All too often little consideration is given to sterilization or reprocessing areas in either existing or newly designed dental practices. Yet it is increasingly important to meet today's hygiene rules regarding reprocessing instruments between patients.
Laundry services in hospitals –linen handling
During any given hospital stay, patients spend most, if not all, of their time in bed.
•That means they are surrounded all day with hospital linens.
•From their gown to their sheets and blankets patients have more contact with these items than anything else in the hospital.
•Adequatesupplyofcleanlinensufficientforcomfortandsafteyofpatientandpersonalappereance&pleasant,neatlyattiredemployeesattendingpatientsinfreshcrispuniformdomuchsellthehospitaltothepublic
•Thereforeitmakessensetoensurethattheyareproperlycleaned,driedandtransportedtoavoidcrosscontamination
Haldor's flagship solution, the ORLocate™ system, tracks, manages and analyses usage patterns of surgical instruments using radio frequency identification (RFID) technology. This highly modular, reliable, scalable and accurate system blends seamlessly with the workflow in the sterile processing department and during the surgical procedures. It also provides the capabilities to interact with the hospital’s real-time location system as well as hospital information systems and technologies. The ORLocate™ system is FDA 510(k) cleared and CE certified.
Laundry services in hospitals –linen handling
During any given hospital stay, patients spend most, if not all, of their time in bed.
•That means they are surrounded all day with hospital linens.
•From their gown to their sheets and blankets patients have more contact with these items than anything else in the hospital.
•Adequatesupplyofcleanlinensufficientforcomfortandsafteyofpatientandpersonalappereance&pleasant,neatlyattiredemployeesattendingpatientsinfreshcrispuniformdomuchsellthehospitaltothepublic
•Thereforeitmakessensetoensurethattheyareproperlycleaned,driedandtransportedtoavoidcrosscontamination
Haldor's flagship solution, the ORLocate™ system, tracks, manages and analyses usage patterns of surgical instruments using radio frequency identification (RFID) technology. This highly modular, reliable, scalable and accurate system blends seamlessly with the workflow in the sterile processing department and during the surgical procedures. It also provides the capabilities to interact with the hospital’s real-time location system as well as hospital information systems and technologies. The ORLocate™ system is FDA 510(k) cleared and CE certified.
by - dr. sheetal kapse, 2nd year p.g. student, dept. of oral & maxillofacial surgery, RCDSR, Bhilai, C.G. please contact for any question...email id - sheetal.kpse@yahoo.com
Daily a huge number of inpatient and outpatient surgical and non-surgical procedures are performed by using Reusable Medical Devices
One of the important measures that must be reliably performed is the appropriate cleaning of the reusable medical devices which come into contact with patient skin, blood and other body fluids and tissues.
In general and following a procedure, a medical device is contaminated with both visible and hidden bioburden. This bioburden or soil may contain hundreds if not millions of potentially infectious organisms. Any soil left on a device following cleaning can pose a risk to the patient.
Therefore, it is imperative that appropriate steps be taken to ensure a thorough cleaning process.
by - dr. sheetal kapse, 2nd year p.g. student, dept. of oral & maxillofacial surgery, RCDSR, Bhilai, C.G. please contact for any question...email id - sheetal.kpse@yahoo.com
Daily a huge number of inpatient and outpatient surgical and non-surgical procedures are performed by using Reusable Medical Devices
One of the important measures that must be reliably performed is the appropriate cleaning of the reusable medical devices which come into contact with patient skin, blood and other body fluids and tissues.
In general and following a procedure, a medical device is contaminated with both visible and hidden bioburden. This bioburden or soil may contain hundreds if not millions of potentially infectious organisms. Any soil left on a device following cleaning can pose a risk to the patient.
Therefore, it is imperative that appropriate steps be taken to ensure a thorough cleaning process.
Safety precautions in the clinic and laboratory.pptxMustafa Al-Ali
Safety precautions in the clinic and laboratory.
Mustafa al-ali, 48
Safety precautions in the clinic and laboratory
Safety precautions in the dental clinic and laboratory are crucial to protect both patients and dental healthcare professionals. Here are some key safety measures to consider:
Personal Protective Equipment (PPE)
Hand Hygiene
Sterilization and Disinfection
Waste Management
Radiation Safety
Emergency Preparedness
Chemical Safety
Ergonomics
Personal Protective Equipment (PPE)
Personal protective equipment (PPE) should be selected based on risk assessment and tasks to be performed.
