Bloodborne Pathogen Annual Training

Transcription

1 Bloodborne Pathogen Annual Training Adriana Modesto Vieira, DDS, MS, PhD, DMD Chair, Infection Control University of Pittsburgh School of Dental Medicine

2 Why Is Infection Control Important in Dentistry? Both patients and dental health care personnel can be exposed to pathogens Contact with blood, oral and respiratory secretions, and contaminated equipment occurs Proper procedures can prevent transmission of infections among patients and personnel

3 Standard Precautions

4 Standard Precautions Integrate and expand Universal Precautions to include organisms spread by blood and also Body fluids, secretions, and excretions except sweat, whether or not they contain blood Non-intact (broken) skin Mucous membranes

5 Elements of Standard Precautions Handwashing Use of gloves, masks, eye protection, and gowns Patient care equipment Environmental surfaces Injury prevention

6 Personal Protective Equipment

7 Why Is Hand Hygiene Important? Hands are the most common mode of pathogen transmission Prevent health care-associated infections

8 Hands Need to be Cleaned When Visibly dirty After touching contaminated objects with bare hands Before and after patient treatment (before glove placement and after glove removal)

9 Hand Hygiene Handwashing Washing hands with plain soap and water

10 Hand Hygiene Antiseptic handwash Washing hands with water and soap or other detergents containing an antiseptic agent

11 Hand Hygiene Alcohol-based handrub Rubbing hands with an alcohol-containing preparation

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14 Hand Hygiene Surgical antisepsis Handwashing before surgical procedures

15 Efficacy of Hand Hygiene Preparations in Reduction of Bacteria Good Better Best Plain Soap Antimicrobial soap Alcohol-based handrub Source:

16 Alcohol-based Preparations Benefits Limitations Rapid and effective antimicrobial action Cannot be used if hands are visibly soiled Improved skin condition More accessible than sinks Store away from high temperatures or flames Hand softeners and glove powders may build-up

17 Special Hand Hygiene Considerations Use hand lotions to prevent skin dryness Consider compatibility of hand care products with gloves (e.g., mineral oils and petroleum bases may cause early glove failure) Keep fingernails short Avoid artificial nails Avoid hand jewelry that may tear gloves

18 Personal Protective Equipment A major component of Standard Precautions Protects the skin and mucous membranes from exposure to infectious materials in spray or spatter Should be removed when leaving treatment areas

19 Masks - Protective Eyewear - Face Shields Wear a surgical mask and either eye protection with solid side shields or a face shield to protect mucous membranes of the eyes, nose, and mouth Change masks between patients Clean reusable face protection between patients; if visibly soiled, clean and disinfect

20 Protective Clothing Wear gowns that cover skin and personal clothing likely to become soiled with blood, saliva, or infectious material Change if visibly soiled Remove all barriers before leaving the work area

21 Gloves Minimize the risk of health care personnel acquiring infections from patients Prevent microbial flora from being transmitted from health care personnel to patients Are not a substitute for handwashing! Hand hygiene should be performed immediately prior to putting on and after removal of gloves

22 Recommendations for Gloving Wear gloves when contact with blood, saliva, and mucous membranes is possible Remove gloves after patient care Wear a new pair of gloves for each patient

23 Recommendations for Gloving Remove gloves that are torn, cut or punctured Do not wash, disinfect or sterilize gloves for reuse

24 Personal Protective Measures Once sterile instrument packages have been opened, all personnel working in the patient cubicle must wear disposable gowns, protective glasses (with side shields) or face shield, disposable masks, and properly fitting disposable gloves during all treatment procedures

25 Personal Protective Measures If sterile instrument packages are not opened, clinical personnel are permitted to engage in conversation with the patient prior to dawning the protective equipment

26 Personal Protective Measures Disposable gloves are only applied immediately prior to actual examination or treatment

27 Personal Protective Measures Gloves must only come into contact with the patient, sterile instruments or items covered with a protective plastic barrier

28 Personal Protective Measures Personnel must remove and discard gloves and sanitize hands if it is necessary to leave the chairside environment or if any contaminated surface is touched

29 Personal Protective Measures IT IS FORBIDDEN TO WEAR GLOVES OUTSIDE THE CUBICLE

30 Personal Protective Measures Phones, doors, cabinets, papers, writing instruments, or any other surface not covered with a protective barrier must not be touched with gloves

31 Personal Protective Measures Patients who wear eyeglasses must leave them in place during treatment

32 Personal Protective Measures Patients who do not wear eyeglasses must wear an alternative means of eye protection during treatment

33 Personal Protective Measures Eyewear must be disinfected with an Environmental Protection Agency (EPA) registered intermediate level disinfectant between patients

34 Personal Protective Measures Caution is needed at all times to minimize the risk of cutting, nicking, or inoculating soft tissues by any instrument or device contaminated by a patient s blood or saliva

35 Keyboard/Mouse All clinic keyboards/mouse set-ups are to be covered with protective covers

36 Keyboard/Mouse The top of the plastic covering is only to be touched by gloved hands The underside of the plastic covering (and keyboard and mouse that lie underneath) is(are) only to be touched by ungloved hands Both plastic coverings must always be secured over the keyboard and mouse as soon as the patient is seated in the chair and remain there until the patient is dismissed

