M1 Infection Prevention - Module 6

Infection control

What are aerosols?

Airborne particles generated by humans or the environment that may contain viable pathogens.

What are laser plumes (surgical smoke)?

Smoke produced by lasers/electrosurgery that contains gases, tissue debris, and aerosolized infectious agents and is considered a potential health hazard.

Why are powdered latex gloves no longer used?

Powder can carry latex allergens into the air, increasing the risk of allergic reactions. The FDA banned powdered surgeon's gloves in 2016.

What are the main functions of an HVAC system in a healthcare facility?

• Maintain comfortable temperature and humidity

• Control odors

• Remove contaminated air

• Reduce airborne pathogens and allergens

• Protect patients and healthcare personnel

Why is proper HVAC maintenance important in healthcare settings?

HVAC malfunctions can lead to poor indoor air quality and increase the spread of airborne pathogens and allergens.

Why are moist environments a concern in healthcare?

They serve as reservoirs where waterborne pathogens can survive and multiply under favorable conditions.

How can waterborne pathogens be transmitted?

• Direct contact with contaminated water

• Ingestion or aspiration of water

• Indirect contact (e.g., improperly reprocessed devices)

• Inhalation of contaminated aerosols

What is the maximum acceptable bacterial count in drinking water?

≤ 500 CFU/mL of aerobic, heterotrophic, mesophilic bacteria.

How can the spread of waterborne pathogens be prevented?

• Hand hygiene

• Glove use

• Barrier precautions

• Minimize contamination at point-of-use fixtures

How should common water fixtures be maintained?

• Clean and disinfect sinks, faucets, and toilets regularly

• Flush eyewash stations weekly with sterile water

Why are dental unit waterlines (DUWLs) a concern?

They can develop biofilms that harbor waterborne bacteria, reducing water quality.

What are fomites?

Environmental surfaces that generally do not contact patients directly but can serve as reservoirs for pathogens.

Why did the CDC add fomites to the instrument classification system?

Because contaminated environmental surfaces can contribute to the transmission of infection.

What are the two main categories of environmental (fomite) surfaces?

• Clinical contact surfaces

• Housekeeping surfaces

How are housekeeping surfaces classified?

• Frequent hand contact: Doorknobs, light switches, walls around toilets

• Minimal hand contact: Floors, ceilings, window sills, blinds, curtains

What factors determine how environmental surfaces are cleaned and disinfected?

• Potential for patient contact

• Degree/frequency of hand contact

• Likelihood of contamination with blood, OPIM, or pathogens

Why is cleaning the first step before disinfection?

Cleaning removes organic matter, soil, and microorganisms that interfere with disinfection.

What are the three levels of disinfect

• High-level

• Intermediate-level

• Low-level

How should clinical contact surfaces be protected and managed between patients?

• Use barriers on frequently touched or hard-to-clean surfaces.

• Remove and discard barriers after each patient while wearing gloves.

• If the surface is visibly soiled, clean and disinfect it.

• After hand hygiene, place new barriers before the next patient.

How should housekeeping surfaces be cleaned and disinfected?

• Clean frequently touched surfaces regularly.

• Clean floors and other low-touch surfaces regularly and when visibly soiled.

• Clean walls, blinds, and curtains only when visibly soiled.

• Use soap and water or a detergent/disinfectant, follow manufacturer instructions, review the SDS, and wear appropriate PPE.

How should spills in patient-care areas be cleaned and disinfected?

• Remove visible organic matter with absorbent material (e.g., paper towel).

• Dispose of waste in a labeled, leak-proof container.

• Disinfect the area with an appropriate EPA-registered disinfectant.

• Wear PPE appropriate for the task.

How should carpets and cloth furnishings be managed in healthcare settings?

• They can harbor microorganisms and allergens.

• Vacuum regularly, but reduction of microbes/allergens is temporary.

• Avoid use in areas where spills are likely.

• No general recommendation exists to avoid them in patient-care areas.

What precautions should be followed for flowers and plants in patient-care areas?

• Limit plant care to staff without direct patient contact.

• Wear gloves and perform hand hygiene after handling plants.

• Change vase water every 2 days and dispose of it away from patient-care areas.

• Clean and disinfect vases after use.

• Avoid plants and flowers in areas with immunocompromised patients.

How should pest control be managed in healthcare settings?

• Eliminate food sources, moisture, and habitats that attract pests.

• Use pesticides or physical methods when needed.

• A pest-control specialist should create a program suited to the facility.

How should contaminated laundry be managed?

• Contaminated laundry includes items soiled with blood or OPIM (e.g., towels, gowns, uniforms, drapes).

• Although textiles can carry pathogens, disease transmission risk during laundry is very low.

• PPE contaminated with blood or OPIM must be laundered by the employer, not at home.

Disposable Surgical Gowns and Drapes

• Must resist liquid and microbial penetration.

• Must be FDA registered.

• Barrier level should match the expected exposure.

• Performance depends on material, repellency, pore size, design, and construction.

What are the guidelines for service animals in healthcare facilities?

• ADA allows people with disabilities to be accompanied by service animals in healthcare settings.

• Service animals generally do not pose a significant infection risk.

• They may be restricted only if they create a direct threat or require major changes to services.

• If separation is necessary, arrangements must be made for the animal’s care and the patient’s needs.

How is waste classified in oral healthcare settings?

Waste is classified as:

• Office waste: Most common; managed by state/local regulations

• Hazardous waste: e.g., lead aprons, computers

• Universal waste: e.g., batteries, lamps, pesticides

• Medical waste: Infectious or non-infectious

What is regulated medical waste?

• Infectious medical waste that may contain blood or OPIM.

• Regulated by OSHA and state agencies to protect workers from exposure risks.

How is non-infectious medical waste managed?

Non-infectious medical waste is managed as regular office waste.

What is the CDC’s “Basic Expectations for Safe Care”?

A 2016 CDC document that provides infection prevention guidelines and an Infection Prevention Checklist for dental settings.

What are the two main sections of the CDC Infection Prevention Checklist?

• Section I: Policies and Practices (institutional infection prevention)

• Section II: Direct Observation of Personnel and Patient-care Practices