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How to improve Infection Prevention efficiency?

With the CDO for England announcing that NHS dentists are obliged to meet 85% of their pre-COVID targets from 1st Jan 2022, what can we do to help improve our IP efficiency and save some time along the way?

One thing we don’t want to do is make changes that will place patient and staff at risk. That said there are some small changes that we could make that will help speed the downtime up a little.

Combination wipe

The treatment centre and working surface, behind the patients’ head, need to be cleaned and disinfected in between each patient to remove any viral load from the surfaces. What are we using to carry this out, spray or wipe? Alcohol or non-alcohol?

If we are using a spray then we should be spraying directing into a non-linting cloth, rather than on the surface. In essence we are making a wet wipe so why not consider changing to wipes? When using a spray, we need to try and keep the aerosol to a minimum, hence spraying into the wipe. With a tub of wet wipes, no aerosol is produced so this issue doesn’t arise.

Are we using alcohol or non-alcohol? If we are using an alcohol product, which is stated as a disinfectant, then we need to ensure that the surface is cleaned first. This makes the process a 2-stage procedure and increases the time to perform.

By using a non-alcohol product, which is water based, the vast majority of these are a combination of cleaning agent and disinfectant. This makes them a 1 stage procedure and will shorten the time to perform the process.

Also, because water-based products have a lower evaporation rate this means that 1 wipe will cover a larger area than its alcohol based equivalent. Typically, 1 alcohol free wipe will cover a 3m squared area, which would be the treatment centre, light and spittoon. By using less wipes, which cover a larger area this will help speed up the time.

Pre-made trays

If we are not already doing this then we should consider making up all of our day’s procedure trays up beforehand. These could be made up the day before and then stored in a cupboard outside of the clinical area. On the following morning these would then be moved into the clinical area ready for the day.

Use a holding solution

After each patient the dental instruments should be cleaned as quickly as possible and should not be allowed to dry. This can sometimes not be possible particularly if we are extremely busy. If this is the case then we should place the instruments into a leak proof ‘dirty’ box and, rather than using water, we should use a holding spray solution that will keep the instruments wet almost indefinitely. These solutions won’t add any additional weight to the box and will start the decontamination process for you.

Water bottle additive

For our water bottles we must use distilled or RO water to ensure that the bacterial load is low. If we use water alone, even though the bacterial count will be low, we will encounter a biofilm problem in our lines over time. Why not try adding an additive to the water that will slow the biofilm growth process down? These additives will ensure that our water quality, entering the patient’s mouth, is maintained and reduce the frequency for disinfecting our units. The vast majority of these additives also require you not to remove the bottles, at the end of each day, so will save time.

Online and Virtual CPD

Ensuring we keep our CPD hours up to date is still hugely important, even in these pandemic times. Nothing beats a face-to-face training session which is a great way at getting the entire team together and trained at once. However, if we really short on time why not consider having the training carried out virtually or online? A virtual training session, carried out over Teams or Zoom, can be carried out at a time to suit you, and can also involve the entire team. This could, for example, be carried out after work so there is no need to schedule time through the day. Online training courses can be carried out when ever the individual wants and are usually pre-recorded video presentations, with a questionnaire to complete afterwards.

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