DNTL 167 - LO1 LS2 PP Review

All information taken from LO1 LS2 PP / Slide Deck

which organizations provide recommendations and regulations for Canadian dental practices

SK Oral Health Professions and Health Canada

our textbooks contains USA regulatory information which does not apply in Canada, which are…

CDC and OSHA

dental offices in SK are required to comply with what standards

the Saskatchewan IPC standards

infection prevention and control standards in the oral health care facility are that…

dental offices in SK are required to comply with the Saskatchewan IPC standards

what is infection prevention and control (IPC or IPAC)

policies, procedures and protocols used to reduce the risk of spreading infectious diseases in the dental office

what are routine practices sometimes called

universal precautions or standard precautions

routine practices includes treating each client as if…

they had infectious diseases (difficult to know which clients have infectious diseases so we assume everyone does)

in routine practices what is the same for every client

procedures/protocols

in routine practices procedures/protocols are…

procedure specific (vary from procedure to procedure)

what immunizations are recommended for personnel health

COVID-19 (update as recommended), hepatitis B, measles, mumps, rubella, varicella, influenza (annual), diphtheria, pertussis, tetanus (every 10 years)

why is immunizations important for personnel health

protects you and your clients

what viruses do we not have a vaccine for

hepatitis C and HIV

exposure to blood borne infections

some infectious diseases spread through blood and body fluids

what are examples of blood borne infections

HIV, Hepatitis B, and Hepatitis C

oral health team is constantly exposed to

blood and body fluids (exposure to blood borne infections)

types of exposures to blood

intact skin - no risk,

non-intact skin - very low risk,

mucous membrane - very low risk,

penetrating wound “needle stick injury” - low risk

procedures and protocol to reduce exposure risk

be very careful at all times, wash hands, get immunized, wear personal protective equipment, follow blood and body fluid exposure protocol, use infection prevention procedures, use work practice controls, and use engineering controls

what are work practice controls

use safe procedures to perform a task and do one-hand scoop to recap needle

what are engineering controls

equipment that reduces need to handle sharp instruments

exposure management protocol

• remove gloves (and clinic attire if necessary) to assess injury

• allow wound to bleed (but do not squeeze)

• wash hands and area with soap and water

• report injury to office IPC officer

• complete documentation

• immediately go to designated health care facility for
  assessment and take documentation with you

what is the designated health care facility for exposure management protocol in Regina

Regina General Hospital Emergency Department

when must the emergency room assessment be done

immediately after the exposure incident

after the exposure incident, who should go for the emergency room assessment

both source client and exposed person

for an emergency room assessment, where would you go and what would you report

go to hospital ER and report a “blood and body fluid exposure incident”

what tests might the ER physician suggest

ER physician will assess exposure and may suggest blood tests for Hepatitis B, Hepatitis C, and HIV

what medicine might the ER physician suggest

post-exposure prophylaxis (anti-viral drugs)

when must post-exposure prophylaxis drugs be started

within one to two hours after the exposure incident

what do you do when you poke yourself on a dental instrument during client care

set it aside so that it is not accidentally used again in client’s mouth

hand hygiene is the most important step for

disease prevention

why do we do hand hygiene

it removes transient microorganisms

when do we do hand hygiene

entering dental clinic, before donning gloves, after doffing gloves, after touching client record, before touching dental instruments, if you touch something contaminated with bare hands

what soap do we use when hand washing for most procedures

liquid soap

what soap do we use when hand washing for surgical procedures

antimicrobial soap

when do we hand wash with soap and water

when hands are visibly soiled

what does ABHR stand for

alcohol-based hand rubs

when do we use ABHR

only if hands are not visibly soiled

why do we use ABHR

better compliance and may cause less skin irritation

hand hygiene recommendations for nails

short and manicured, no nail-biting, no peeling or chipped nail polish, and no artificial nails

hand hygiene recommendations about gloves

wear good quality gloves, wear gloves that fit, and only wear gloves when necessary

hand hygiene recommendations

no jewelry, dry hands completely after washing, and use good hand cream

examples of personal protective equipment (PPE)

gloves, medical face masks, protective eyewear, face shield, and protective clothing

how many types of gloves are there

3 and type to use depends on procedure

gloves must ___ properly

fit

when are gloves are used for most dental procedures

examination gloves

what are examination gloves

disposable and used for 1 patient only

what type of examination gloves are most common

latex and nitrile

what sizes do examination gloves usually come in

XS, S, M, L, XL

what gloves are usually designed to fit both right and left hand

examination gloves

what gloves are used for surgical procedures such as oral
surgery, root canal surgery, periodontal surgery or implants surgery

sterile surgical gloves

sterile surgical gloves come in what package

in sterile package

what kind of gloves are usually specific for right and left hand

sterile surgical gloves

sterile surgical gloves come in what sizes

specific sizes (6, 6.5, 7, …)

utility gloves are ____ resistant

puncture

why do we wear utility gloves

to protect hands from microorganisms and chemicals

when do we use utility gloves

for operatory clean-up

adverse reactions to latex are…

common

Sask Polytech Dental Clinic is ___ safe

latex

what are non-latex options

nitrile gloves

medical face masks minimize exposure to

airborne microorganisms and chemicals

when should you wear medical face masks

during treatment and clean-up

medical face masks must be a certified medical mask and meet what standard

American Society of testing and materials standard ASTM F2100

when should you discard your medical face masks

if moist, dirty, and/or at least every 1hr

what are the ASTM standards for medical face masks

1. Bacterial filtration efficiency (BFE)
2. Particulate filtration efficiency (PFE)
3. Fluid resistance
4. Delta P (pressure differential)
5. Flammability

how many levels are there of medical face masks

3

what is the first level of medical face masks

level 1 (low barrier) for procedures with low spatter or aerosols

what is the second level of medical face masks

level 2 (moderate barrier) for moderate spatter or aerosols

what is the third level of medical face masks

level 3 (high barrier) for heavy spatter and aerosols

what is an example of a particulate filter respirator

N95

an N95 filters 1-μm particles with an efficiency of

greater than 95% (filter leakage <5%)

what two prerequisites are mandatory before a person can own an N95 respirator

must be fit tested and require training to don/doff

when are we required to wear N95 respirators

when respiratory precautions are necessary (pandemics and with tuberculosis)

what does protective eyewear do

protect your eyes from airborne microorganisms and aerosols

what is protective eyewear

safety glasses with side shields or goggles

what is a face shield

a clear plastic which covers face and protects face and
mask/respirator from becoming contaminated with splatter and aerosols

what does protective clothing do

prevents blood from spattering skin and clothing

what does protective clothing includes

scrubs, clinic jacket, bonnet, shoes, and some offices use disposable gowns

when should you wear protective clothing

only wear at office

what is the best practice for cleaning protective clothing

to launder on site or professional laundry service

what is the best practice for cleaning protective clothing at home

separate from regular laundry and use hot water, hot dryer, and iron