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Chapter 9:Preparing for Patient Safety and Occupational Health
1.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. Preparing for Patient Safety and Occupational Health Chapter 9 1
2.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
3.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
4.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. Developing a Safety Culture (Cont.) 4
5.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. Examples of Unsafe Practices 5
6.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
7.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
8.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
9.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
10.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
11.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
12.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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
13.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. How Infection Control Benefits Patients (Cont.) Infection control recommendations from the CDC Immunizations Hand hygiene Gloving Facemask Protective clothing Divided instrument processing areas 13
14.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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 How Infection Control Benefits Patients (Cont.)
15.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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 How Infection Control Benefits Patients (Cont.)
16.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. 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 How Infection Control Benefits Patients (Cont.)
17.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. Disease prevention training of dental personnel Maintenance of infection control equipment Office policy on infectious diseases work restrictions and exclusions for dental personnel 17 How Infection Control Benefits Patients (Cont.)
18.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. How Infection Control 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
19.
Copyright © 2017,
Elsevier Inc. All Rights Reserved. How Infection Control 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
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