By Leslie Canham, CDA, RDA
Every dental office should have at least one person in charge of the infection-control program. This article will define the role of the infection-control coordinator.
The term infection control means controlling the spread of disease agents by performing specific procedures. To be an effective infection-control coordinator, one needs to be competent in infection-control practices and understand the basic elements of an infection-control program. The responsibilities of the infection-control coordinator include:
- Ensuring that employee training has been conducted and necessary immunizations have been made available
- Evaluating the office infection-control protocols for patient and employee safety
- Ensuring that appropriate disinfectants and sterilants are used
- Monitoring office infection-control systems for effectiveness and compliance with state and federal regulations
Training
The first step in an effective infection-control program is proper training for dental health-care providers (DHCP). The infection-control coordinator can conduct the infection-control and safety training as it relates to the workplace. OSHA requires that initial training be provided to all employees before they perform tasks that could expose them to infectious agents. This training should include techniques to prevent contact with infectious agents, instrument processing protocols, and personal protective equipment (PPE) that is available for use. The training must be site-specific and include information on the office’s exposure control plan. The office OSHA manual is a good training resource.
Immunizations
The infection-control coordinator should make sure that employees have information about recommended immunizations. DHCP are at risk for exposure to, and possible infection from, infectious organisms. Immunizations substantially reduce both the number of DHCP susceptible to these diseases and the potential for disease transmission to other DHCP and patients. Thus, immunizations are an essential part of prevention and infection-control programs for DHCP, and a comprehensive immunization policy should be implemented.1
Personal Protective Equipment
The infection-control coordinator can help employees locate Personal Protective Equipment (PPE) and provide instructions on the disposal of paper gowns, gloves, single-use face shields, and surgical masks. For reusable items, the infection-control coordinator can train employees on proper decontamination techniques.
Hand hygiene
The infection-control coordinator should evaluate whether hand hygiene procedures are followed. Employees must wash hands before donning gloves and every time gloves are removed. Effective handwashing includes vigorously rubbing together all surfaces of lathered hands for at least 20 seconds, followed by rinsing under a stream of water. If the hands are not visibly soiled, an alcohol-based hand rub may be used.
Environmental surface disinfection
The infection-control coordinator should make sure that environmental surfaces such as dental carts, countertops, dental chairs, and X-ray equipment are disinfected correctly using appropriate products. Items or surfaces that are likely to become contaminated and difficult to clean and disinfect should be protected with barriers.
The sterilization area
The infection-control coordinator is responsible for overseeing disinfection and sterilization of patient care items. When using sterilizers, ultrasonic tanks, instrument washers, or other cleaning devices, it is important to follow the manufacturers’ instructions. Sterilizers should be properly maintained, serviced, and operated.
The infection-control coordinator can inspect instruments bags, cassettes, or wraps to ensure sterility. Any bags or cassettes that are compromised by punctures, tears, or contamination should be reprocessed.
The infection-control coordinator must verify that sterilization monitoring is performed. Correct functioning of sterilization cycles should be verified for each sterilizer by the periodic use, at least weekly, of biological indicators. Biological indicators, also known as spore tests, are the most accepted method for monitoring the sterilization process.1 The infection-control coordinator is responsible for documenting the results of these tests, reviewing any failed tests, and maintaining the results in a log.
Conclusion
The infection-control coordinator is responsible for protecting patients and staff from infection transmission. There are many helpful resources, such as The Organization for Safety and Asepsis Procedures at www.OSAP.org, CDC Guidelines for Infection Control in Dental Health-Care Settings — 2003, and the most current CDC updates to Sterilization and Disinfection in Health Care Settings at www.cdc.gov. In addition, check with the dental board in your state to determine if the minimum standards for infection control differ from the Centers for Disease Control (CDC) guidelines. If you would like a complimentary copy of an Instrument Processing Protocol, send an e-mail to [email protected].
Author bio
Leslie Canham is a dental speaker and consultant specializing in infection control and OSHA compliance. She has more than 36 years of experience in dentistry. Canham is the founder of Leslie Canham Seminars, providing in-office training, mock inspections, consulting, and online seminars and webinars to help the dental team navigate state and federal regulations. Reach Canham at (888) 853-7543 or Leslie Canham.
References
1. Kohn WG, Collins AS, Cleveland JL, et al. Guidelines for infection control in dental health-care setting — 2003. MMWR Recomm Rep. 2003;52(RR-17):1-61. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm. Accessed Dec. 3, 2009.
