Safety Day Outline Review

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74 Terms

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Infection Control Regulation

  • OSHA-The U.S. Occupational Safety and Health Administration

  • OSAP-Organization for Safety, Asepsis, and Prevention

  • CDC-The U.S Centers for Disease Control and Prevention

  • Employees in healthcare must have annual OSHA training

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OSHA

The U.S. Occupational Safety and Health Administration

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OSAP

Organization for Safety, Asepsis, and Prevention

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CDC

The U.S Centers for Disease Control and Prevention

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Chain of Infection

Mode of Transmission → Chain of Transmission → Exposures/Risk of Infection → Definitions

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Mode of Transmission

  • Direct contact- contact with infected person’s blood/fluid

  • Indirect contact- contact with contaminated objects, droplets in air, or insects

  • Bloodborne-contact with infected blood/body fluids

  • Airborne- inhaled pathogenic droplets in air

  • Vector -insect bite from insect carrying pathogen

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Direct contact

contact with infected person’s blood/fluid

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Indirect contact

contact with contaminated objects, droplets in air, or insects

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Bloodborne

contact with infected blood/body fluids

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Airborne

inhaled pathogenic droplets in air

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Vector

insect bite from insect carrying pathogen

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Chain of transmission

  1. Reservoir (infected person, animal, food, plant, soil, water, or dust)

  2. Infectious pathogen exits reservoir

  3. Transmission of pathogen through one of the above modes of transmission

  4. Susceptible Host (entry portal through open wounds or mucous membranes)

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Chain of transmission #1

Reservoir (infected person, animal, food, plant, soil, water, or dust)

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Chain of transmission #2

Infectious pathogen exits reservoir

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Chain of transmission #3

Transmission of pathogen through one of the above modes of transmission

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Chain of transmission #4

Susceptible Host (entry portal through open wounds or mucous membranes)

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Exposures/Risk of infection

  • Dependent on host (age, immunization status, immune status)

  • Dependent on # of pathogens present

  •   Dependent on type of exposure/injury

  •   Nosocomial infection- infection acquired in hospital setting

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Definitions: Universal precautions

Safety guidelines in which ALL blood and OPIMs (other potentially infectious material) are handled as if they are infected with disease

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Definitions: Standard of care

level of care that is competent in treatment of ALL patients at ALL times whether they have disease or not

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Definitions: continued

Assume that every bodily fluid is infected with bloodborne pathogens

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Bloodbourne pathogens

bacteria, virus, fungus, or parasites transmitted through blood or OPIMs

  • Hepatitis B,C, and HIV/AIDS

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Hepatitis B

  •    Inflammation of the liver caused by hepatitis B virus

  •   Transmitted through blood, sexual activity, or perinatal

  •    Can lead to liver damage, liver cirrhosis, & liver cancer

  •    Vaccination available

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How is hepatitis B transmitted?

Transmitted through blood, sexual activity, or perinatal

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What can hepatitis B lead to?

Can lead to liver damage, liver cirrhosis, & liver cancer

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Is there a vaccine available for hepatitis B?

Yes

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Hepatitis C

  • Inflammation of the liver caused by hepatitis C virus

  • Transmitted through contaminated needles

  • Can lead to liver damage, liver cirrhosis, & liver failure

  • NO vaccine available

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How is hepatitis C transmitted?

Transmitted through contaminated needles

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What can hepatitis C lead to?

Can lead to liver damage, liver cirrhosis, & liver failure

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Is there a vaccine available for hepatitis C?

NO vaccine available

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HIV/AIDS

  • HIV- Human Immunodeficiency Virus

  •   AIDS- Acquired Immunodeficiency Syndrome

  •    Fatal disease where cells that are essential for immune function are damaged

  •    Transmitted through blood, sexual activity, and perinatal

  •   No vaccine, no cure, but there are treatments and prevention meds available

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HIV

Human Immunodeficiency Virus

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AIDS

Acquired Immunodeficiency Syndrome

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How is HIV/AIDS transmitted?

Transmitted through blood, sexual activity, and perinatal

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What can HIV/AIDS lead to?

Fatal disease where cells that are essential for immune function are damaged

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Is there a vaccine available for HIV/AIDS?

No vaccine, no cure, but there are treatments and prevention meds available

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Airborne pathogens

Bacteria, virus, or fungus transmitted through air droplets

  • Tuberculosis, influenza, and COVID-19

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Tuberculosis

  •    Disease that primarily affects the lungs

  •    Caused by mycobacterium tuberculosis

  •    Spreads through air droplets from infected person coughing, sneezing, etc.

  •    Can live up to 1.5 hours outside body

  •    5-10% of people infected develop the disease

  •    Infection vs. disease

    •   Infection-latent & not contagious; no symptoms

    •   Disease- active disease & very contagious; symptoms present

  •   TB test- fluid is injected under skin & is rechecked in 2-3 days to reveal if a person is infected

  •    Positive TB tests cannot determine if person has latent infection or developed disease; patient must have a chest x-ray to confirm

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What causes tuberculosis and how is it spread?

  • Caused by mycobacterium tuberculosis

  •   Spreads through air droplets from infected person coughing, sneezing, etc.

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How long can tuberculosis live outside the body?