These items are designed to provide a protective barrier during dental procedures and through the sterilization process. PPE must also be considered for patients as they enter the facility and provided to administrative staff who may be screening them upon arrival.
Personal Protective Equipment (PPE)
Gown
Dental Hygiene Care Professionals (DHCP) should wear protective clothing (eg, gowns, jackets) to prevent contamination of scrubs and to protect the skin from exposure to blood and bodily fluids.
Sleeves should be long enough to protect the forearms.
Protective clothing should be changed after use or when it becomes visibly soiled by blood or other bodily fluids.
DHCP should remove protective clothing before leaving the work area.
Personal Protective Equipment (PPE)
Eyewear/Face Shields
Protective Eyewear
DHCP should wear protective eyewear with solid side shields or a face shield during procedures likely to generate splashes or sprays of blood or bodily fluids or the spatter of debris. Reusable protective eyewear should be cleaned with soap and water, and when visibly soiled, disinfected between patients.
Personal eyeglasses are not considered PPE.
Protective eyewear should be provided to patients.
Face Shields
Face shields provide full-face coverage.
Must be worn with a face mask.
Personal Protective Equipment (PPE)
Gloves
DHCP should wear gloves to prevent contamination of their hands when touching mucous membranes, blood, saliva, or other potentially infectious materials and to reduce the likelihood that microorganisms on their hands will be transmitted to patients during patient care.
Gloves should be used for one patient only and discarded appropriately after use.
Hand hygiene should be performed prior to donning gloves and immediately after glove removal.
Hand Hygiene
Hand hygiene is extremely important to prevent the spread of the SARS CoV-2 virus. It also interrupts the transmission of other viruses and bacteria, thus reducing the overall burden of disease, Dental healthcare facilities should ensure that hand hygiene supplies are readily available in every patient care location.
Pre-washing considerations
Remove jewelry, ring, watches, or bracelets
Remove artificial nails if present.
Cover skin cuts, abrasions, breaks or cracks with waterproof adhesive dressings.
Use running water; avoid dipping or washing hands in a basin of standing water
Infection Control Guidelines for Dental Clinics [compatibility mode]drnahla
Infection Control Guidelines for Dental Clinics
Infection Prevention in Dental Clinics
Dr. Nahla Abdel Kader.MD, PhD. Infection Control Consultant, MOH Infection Control Surveyor, CBAHI Infection Control Director,KKH.
Most people think of a steam steriliser as a silver bullet for the sterilisation of dental instruments, however, infection control can be easily compromised by errors and oversights during instrument reprocessing.
o Describe why policies and procedures are required for an
effective decontamination unit.
Describe international standards available for decontamination units.
Introduction to operating room (Part one).pdfTalal Albudayri
Introduction to operating
room techniques
Up on completion of this session , you will be a will :
Define common terminologies
Understand physical organization of operating room
Identify deign of operating room
Distinguish traffic flow and activity patterns
Identify operating suite equipment's.
Identify the relationship between operating team
Identify and prevent hazards in operating room
White paper - Key factors for developing a pharmaceutical cleaning strategyFedegari Group
Pharmaceutical Cleaning Strategies: What are the key factors to consider when developing a quality procedure?
Cleaning is an essential practice for any pharmaceutical activity: it is impossible to manufacture drugs in dirty conditions, even if dirt is not evident. Many aspects need to be considered in setting up a cleaning procedure. This is certainly a multidisciplinary issue that involves various company areas: from “Regulations” to Engineering, from Quality Control lab to Production department. Contributions of all these areas together can lead to a robust and reproducible cleaning process.
In these conditions, even regulatory bodies struggle. Essentially, they allow manufacturers considerable flexibility in establishing their own cleaning specifications. The FDA, for example, does not define methods describing how a cleaning process should be validated.
Therefore, there are many aspects to be considered when approaching the issue of pharmaceutical cleaning. First of all, one has to consider where to perform cleaning activity: in-place (CIP) or out-of-place (COP).
When dentist Dr Corbin Barry was designing his new practice in Darlinghurst NSW, his philosophy was to make a practice that looks nothing like your typical dental practice. Read more about how A-dec 400 dental units were incorporated into this vision.
Bite Magazine Chair Buyers Guide MAR 2023.pdfA-dec Australia
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With increased focus on infection procedures in the dental environment, testing microbiological activity accurately in waterlines has also become important.
When Dr Claire hen Sydney dentist Dr Claire Kim decided to relocate her dental practice into modern new premises close to Strathfield’s commercial hub, she also took the opportunity to upgrade her dental equipment to match the image of the practice.
