Dental Nursing Flashcards Health and Safety
Reporting Incidents to HSE under RIDDOR
3 incidents that should be reported under RIDDOR:
Contracting Hepatitis C/B
Bone fracture
Surgery fire
Environmental Legislation
Which act is concerned with the disposal of special waste?
Environmental Protection Act
Which Scottish agency is responsible for the regulations concerning the disposal of special waste?
SEPA (Scottish Environment Protection Agency)
Chemical Handling and Storage Procedures
Etch Storage and Handling
How should etch be stored?
Away from direct heat, in a cool, dry, dark area.
How should etch be handled?
Wearing personal protective equipment (PPE), with care.
Ethyl Chloride Storage and Handling
How should ethyl chloride be stored?
Away from direct heat, in a cool, dry, dark area.
How should ethyl chloride be handled?
Wearing personal protective equipment (PPE), with care.
Health and Safety Regulations
Who does the Health and Safety at Work Act 1974 apply to?
Hospital departments
Community clinics
Practices with 5 or more employees.
Hazards in Dental Environment
3 hazards associated with working within a dental environment:
Radiation
Cross-infection
Mercury
Which waste stream is sent to landfill for heat disinfection?
Orange stream.
What waste is in the orange stream?
Clinical waste.
COSHH Regulations
Definition and Purpose
What does COSHH stand for?
Control of Substances Hazardous to Health.
What is COSHH concerned with?
Risk assessment of chemicals.
Substances Covered by COSHH
3 substances covered under COSHH found in a dental practice:
Etch
Amalgam capsules
Developer.
Risk Assessment Process
What are the 3 stages of the risk assessment?
Identify the risk.
Identify who is at risk.
Identify how to avoid/minimize risk.
RIDDOR Overview
What does RIDDOR stand for?
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations.
2 incidents not covered under RIDDOR or reported to HSE:
Patient tripping up.
Burn from autoclave.
Needlestick injury is also not covered.
Coverage under Health and Safety Act
Who in a dental surgery is covered by the Health and Safety at Work Act 1974?
Employers
Employees
Patients.
Equipment Storage Safety
2 ways of storing equipment safely and securely:
Locked cupboard.
In original packaging.
What 2 considerations should be taken when moving and handling heavy items in a dental surgery?
Dividing the load.
Asking for assistance.
Needlestick Injury Prevention
How would you prevent potential harm that could occur from a needlestick injury?
Safe handling and disposal of sharps.
Risk Reduction Guidelines
Bunsen Burner
How can you reduce the risk from a bunsen burner?
Do not leave unattended.
Turn off after use.
Computer Workstation
How can you reduce the risk from a computer?
Take regular breaks.
Ensure correct workstation height.
Disposal of Sharps
How can you reduce the risk from the disposal of sharps?
Safe handling and correct disposal in the sharps box.
Importance of Guidelines
Why is it important to follow HSE, SDCEP, and HPS guidelines?
To ensure staff, patient, and public safety.
Mercury Spillage Management
Handling Spillage
4 items that can be used to deal with a spillage of mercury:
Disposable syringe.
Brush and shovel.
Sealed container.
Disposable syringe.
Who should be informed if there is a large mercury spillage?
HSE (Health and Safety Executive).
Minor Spillage Procedure
If there has been a minor mercury spillage and you reported the incident to your manager, what 2 other actions should you take?
Evacuate patient + open window to ventilate the room.
Using a brush, move globules of mercury together to form one large pool and aspirate with a disposable syringe, dispensing it into a sealed container.
Waste Disposal Streams
Which stream should amalgam capsules be disposed in?
Red stream.
What waste is in the red stream?
Special waste.
Which stream should a used bur be disposed in?
Yellow stream.
What waste is in the yellow stream?
Clinical waste.
Clinical waste bags should not be more than how full and weigh more than what?
3/4 full and not weigh more than 4 kg.
Incident Reporting
3 incidents that should be recorded in the accident book:
Burn.
Fall.
Needlestick injury.
3 details that should be included in the accident book:
Date and time of incident.
Details of injury.
Action taken.
2 examples of yellow clinical waste:
Used needles.
Matrix bands.
2 examples of red clinical waste:
Amalgam capsules.
Developer.
Orange stream risk level:
Low risk.
Yellow stream risk level:
High risk.
Fire Safety Equipment
2 types of firefighting equipment:
Fire extinguisher.
Fire blanket.
3 actions taken in the event of a fire:
Raise alarm.
Evacuate the building.
Call 999.
3 security measures in place to protect staff and patients:
CCTV.
Zero tolerance policy.
Buzzer entrance.
Hazards Related to Chemicals
What is a hazard associated with etch?
Corrosive.
What is a hazard associated with mercury?
Harmful to the environment.
Micro-organisms Overview
Types of Micro-organisms
List 3 types of micro-organisms:
Bacteria.
Fungi.
Virus.
Bacterial spore.
What is cross infection?
Transfer of micro-organisms from one person to another.
What is disinfection?
Chemical killing of bacteria and fungi, but not all viruses or spores.
What is sterilisation?
Killing of all micro-organisms: bacteria, fungi, viruses, and spores.
What is decontamination?
A range of processes (cleaning, disinfection, and/or sterilisation) that render instruments and equipment safe for reuse.
What does pathogenic mean?
