ITC PART 1

dress code, needle stick injuries, sterilisation procedure, cross infection prevention

general principles for uniform wearers

• clean, presentable, fitting, professional uniform

• should allow for unrestricted movement

• staff must have access to a spare uniform in case one becomes soiled during shift

footwear guidelines

• safe, sensible, smart, clean

• soft soled, full shoe closed over the entire foot

• low heel (≈ 3cm)

• non-slip

• black or navy blue

• plain black, navy blue or white trainers are acceptable if they are also made of wipeable/ washable materials

• plain black or navy blue socks

• no distinctive logos

Bare Below the Elbow (BBTE) guidelines

• whilst in clinical uniform/ in a clinical area

• disposable sleeves should be worn if BBTE cannot be adhered to for religious reasons

• Sikh Kara must be worn as high up the forearm as possible or removed - if this is not possible then it must be covered by disposable gloves

• keep fingernails short and clean

• no artificial nails, gels or wraps

• no nail polish or shellac

• no hand jewellery other than a simple unstoned plain band

• no wrist watches or fitness devices or other wrist adornments

jewellery, piercings, badges and other accessories guidelines

• one plain band with no protruding jewels, metal work or indentations

• the ring must be mobile enough to allow the wearer to wash underneath it

• one pair of small plain stud earrings is permissible

• in addition one discreet nose, tongue, ear or facial piercing is permitted - no stones, must be a stud

• a ‘tunnel’ or ‘plug’ if worn must be as close to the natural skin tone as possible - this is the equivalent to one pair of plain earrings

• no other jewellery including neck chains

• medical alert bracelets may be worn but must be cleanable, plain and discreet

• a medical alert necklace should be worn in preference to a medical alert bracelet - ensure line manager is aware of medical alert situation

hair and headscarves guidelines

• hair should be neat and tidy at all times

• long hair should be tied back off the face - should not be able to fall forward and contaminate a patient’s personal space or be caught in moving machinery

• a plain hair adornment is acceptable

• beards should be short and neatly trimmed

• beards that cannot be controlled should be covered with a beard net with a mask on top

• headscarves should be neutral, black or navy blue in colour, as small and neat as possible

• headscarves should not have adornments attached e.g. brooches, beads and tassels

what is a needle stick injury

needle stick injury: accidents or injuries involving biologically contaminated material including “sharps” injuries

• blood and body fluids from one individual contaminate the mucous membranes/ uncovered wounds/ broken skin of another person

needle stick injury procedure (8)

1. encourage bleeding by gently squeezing the site

2. wash the wound in warm running water with soap

3. dry and apply waterproof dressing

4. if eyes are contaminated, wash with copious amounts of water before and after removing the lens if worn

5. for a splash in the mouth, irrigate thoroughly with drinking water for at least five minutes without swallowing the water

6. report the incident to the Supervisor or Senior Dental Nurse who should refer to the “Blood and Body Fluid Exposure Incident Management Pack”

7. refer to Occupational Health if significant exposure

8. fill in a Datix form on the STH intranet site

dental instruments can either be…

single use or multiple use

give examples of items that are single use

• matrix bands

• files

• reamers - clean and shape the root canal

which other items can be single use

• injection needles

• aspirators

important points when sterilising instruments

• appropriate PPE should be worn when decontaminating instruments i.e. goggles, gloves, mask, apron

• regulatory standards in England applicable to decontamination of dental instruments is HTM 01-05

• initial effective cleaning is very important

• handpieces need to be cleaned and oiled prior to autoclaving

• instruments should be appropriately packaged after first examining them to ensure they are free from dirt, debris and function, before their use on patients

• autoclaved instruments should then be stored correctly

• records are maintained to demonstrate compliance with standards

which members of the dental team must be immunised against HBV

every registered member

what is the importance of cross infection control policies

• prevent spread of deadly blood borne viruses and bacteria

• control the spread of Hepatitis B (HBV) and HIV

types of organisms

• non-pathogenic (commensals)

• pathogenic

how do pathogens spread

1. through the air - can be ingested, breathed in, or enter via the cornea when someone coughs on you

2. direct contact - via blood in a needle stick injury

3. indirect contact - via blood on a work surface (may contain HBV which survives for a considerable time in droplet form)

outline sterilisation VS disinfection

• sterilisation: kills all known organisms and spores on an instrument

  • autoclaving (kills spores)

  • industrial gamma radiation (kills spores)

• disinfection: uses disinfectants to kill most microorganisms - not spores

when are disinfectants used

• cleaning surfaces of the dental chair, its controls, the spittoon and the dental light in between patients

which measure of infection control is the most important

hand washing

gloves used in the Sheffield Dental Hospital are all…

latex free

what type of waste are gloves disposed into

clinical waste

whose duty is it to dispose appropriately of sharps

the clinician’s

• sharps:

  • used anaesthetic needles and cartridges

  • contaminated scalpel blades

  • single use steel burs

  • matrix bands

which legislation does clinical waste come under and what does it state

Environmental Protection Act (1990)

• clinical waste must be stored and disposed of correct in appropriately labelled sacks which are not more than ¾ full

• clinical waste must not be placed in a normal household dustbin

what are other precautions that should be taken into account

• covering blood spillages with hypochlorite crystals

• during a RCT the files are used on that patient only and then discarded

• diamond burs are autoclaved

• triple syringe tips are disposable and therefore changed between each patient