CROSS INFECTION CONTROL POLICY

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Decontamination Cycle
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Our effective infection-control measure

As a reputed dental clinic, we are dedicated to taking care of the health and wellbeing of both our patients and staffs. We believe real cleanliness lies beyond what a person can see. So we take necessary and well-defined measures to ensure the highest standard of sanitation and hygiene at our clinic. Every member of our team goes through a systematic disinfection routine every day to keep away the dirt and germs away.

Moreover, Colchester Dental Implant Centre uses disposable items including sterilized bottles throughout the range of its operations. The disposable items are methodically replaced with the new ones right after a single use. We take exhaustive measures to keep all our instruments clean and insulated from harmful viruses and microorganisms that might affect your fast recovery.

As a unique approach to focus on hygiene and wellbeing, Colchester Dental Implant Centre has set up a specially designed decontamination room at its clinic. This room is fully equipped with the latest range of disinfection system involving cutting-edge tools and equipment that modern technology offers. Our practice employs the use of two autoclaves to ensure equipment is fully decontaminated.

Our support staffs keep the equipment wrapped and protected so that the tools remain sterilised until the moment they are required to use. The infection-control regulations that we follow are unique in the dental healthcare industry and these measures have been appreciated time and again by various relevant and statutory bodies.

Currently, the public awareness in the UK about contamination and diseases is rising. Dental Implant Colchester appreciates this change and is ready to stand up to the new possibilities. Our exclusive infection control policies are meant to keep both our patients and staffs safe from infections.

Our well defined decontamination drive includes the following measures:

  • Cleaning
  • Sterilisation and
  • Disposing all reusable components after single-use

Our qualified staffs also make necessary efforts to keep the environment clean. All our staff members follow strict hand hygiene measures using disinfectant agents both before and after using gloves.

Minimising the chances of infection spreading is crucial in healthcare. Colchester Dental Implant Centre considers it even more relevant for the specialised oral health sector. Thus, we impart special training to our staffs on issues like infection control, decontamination of dental equipment and instruments as a part of our induction program.

Our practiced approaches on decontamination policy are as following. We expect all our staffs to have sufficient clarity on these clauses. Any of our patients may ask you about any of these clauses at any time.

Minimizing blood-borne virus transmission

The staffs should be immunised against Hepatitis B and hepatitis B seroconversion records will be assessed securely by the responsible heads so that there is no compromise on confidentiality. Appropriate course of action will be suggested for individuals who cannot be immunised or subjected to seroconvert.

Those staffs who are at higher risk to get contaminated with blood borne viruses have to undergo an occupational health examination and this service will be provided by local occupational health services. The findings of these tests will be considered as classified information and confidentially maintained by the practice.

While treating inoculation injuries, the wound should be allowed to bleed first and then washed well by holding the affected area under running water. Lastly, the wound will be dressed with waterproof bandage.

It is to be noted that all cases of inoculation injuries are to be brought under the notice of either Mr. Mansour Kangi or Sam Mathews. They will consider any further action over such issues and will also maintain confidentiality of records that is statutory under the current law. The local occupational health services behind the clinic will provide any advice related to post-exposure prophylaxis.

Proper cleansing and sanitisation of instruments and equipment

Equipment and instruments that are meant for single-use are to be identified carefully and then carefully disposed of. In no circumstance will these instruments be re-used. The reusable instruments need to be thoroughly decontaminated after use and measures should be taken to ensure they can be safe for reusing. Gloves and proper eye-protection gears should be worn by respective staffs while handling and sanitizing these tools and instruments.

All new instruments should be properly sanitised as per respective manufacturer’s instructions before being used. Instruments that are to be manually cleaned are to be identified and listed separately. Whenever it will become possible, the management will procure instruments that can be automatically cleaned and sanitised through ultrasonic cleaner or washer disinfectors. The practice manual will contain the practice policy for every new instrument that is purchased.

All instruments must be transferred to the decontamination area for reprocessing at the end of treating each patient. The practice manual will have detailed procedures about transferring the used instruments and equipment. For both decontamination and clinical rooms, the workflow has to pass from dirty zones through the decontamination process into the cleaning zone on every occasion. The practice manual will also contain all necessary instruction and guidance on local zone and practice procedures.