A-dec Joins Australian Dental Health Foundation as supporting sponsorA-dec Australia
A-dec is pleased to announce that it has joined the Australian Dental Health Foundation (ADHF) as a supporting sponsor, to help the organisation deliver the operation of charitable dental programs to assist disadvantage Australians.
Management of aerosols is an important part of day-to-day infection practices in the the dental surgery and even more important in the current COVID-19 pandemic
Discover how fluorescence technology coupled with high resolution cameras, can improve your diagnostic capability over existing electronic detection aids.
Batch Control Identification (BCI) in the dental setting allows dental practitioners to demonstrate that any critical dental instruments used on a patient have been through a particular steriliser cycle with verifiable performance data.
Discover how this practice incorporated A-dec 400 dental units into a spectacular make over of an existing practice into a Hamptons-style 'dental spa'.
Proper infection control in your practice requires certain protocols be followed by staff to ensure patient safety. This article focuses on proper hand piece management.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Fundamental principles in designing reprocessing areas
1. 106 Australasian Dental Practice January/February 2016
I
t is recognized all too often
that very little consideration
is given to sterilization or
reprocessing areas in either
existing or newly designed
dental practices. And yet
reprocessing instruments
between patients is crucial to
meet today’s hygiene rules in
dental practices.
Dental practitioner’s also have a moral
and legal duty of care calling for effective,
well-defined and implemented infection
control measures to prevent the trans-
mission of infectious diseases to patients
and staff.
Reprocessing areas
It is particularly noticeable that since the
emergence of SARS, the avian influ-
enza outbreaks and the recent 2015 Ebola
pandemic in Africa, that patients have
become more sensitive to hygiene issues,
not hesitating to question dental profes-
sionals about asepsis rules and standard
precautions. This is also the case with
tattoo, piercing and podiatry salons.
In Australia, a breakdown in infection
control protocols in a number of Sydney-
based dental surgeries in early 2015 raised
fears of possible exposure of patients
to blood-borne viruses. This and other
similar incidents have focussed the atten-
tion of the Dental Board of Australia on
infection control standards.
Beyond the purely regulatory and safety
aspects, many dentists have made the ster-
ilization area of their practice a key asset
for their activity. Locating this in a prime
and visible location lets patients see up
front that their health and safety is impor-
tant. The staff don’t hesitate to share this
passion for hygiene with patients, happy
to answer any questions they may have.
Flattered by this attention, it makes the
patient feel confident and secure.
Fundamental principles
in designing reprocessing areas
By Christian Stempf
infection | CONTROL
Figure 1. Instruments must travel in one direction in the reprocessing (i.e. sterilisation) area from the dirty zone towards the clean
zone. Conversely, airflow should be designed to prevent air from the dirty zone being forced into the clean zone.
2. 108 Australasian Dental Practice January/February 2016
infection | CONTROL
Disposal Soaking Rinsing Cleaning Rinsing
Basin
1
Sonic
cleaner
Sharp
Garbage
Basin
2 Demin. water
supply
Handwashing
Sink
Figure 2. Dirty instruments are cleaned and rinsed on entry to the reprocessing area.
To create new reprocessing areas or
enhance existing ones is not an “insur-
mountable” challenge. It simply requires
some basic principles that this article
will outline.
The amount of space required
Having sufficient space dedicated to
the reprocessing area is essential. In
many cases, it is undersized. The room
must be functional, well lit and in propor-
tion to the size of the dental practice and
volume of instruments to be reprocessed.
There must be space for cleaning and
sterilization devices with their respec-
tive accessories, as well as enough bench
space for intermediate stages i.e. instru-
ments before/after cleaning; before/after
packaging; and after sterilization.
The first fundamental principal is to
have two zones: a dirty zone and a clean
zone. Rationally, instruments must travel
in one direction from the dirty zone
towards the clean zone. As a consequence
of this one-way flow, processed (clean)
instruments must not enter the dirty zone;
hence one preferred design for a repro-
cessing area would be rectangular - a
corridor with two doors (IN and OUT)
(Figure 1).
Both zones require ventilation and the
airflow should be designed to prevent air
from the dirty zone being forced into the
clean zone. Where the areas are beside
one another, this can be achieved by
pressurizing the clean area though air con-
ditioning outlets and/or having exhaust
fans in the dirty area.
At the entrance, there should be a hand-
washing basin. Having a wall-mounted
liquid soap dispenser means this can be
operated by the elbow, which avoids con-
taminating it with soiled hands.
