Controlling infection is essential. Every clinical member of staff receives training in all aspects of infection control, including decontamination of equipment, as part of their induction programme and through regular update training. This policy describes the routines for our practice that you must always follow. If there is any aspect that is not clear, please ask Dr. A. ogunro/Dr.K.Banai.
Minimising blood-borne virus transmission
All staff are immunised against hepatitis B. Records of hepatitis B seroconversion are held securely by the practice to maintain confidentiality. If you do not seroconvert or cannot be immunised, we will seek advice on the appropriate course of action.
We routinely use ‘safer sharps’, which have a shield or cover which slides or pivots to cover the needle after use. If we need to use traditional, unprotected sharps, we will follow procedures for safe use and disposal.
If you receive an inoculation injury, you must follow the practice policy and allow the wound to bleed, wash it thoroughly under running water and cover it with a waterproof dressing. The practice policy for dealing with inoculation injuries in the practice policies folder. You should record the incident in the accident book.
All inoculation injuries must be reported to Mrs. Dilhani Silva who will assess whether further action is needed (seeking advice as appropriate) and maintain confidential records of these injuries. If you are considered to be at risk of hepatitis B, we will refer you Occupational Health, Tele 01234792123, Bedfordshire NHS Trust for post-exposure prophylaxis advice.
Decontamination of instruments and equipment
We provide training to all staff to ensure they are competent to decontaminate existing and new reusable dental instruments. We keep records of all training provided. In summary:
- Single-use instruments and equipment must never be reused and must be disposed of safely.
- Re-usable instruments must be decontaminated after use to ensure they are safe for reuse. You must always wear gloves and eye protection when handling and cleaning used instruments.
- New instruments must be decontaminated before use, according to the manufacturer’s instructions. Wherever possible, we will purchase instruments that can withstand automated cleaning by a washer-disinfector or an ultrasonic cleaner.
Contaminated instruments are transferred to the decontamination area for reprocessing, following the practice procedure, which in the practice policies folder.
Cleaning
Rinse instruments thoroughly by immersion using satisfactory mains water and dry them using non-linting cloths.
Where instruments are cleaned manually, we follow the practice policy for manual cleaning. The policy Is in the Practice Policies folder.
Inspection
After cleaning, inspect instruments for residual debris and check for any wear or damage using task lighting and a magnifying device. If residual debris is present, remove it by hand following the practice manual cleaning protocol and then re-clean the instrument.
Sterilisation
Where instruments are stored for use later, they are wrapped or put in pouches prior to being placed in the autoclave and sterilised according to manufacturer’s instructions. Following sterilisation wrapped instruments stored in clean, enclosed cupboards, drawers or boxes and ordered to allow first-in, first-out stock rotation. They are stored for upto one year; after this, instruments are reprocessed. Instruments for same-day use do not need to be wrapped.
Impressions and laboratory work
Dental impressions are rinsed until visibly clean and disinfected by Perform ID as recommended by the manufacturer and labelled as ‘disinfected’ before being sent to the laboratory. Technical work being returned to or received from the laboratory should be disinfected and labelled.
Hand hygiene
Nails must be kept short and clean and free of nail art, permanent or temporary enhancements (false nails) or nail varnish.
Between each patient, before putting on or removing gloves, you should either wash your hands or use anti-bacterial hand gel.
- The handwashing technique is displayed at each hand-wash sink. Avoid using nail-brushes as they can cause skin abrasion.
- You wash your hands for 20senconds or more
- If your hands appear clean, you can use antibacterial hand gel using the same techniques as for handwashing. You should limit the number of applications and, if your hands become ‘sticky’, you should wash them using liquid soap.
At the end of each session and following handwashing, use hand cream to counteract dryness. Do not use hand cream under gloves as it can encourage the growth of micro-organisms.
Waste disposal
We provide training in handling, segregating and storing healthcare waste generated by the practice.
All clinical healthcare waste is classified as ‘hazardous’ waste and placed in orange sacks for collection. Clinical waste sacks must be no more than three-quarters full, have the air gently squeezed out to avoid bursting when handled by others, labelled according to the type of waste and tied at the neck, not knotted.
Sharps waste (needles and scalpel blades etc) are disposed of in UN-type approved puncture-proof containers (to BS 7320), and labelled to indicate the type of waste. Sharps containers are disposed of when no more than two-thirds full.
Clinical waste and sharps waste are stored securely in the locked cupboard at the back before collection for final disposal by Initial Medical which holds a certificate of registration with the Environment Agency.
Dental amalgam and developer and fixer solutions are disposed of as hazardous waste.
When waste is collected by the waste carrier, we receive a consignment note, which is kept by the practice for 3 years. All consignment notes should be given to Mrs. Dilhani Silva.
Personal protective equipment
We provide training in the correct use of PPE as part of our staff induction programme and regular updates to all staff, especially if new PPE is introduced.
PPE includes protective clothing, disposable clinical gloves, plastic disposable aprons, face masks, and eye protection. Household gloves must be worn when handling and manually cleaning contaminated instruments. Footwear must be fully enclosed and in good order.
The clinical gloves provided by the practice are CE-marked and single-use; they must be disposed of as clinical waste. You must inform Mrs. Dilhani Silva immediately if you develop a reaction to the gloves.
You must ear domestic household gloves when undertaking decontamination procedures. After each use, they should be washed with detergent and hot water to remove visible soil and left to dry. We replace these gloves weekly and more frequently if they are torn or cannot be cleaned.
Plastic aprons must be worn during all decontamination processes. The aprons are single use and must be disposed of as clinical waste. You should remove it by breaking the neck straps and gathering the apron together, touching the inside surfaces only.
Face and eye protection must be worn during all operative procedures. They are single use items and must be disposed of as clinical waste.
If you wear spectacles that do not provide sufficient eye protection, you must protect your eyes by wearing a (disposable) visor or face shield. You should clean your eye protection when it becomes visibly dirty and/or at the end of each session.
Protective clothing worn in the surgery must not be worn outside the practice premises. Surgery clothing must be clean and freshly laundered; it should be washed at the highest temperature recommended for the fabric.
Blood spillage
If a surface becomes grossly contaminated with blood or blood/saliva, you must decontaminate it using hypochlorite at 1000 ppm available chlorine, leaving it in contact with the surface for at least five minutes. Do not use alcohol at the same time.
General cleaning
The practice cleaning policy in the Domestic Cleaning folder. Cleaning equipment stored outside patient care areas in staff utility area.
Date of policy: 16th March 2020 – Dilhani Silva
Review date: 16th March 2021