The relevant staffs need to be properly trained so that they are competent to properly sanitize both existing and new reusable dental instruments. Records and strategies of all these training programs are to be carefully preserved.

Cleaning

All the used instruments required to be cleaned in the ultra-sonic bath, according to the manufacturer’s instructions. However, for instruments that that cannot be sanitised in the ultrasonic bath, should be placed in the washer-disinfector. While placing instruments in the washer-disinfector, care should be taken so that:

  • There is no overloading of instrument carriers
  • No overloading of instruments
  • The open instruments that can be disassembled should be appropriately disassembled from the right joints and hinges.

In cases where instruments are manually cleaned, the practice policy for manual cleaning should be followed strictly. This policy can also be found in the practice manual Inspection.

After the cleaning is complete, it is necessary to inspect instruments for residual debris. Moreover, those should be properly checked using task lighting and a magnifying device for any wear and tear. The residual debris, if found, should be removed immediately by hand and the instrument has to be cleansed again.

Sterilisation

Instruments that are to be preserved for future use should be properly wrapped and placed in pouches after the sterilisation process, following the manufacturers’ instructions. In no circumstance, this storage should exceed 1 year. After 1 year, the instruments have to be reprocessed. Instruments that are to be used on the same day should not be wrapped and placed in a non-clinic environment till those are required.

Work surfaces and equipment

The area designated to treat patients should be thoroughly cleaned after each treatment session. This has to be done even if the area appears to be free from any contamination and this should be done using disposable cloths.

The local working area and all relevant equipment must be cleaned with single-use disposable cloths. This exercise will cover designated treatment areas, inspection light and handles, hand controls, dental chair, delivery units, spittoons and aspirators. If, the x-ray units and controls are used then those should also be cleansed in the proper way. Moreover, all other equipment that has a chance of being contaminated should also be cleaned.

Additionally, exposed surfaces like cupboard doors, dental inspection light fittings and floor surfaces should also be cleaned on every day basis.

Cleaning impressions and laboratory work

Dental impressions require to be rinsed unless they are visibly clean. Those also have to be disinfected by immersing into proper solution as recommended by the manufacturer. They will be appropriately labeled as ‘disinfectant’ before being sent back to the laboratory.

Hand hygiene

The aspect of maintaining hand hygiene is of utmost importance and it must be followed routinely. The entire procedure is thoroughly stated in the practice manual and just a short summary is being included here.

Fingernails should be cut regularly and they should also be free from any kind of nail art. There should not be any type of either temporary or permanent nail enhancements including false nails and nail varnish. To clean the nails, one should only use a blunt ‘orange’ stick.

One should wash hands with liquid hand-wash every time before wearing and after removing the gloves while treating a patient. While washing the hands, everyone should stick to the hand-washing technique displayed at every sink. Using of scrubs or nail brushes is strictly forbidden as these can create abrasions in the skin where the microorganisms may reside. Use the hand drying machine or paper towels while drying the palms so that the skin is not damaged.

 Gels or solutions having antibacterial base can be used if the hands appear visibly clean instead of hand-washing while attending surgery sessions. These gels and solutions must be applied using the same techniques as for hand-washing. In case the hands become ‘sticky’, one should use liquid soap to get rid of the stickiness.

After washing hands every time, one should apply hand cream to avoid dryness of the skin. However, no one should use hand cream under the gloves or during a treatment session as it can lead to the growth of microorganisms.

Clarity on clinical waste disposal

Each and every category of clinical or healthcare waste is ‘hazardous’ and should be placed in orange sacks for collection.

Not even a single sack carrying clinical wastes should be more than three-quarters full. Carefully, squeeze out the air to avoid bursting when handled by others. Place proper labels at the neck of the sack indicating the type of waste it contains. Do not tie the labels to the sacks.

Clinical wastes with sharp edges like needles and scalpel blades should be put into UN-type approved puncture-proof containers and properly labeled to indicate the type of wastes those are.

Clinical wastes with sharp edges should be stored carefully in a separate area for final disposal by the registered waste carrier appointed by the management. The waste carrier should possess a registration certificate issued by the Environment Agency.

