The day to day lives of all members of the Dental team can be extremely hectic and it can be easy, sometimes, to overlook the basics when it comes to IPC. IPC standards are an immensely important factor that needs to be constantly reviewed and monitored to assure Patient and Staff safety.
I usually refer to the rationale of effective IPC as meaning ‘a patient, staff member or visitor should be able to enter the practice and not leave with something they didn’t have when they came in’.
Hand Hygiene
Its important that we keep on top of and constantly monitor our hand hygiene procedures throughout the day. At the start of the day, we should be washing and disinfecting our hands, which should take approximately 30 seconds for both. Using the systematic method of 8-10 steps will ensure complete coverage of all areas. Ensure that you don’t use any nail brushes, except for surgical procedures (although these will be sterile and included in custom drape packs).
In between every glove change we should be disinfecting our hands, using the same method. At the end of the clinical session wash, disinfect and moisturise your hands, preferably with an emollient, water based, cream. Repeat the processes for the afternoon session.
Always ensure that nails are kept short and that no nail varnish or false nails are worn. You should also ensure that no wrist Jewellery or rings are worn, as these can be difficult to clean.
The hand hygiene procedure should be reviewed on an annual basis and should always form part of any new staff induction. You should also ensure that hand hygiene procedures only take place in dedicated hand washing sinks.
Face Masks
Always ensure that a face mask, either clinical or surgical, are worn when carrying out any clinical procedures. The face mask should be rubbed along the bridge of the nose and tucked under the chin to provide adequate protection against aerosol splatter and inhalation.
Face masks should also be removed before leaving the clinical area and not worn around the neck. Always ensure that, when removing face masks, the correct doffing procedures are followed, which are:
1. Gloves removed and folded in on themselves
2. Goggles or visor
3. Face Mask
The donning procedure is the reverse of this.
Gloves
Once the hands have been disinfected gloves need to be put on. When it comes to hands you have 3 barriers to protect you against any form of pathogen:
1. Skin – ensure your hands have no cuts or open wounds
2. Disinfected – this will act like a varnish and add a second layer of protection
3. Gloves – either surgical, clinical or decon
Always ensure that a new pair of gloves are worn for each patient. If a procedure changes, which they often do, and more material is required ensure that your gloves are removed, obtain what you need, and then don a new pair. Never where gloves in non-clinical areas and try to minimise the amount of touch points.
When carrying out any decontamination work you need to ensure that you are wearing heavy duty gloves, rather than surgical. Heavy duty gloves, or marigold, offer you more protection against the potential risks of sharps injury. There are decontamination gloves on the market that are puncture resident and can be autoclaved up to 5 times.
Goggles and Visors
Goggles or Visors need to be worn to prevent any ingestion from aerosol. Its really important that you protect our eyes whilst working in the clinical and also the Decontamination room, especially manual cleaning.
Tunics or Scrubs
No outdoor wear should be worn whilst undertaking any clinical procedures. The best option, that I see more and more, would be scrubs as these eliminate the potential of wearing any outdoor clothes. Scrubs should only be worn within the surgery and not worn outside. The main reason for this, unlike hospital counterparts, is due to aerosol. No other industry, within healthcare, produces the level of aerosol that dentistry does so the potential risk factors of unknown bacterial or viral pathogens landing on scrubs is dramatically increased.
For this reason, scrubs should be removed before leaving the practice and washed at the highest temperature possible. We also need to ensure that all arms are exposed from the elbow down, again due to aerosol splatter.
These IPC basics are there to protect all members of the team from the potential risks associated with dentistry.
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