Form follows function
The configuration of each part of the
sterilizing room follows the repro-
cessing steps i.e. cleaning and rinsing;
packaging; and sterilization. This room
must not be used for any other purpose.
Floors and working surfaces must be
smooth and edges and be easy to clean.
Soaking
In order to prevent blood, saliva and
debris from drying, if not cleaned imme-
diately, it is prudent to place instruments
into a holding solution containing deter-
gent. Note the manufacturer’s guidelines
NOT to immerse or soak certain items such
as handpieces in solutions, which instead
require specific lubrication. Having the
holding solution warm will make this step
more effective. The temperature of the
solution should not exceed 40-45°C, thus
preventing coagulation of blood proteins.
After soaking, the instruments should be
rinsed free of the holding solution and
then cleaned using mechanical cleaning
(e.g. ultrasonic baths or instrument washer
disinfectors for solid instruments).
Cleaning
The cleaning step is of utmost impor-
tance. Manual cleaning is discouraged,
as this is the least efficient method of
cleaning particularly for complex or
hollow instruments and rough surfaces.
It also poses more health and safety con-
cerns because of the risk to staff of skin
penetrating injuries.
After ultrasonic cleaning, thorough
rinsing is essential to remove chemicals
and bioburden. This is normally done with
tap water. Ideally this would be followed
by a second rinse with demineralized
water to eliminate residues and salts pre-
sent in tap water that could lead to stains
on sterilized instruments (Figure 2).
3. January/February 2016 Australasian Dental Practice 109
infection | CONTROL
Disposal Soaking Rinsing Cleaning Rinsing Drying - HPs Packaging Sterilization
Basin
1
Sonic
cleaner
Area for
drying / high-
low-speed
maintenance
Area for
storage
prior to
sterilization
Sharp
Area for
cooling and
labelling
Garbage
Basin
2
Handwashing
Sink
Compressed
air supply
Figure 3. Clean and dry instruments are then packaged and sterilised.
Instrument washers (also known as
thermal disinfectors or washer-disinfec-
tors) are a preferred mechanical cleaning
method, since they give a clean, dry
and disinfected load at the end of the
cycle. Their cleaning cycle includes pre-
washing, rinsing, washing and drying
without manual intervention.
Bench space for
inspection and sorting
Next to the sink, space is needed
to check the dryness, cleanliness
and integrity of items which have been
through the cleaning processes. There also
needs to be provision for handpiece lubri-
cation systems, which range from pressure
pack units through to dosed lubricators to
handpiece combination lubricators and
sterilizers. Using pressure pack lubrica-
tion cans does not give complete internal
cleaning of handpieces.
Packaging
In this area will be pouch heat sealing
devices as well as space for packages to
be labelled with batch numbers until they
are to be sterilized. To ensure safe and
efficient sterilization, it is crucial to check
the correct cycle is being used for the type
of load (e.g. wrapped cycle for wrapped
items) and that the parameters have been
validated for the type of load.
Sterilizing
Additional space beside the sterilizer is
needed for items to cool and for the
record books which keep details of each
cycle as well as for storage of printouts.
Special attention must be paid to ensure
that pouches are hermetically sealed and
are completely dry. Damp packages are
not acceptable as sterile (Figure 3).
Once cool, packaged items can then be
transferred to storage. This is normally
outside the reprocessing area and in the
surgery (operatory) in drawers or cabi-
nets that are kept closed so the items are
no exposed to dust, aerosols or splashes
of material.
Conclusion
All readers should reflect on these
definitions:
• Reprocessing: “All activities that are
required to ensure that a used medical
device is safe for reuse”.
• Sterilization: “A validated process
used to render a product free from
viable microorganisms”.
• Duty of care: “The individual prac-
titioner is responsible for ensuring
compliance with infection control
requirements throughout the prac-
tice. This cannot be delegated.” (ADA
Guidelines, Third Edition 2015)”
Always bear in mind that each step of
the reprocessing cycle is important. None
shall be rushed or skipped, which would
compromise sterility and the safety of
patients and staff.
About the author
Christian Stempf has worked exten-
sively within the European dental
industry. He has been involved in infec-
tion prevention for over 20 years with a
focus on reprocessing reusable medical
devices, in particular sterilization and
organization of sterilization areas. He
is a member of the European (CEN-
TC102) normalization committee
participating to two working groups i.e.
benchtopsterilizers(EN13060)andwasher
disinfectors (EN15883).