A micro-organism capable of causing disease.
What is asepsis?
Absence of all living pathogenic micro-organisms.
2 examples of diseases caused by pathogens:
Hepatitis B.
Tuberculosis (TB).
Infection Control Procedures
Standard Precautions
What is a standard precaution?
Treat all patients as infectious.
What is SICPs?
Standard Infection Control Precautions.
How do you apply SICPs?
Treat all patients as infections.
Prions and Validation
What is a prion?
An abnormal protein unable to be destroyed by autoclaving.
What is validation?
A documented quality assurance procedure applied to each stage of the decontamination process to ensure the procedure is carried out to a required standard.
Records Related to Infection Control
2 examples of records that should be kept in relation to infection control:
Waste consignment notes.
Logbooks.
Specific Micro-organisms and Their Effects
What is streptococcus mutans?
A bacterium.
What does streptococcus mutans cause?
Dental caries.
What is Candida albicans?
A fungi.
What does Candida albicans cause?
Oral thrush, denture stomatitis, angular cheilitis.
What is herpes simplex?
A virus.
What does herpes simplex cause?
Herpes labialis.
What does lactobacilli cause?
Dental caries.
What does Borrelia vincentii cause?
ANUG (Acute Necrotizing Ulcerative Gingivitis).
What does legionella cause?
Legionnaires disease.
Micro-organism Shapes
What shape is cocci?
Round.
What shape is bacilli?
Rod.
What shape is vibrios?
Comma.
What shape is filamentous?
Thread-like.
What shape is spirochaetes?
Spiral.
What micro-organism is rod-shaped?
Bacilli.
What bacteria is round-shaped?
Cocci.
Lactobacillus and Oral Thrush
Is lactobacillus a bacterium?
Yes.
Is oral thrush caused by a virus?
No.
SDCEP Definition
What does SDCEP stand for?
Scottish Dental Clinical Effectiveness Programme.
Sterilisation Procedures
Manual Test of Steriliser
3 things you record during manual testing of a steriliser:
Time.
Temperature.
Pressure.
3 items sterilised by gamma-radiation:
Scalpel.
Sutures.
Disposable syringes.
Autoclave Fault Protocol
What procedure do you take if a fault occurs with an autoclave?
Stop the autoclave immediately.
Report the issue.
Place "out of use" notice on the door.
Use alternative autoclave.
Contact an engineer or identify faults from the manual.
Washer Disinfection Cycle
Sequence of washer disinfection cycle:
Flush.
Wash.
Rinse.
Thermal disinfection.
Dry.
What temperature and time are required to reach the thermal disinfection stage in washer disinfection?
80 °C for 10 minutes or 90 °C for 1 minute.
What is the maximum temperature in a washer disinfected during the flush stage?
Less than 45 °C.
Why should the temperature during the flush stage not exceed 45 °C?
To prevent protein coagulation.
Dental Unit Water Lines (DUWL)
Micro-organism commonly found in DUWL:
Legionella.
How long should DUWL be flushed for between patients?
30 seconds.
How long should DUWL be flushed for at the beginning of a session?
2-4 minutes.
Why do we flush waterlines?
To minimize the risk of legionella lying in the waterlines.
Vaccination Recommendations
2 diseases dental nurses should be vaccinated against:
Hepatitis B.
Tuberculosis (TB).
After the third inoculation for Hepatitis B, a blood sample is taken to check what?
To check titre levels.
Immunisations Overview
What do immunisations do?
Initiate the body to produce antibodies.
Types of Immunity
2 types of immunity:
Natural/artificial.
Active/passive.
What does PPE stand for?
Personal Protective Equipment.
Clinical Hand Hygiene Recommendations
How long is the recommended time for clinical hand hygiene?
20-30 seconds.
How long is the recommended time for a surgical scrub?
3-4 minutes.
What are 2 procedures that involve surgical hand hygiene?
Implant procedures.
Surgical extractions.
Needlestick Injuries
What is an inoculation injury?
A needlestick injury.
4 ways a dental nurse can reduce the risk of cross-infection:
Handwashing between patients.
Zoning in surgery and LDU (Local Decontamination Unit).
Disinfect work surfaces between patients.
Wear PPE for protection.
Examples of Infection Transmission
Example of transmission by direct contact:
Handshake.
Coughing around a person.
Disinfectant Usage
What disinfectant is used to deal with blood spillage?
Sodium hypochlorite.
2 solutions to decontaminate surgery surfaces:
Sodium hypochlorite.
Detergent.
Cleaning Protocols
How should work surface areas be cleaned?
Use alcohol, disinfectant, and detergent wipes between every patient and before the start and end of each clinical session.
2 standard infection control procedures that should be covered during staff induction:
Hand washing policy.
Sharps injury procedure.
2 records that should be kept in surgery in relation to cross-infection:
Waste consignment notes.
Autoclave cycles.
Routes of Pathogen Entry
3 ways pathogens can enter the body:
Inhalation.
Ingestion.
Direct contact.
How is Hepatitis B mainly transmitted?
Through blood.
How is MRSA mainly transmitted?
Skin-to-skin contact (hands).
Ultrasonic Bath Functionality
What is an ultrasonic bath for?
Debris removal.
What do you label a lab sheet as after disinfecting what you are sending off?
Disinfected.