contamination.
Observe if:
Medical waste (e.g., cotton wool, gauze, etc):
• Medical waste is placed in a washable
container with a leak proof plastic bag
• Containers are closed and collected when ¾
full or daily if not ¾ full
Sharps:
• Sharps are placed in a puncture-resistant
container (heavy card box, empty plastic
container, metal container with small
opening)
• Containers are closed and collected when ¾
full
• Sharps containers are used only once
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Total of criteria 14
Total observed
Dental Department, November 2008 7- 10