1.5 hours outside the body

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Infection

latent & not contagious; no symptoms

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Disease

active disease & very contagious; symptoms present

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TB test

Fluid is injected under skin & is rechecked in 2-3 days to reveal if a person is infected

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Positive TB tests

cannot determine if person has latent infection or developed disease; patient must have a chest x-ray to confirm

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Influenza and COVID-19

Viral infection that affects the respiratory tract

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Infection control includes

  • Hand hygiene

  • Decontamination

  • Sterilization

  • Environmental Infection control

  • Engineering controls

  • Dental unit water lines

  • Dental handpieces

  • Pre-procedural rinsing

  • Waste handling and disposal

  • Handling needles/Needlestick protocol

  • Work-area restrictions

  • PPE (Personal Protective equipment)

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Hand Hygiene

  •    The most important way to reduce risk of disease transmission

  •    Handwashing should be performed when hands are visibly contaminated, before/after patient contact, before/after glove use, and after using restroom

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Decontamination

Removes, inactivates or destroys bloodborne pathogens on surfaces

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Sterilization

Destroys ALL microbial life on items that are placed in the patient’s mouth

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Environmental infection control

  •   Intermediate level disinfectants should be used on surfaces directly contaminated

  •    Intermediate level disinfectants are tuberculocidal and have HIV/HBV kill claims

  •    Low level disinfectants only have HIV/HBV kill claims

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Engineering control

Sharps waste, biohazardous labels, handwashing/eye stations, needle shields

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Dental unit water lines

  •    Biofilm lives in water lines; safe level is less than 500 CFU/mL

  •   Flush lines 2 min at beginning of day and after each patient 20-30 seconds

  •    Clean suction lines each day

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Dental handpieces

  •    Can retract oral fluids into internal compartments

  •    Must run water lines & air for 2 min at beginning of each day & 20-30 seconds between patients

  •    Must be disinfected/sterilized after each patient

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Pre-procedural rinsing

  •   Have the patient rinse with a solution prior to treatment

  •   Reduces risk of disease transmission & # of microorganisms in the oral cavity

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Waste handling and disposal

  •    Must be marked with universal biohazard symbol

  •    Dispose in biohazardous waste if:

    •   Items with blood or OPIMs that can release liquid if squeezed (saturated gauze for example)

    •   Items with dried blood

    •   Contaminated sharps

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Handling needles/needlestick protocal

  •    Sharps container must be easily accessible

  •    Needles must be recapped after use or properly disposed

  •    Needlesticks are the #1 accident/exposure incidents in dental offices

  •    If needlestick occurs, Wash area with soap and water and report immediately

  •    Do not squeeze wound to express blood; can cause more damage/infection

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Work area restrictions

  •    No food or drink

  •    Countertops clear

  •    Avoid touching contact lenses

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What is the correct order of putting on PPE (Personal Protective Equipment)?

Gown, mask, eyewear, gloves

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Gloves

  •   Caution latex allergies

  •   Do not use petroleum-based lotion or lip moisturizer for patients; this can cause gloves to disintegrate

  •   Do not cross contaminate; gloves should only come in contact with patient, dental instruments or surfaces with barriers

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Protective Eyewear

Both patients and clinicians should wear eyewear

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Faceshields

Must be worn during aerosol-producing procedures

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Masks

Should be changed every patient, every hour, after wet/soiled

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Gowns, socks, and caps

Covers skin/protects body from blood and OPIMS & prevents spread

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Emergency Procedures: Allergic Reactions

  •    Irritant contact dermatitis (not an allergy, example hands irritated from sanitizer)

  •    Allergic contact dermatitis/delayed type IV hypersensitivity (allergic reaction)

  •    Immediate type I hypersensitivity (can lead to an emergency due to anaphylaxis reaction; example latex allergy)

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Irritant contact dermatitis

not an allergy, example hands irritated from sanitizer

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Allergic contact dermatitis/delayed type IV hypersensitivity

allergic reaction

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Immediate type I hypersensitivity

can lead to an emergency due to anaphylaxis reaction; example latex allergy

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Emergency Procedures: Exposures

  •    If blood or OPIMs splashes eyes, flush area with water for 20 min

  •    Wash area with soap & water, report to employer asap, & seek medical care

  •   Employers are required to inform you of how to make incident reports

  •    If exposed/injured, the employer must:

    • document the name of person exposed/injured

    •   document name of source of blood or OPIM

    •   obtain consent to test source’s blood and consent to receive results and arrange testing

    •   inform exposed/injured person of results

    •   arrange to have exposed/injured person tested and receive medical care as needed

    •   maintain confidentiality of incident

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CPR Review

  • Verify scene safety

  •    Check patient response

    •    Tap patient and say “are you ok?”

    •    Check pulse (check carotid for adults and children; check brachial for infants)

    •    Listen and look for breaths/chest rises

  • Activate emergency response- call 911 and get the AED

  • Begin chest compressions

    • 100-120 chest compressions per minute

    • 30:2 compressions & breaths

    • 15:2 compressions and breaths for children & infants with 2 person CPR

    • Compress at 2 inch chest depth for adults and children; 1.5 inch chest depth for infants

    • Allow heart to adequately refill between each compression

  • Giving Breaths

    • Do not overventilate; give effective breaths over 1-second each

    • Head tilt-chin lift

  •        Follow AED prompts & compress until EMS arrives or patient regains responsiveness

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CPR #1

Verify scene safety

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CPR #2

Check patient reponse

  • Tap patient and say “are you ok?”

  •    Check pulse (check carotid for adults and children; check brachial for infants)

  •    Listen and look for breaths/chest rises

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CPR #3

Activate emergency response- call 911 and get the AED

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CPR #4

  • Begin chest compressions

    •    100-120 chest compressions per minute

    •    30:2 compressions & breaths

    •    15:2 compressions and breaths for children & infants with 2 person CPR

    •    Compress at 2 inch chest depth for adults and children; 1.5 inch chest depth for infants

    •    Allow heart to adequately refill between each compression

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CPR #5

  • Giving Breaths

    • Do not overventilate; give effective breaths over 1-second each

    • Head tilt-chin lift

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CPR #6

  • Follow AED prompts & compress until EMS arrives or patient regains responsiveness