Substances like dental amalgams and fixer solutions need to be disposed of by the appointed waste carrier after being labeled as hazardous waste.

The waste carrier will issue a consignment note each time while collecting waste and this note will be retained by the management for 3 years. All consignment notes are to be submitted to Mr. Sam Mathews.

Every staff handling clinical waste has to be vaccinated against hepatitis B. Moreover, every staff requires to be thoroughly trained in handling, segregation and storage of healthcare waste.

Personal Protective Equipment (PPE)

Our staff induction programs include training on correct use of PPE. Whenever a new PPE is introduced, all our staffs receive timely updates about its use and application.
 The list of PPE includes items like protective clothing, disposable clinical gloves, plastic disposable aprons, face masks, and eye protection. Moreover, it is recommended that household gloves should be worn while handling and manually cleaning contaminated instruments. Staffs also require wearing properly covered footwear.

Gloves

At our clinic we use disposable clinical gloves with CE-mark that are low in extractable proteins, low in residual chemicals and powder-free. In case anyone developing a skin eruption or any other reaction to protective gloves or a chemical should immediately bring the matter to Mansour Kangi.

Clinical gloves are meant for one-time use and should be disposed of as clinical waste.

Long fingernails can easily damage clinical gloves. So, we expect everyone associated with the practice to keep their nails short. Gloves should not be cleaned with alcohol rubs and neither those should be washed.

It is required to wear domestic household gloves along with plastic disposable aprons and protective eye gear while performing any decontamination procedure. The household gloves must be washed with detergent and hot water after every use and then left to dry. In no circumstance, use of a pair of these gloves should extend over a week.

Plastic aprons

Wearing plastic aprons is a must during every decontamination process. Aprons are meant for single use and should be properly disposed of as clinical waste after being used. While removing plastic aprons, break the strap at the neck; gather a used apron only by touching its inside surface.

Face and eye protection

It is necessary to wear the protection gears for the face and the eye during all surgical and operative procedures. It is ideal to remove face masks either by breaking the straps or lifting it over the ears. These are meant for one-time use and should be disposed of as clinical waste.

Spectacles do not provide sufficient protection to the eyes and so we expect our staffs to wear a visor or face shield. Eye protection gears should be cleansed according to manufacturers’ instructions. Disposable visors can be used at every possible opportunity.

Protective clothing

Protective clothing is meant to be worn during surgeries. It is forbidden to wear these outside the practice premises. Changing and storage facilities for protective clothing are duly provided next to the kitchen.

It is natural for the protective clothing to get contaminated during surgical and decontamination procedures. Therefore, clothing meant for surgery need to be cleaned regularly and freshly laundered clothing has to be worn every day. These clothing items can be machine washed at 60oC using a suitable detergent.

Blood spillage procedure

Blood spillage is very rare in dentistry. However, in such situations, the affected area has to be saturated with 1% sodium hypochlorite with a yield of at least 1000 ppm free chlorine. Leave this substance intact for about 5 minutes and then use disposable clothes to wipe the place clean. The clothes that are used for wiping have to be disposed as clinical waste.

Blood spillage should be attended to as a matter of emergency. Cover the entire area spilled with blood using disposable towels. It is then treated with sodium hypochlorite solution or sodium dichloroisocyanurate granules, both producing 10,000 ppm chlorine. Then ensure good ventilation to the place.

While clearing away a spillage, it is necessary to wear protective clothing gears including household gloves, protective eyewear and disposable aprons. One also needs to carefully avoid unnecessary contact with metal fittings so that those do not corrode away in presence of sodium hypochlorite. There is no need to use alcohol to decontaminate the surrounding.

Environmental cleaning

The non-clinical areas need to be cleaned according to the practice policy mentioned in the practice manual.

All cleaning-related equipment is to be stored in the cleaning cupboard and this cupboard should be placed outside patient care areas.

Each and every record related to cleaning protocols should be retained in the office.

Review

This set of policies will be regularly reviewed. Based on these reviews, necessary amendments can be introduced to the policies from time to time.

Date of policy...January 2015...

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Colchester Dental Implant Centre

13a Nayland Road, Colchester CO4 5EG

01206 752500