37 Keyboard/Mouse The plastic coverings must always remain draped and are NEVER to be lifted- up during the appointment

38 Instrumentation If water-spray handpieces or ultrasonic water-cooled scaling devices are used, their use should be accompanied by highvolume suction When cutting hard tissues with water-spray handpieces, rubber dams (if appropriate) and proper patient positioning will minimize contaminated aerosols Reducing the volume of aerosols and protecting personnel exposed to such aerosols will minimize the risk of airborne transmission of disease

39 Saliva Ejectors Previously suctioned fluids might be retracted into the patient s mouth when a seal is created Do not advise patients to close their lips tightly around the tip of the saliva ejector

40 Digital Radiography Once exposed, all sensors/psp plates will be thoroughly wiped with a disinfectant (Cavi-wipes), allowed to dry, and, after changing gloves, then wiped a second time and dried with a paper towel Once cleaned, the plates will be processed with clean hands or clean gloves Once processed, the plates will be wiped with alcohol wipes before they are re-bagged

41 General Clinic Cleanliness Eating or drinking is forbidden in all clinics, dispensaries, and laboratories

42 Environmental Surfaces May become contaminated Not directly involved in infectious disease transmission Do not require as stringent decontamination procedures Categories Clinical contact surfaces Housekeeping surfaces

43 Clinical Contact Surfaces Risk of transmitting infections greater than for housekeeping surfaces High potential for direct contamination from spray or spatter or by contact with personnel s gloved hand

44 Clinical Contact Surfaces Might be touched frequently with gloved hands during patient care or might become contaminated with blood or other potentially infectious material and subsequently contact instruments, hands, gloves, or devices

45 Clinical Contact Surfaces Barrier protective coverings (clear plastic wraps) will be used to maintain these surfaces, particularly those that are difficult to clean such as light handles, and chair switches The coverings will be changed when visibly soiled or damaged and routinely between patients Protected surfaces will be disinfected at the end of each day or if contamination is evident

46 Clinical Contact Surfaces Clinical contact surfaces not protected by barrier must be disinfected with an Environmental Protection Agency (EPA) registered intermediate level disinfectant between patients This process is accomplished by first cleaning the surface with a moist Cavi- wipe and then re-wiping the surface with a second Cavi-wipe

47 Housekeeping Surfaces Do not come into contact with patients or devices Limited risk of infectious disease transmission

48 Housekeeping Surfaces Cleaning of housekeeping surfaces in the operatory/laboratory is the resident s/student s responsibility Housekeeping surface cleaning is accomplished by a single wipe with a moist Cavi-wipe

49 Cleaning and Disinfection Upon completion of patient care, cleaning and disinfection are the resident s/student s responsibility Use barrier precautions (e.g., gloves, masks, protective eyewear) when cleaning and disinfecting

50 Cleaning and Disinfection Following patient treatment and before returning instrument cassettes to a receiving area, the resident/student will remove any gross amounts of blood and debris and return instruments to their proper position in the cassette Sharp edges should not protrude through cassette openings

51 General Clinic Cleanliness Upon completion of patient treatment and following environmental decontamination procedures, gloves are to be removed and discarded into commercial waste containers located in patient treatment areas unless saturated with blood Blood-saturated infectious waste is to be disposed of in one of the red biohazard receptacles located in all clinical areas

52 Sharps Used syringe needles are not to be purposefully bent, broken, sheared, or otherwise manipulated by hand If it is necessary to recap a used needle, an on- handed scoop method is expected All sharps, such as syringes, needles, scalpel blades, anesthetic carpules, burs, endodontic reamers, files, and orthodontic wire, are only to be disposed in a sharps container All used sharps are considered to be potentially infectious and will be handled with caution to prevent unintentional injuries

53 Dental Unit Waterlines and Biofilm Microbial biofilms form in small bore tubing of dental units Biofilms serve as a microbial reservoir For routine dental treatment, the water must meet regulatory standards for drinking water

54 Dental Unit Water Quality All dental units at the SDM are supported by selfcontained water-systems Water is purified through an iodine filtering rod in the unit Clinical staff members and students are charged with maintaining the water system following the dental unit maintenance protocol

55 Dental Laboratories Dental prostheses, appliances, and items used in their making are potential sources of contamination Handle in a manner that protects patients and personnel from exposure to microorganisms

56 Dental Laboratories All dental prostheses and impressions must be disinfected prior to entering and before leaving the laboratory Disinfection protocols to prevent cross-contamination between dental offices and prosthetic laboratories are in place Wear appropriate PPE until disinfection has been completed

57 Dental Laboratories Masks and compliant eye protection (over-glasses, eyeglasses with side shields or face shields) must be worn when using any rotary tools including lathes, model trimmers, and handpieces

58 Dental Laboratories Gloves may be used when handling pumice but must be removed when using dental lathes Hair and loose clothing must be restrained

59 Supplemental Materials UPSDM Clinic Manual Exposure Control Plan Accident / Injury / Exposure Incidents Videos Instrument Processing and Sterilization Cubicle setup Cubicle breakdown Impression technique NOMAD Centers for Disease Control and Prevention Website

60 You have now completed the Bloodborne Pathogen Annual Training Module. Please click below to fill out the completion form and upload verification into Credential Keeper BLOODBORNE PATHOGEN FORM