The application of standard infection control precautions (SICPs) is essential for any forward-thinking practice to ensure patient safety. It’s important that we, as a profession, make things achievable and are able to evidence that we are applying ICPs effectively
The introduction of HTM 01-05 has driven change across the dental industry in England and Wales, raising awareness of decontamination and infection control and practice standards significantly over the past decade. However, in order to continue its success, facilitation will be key to the process, bringing people with you and persuading them that such procedures can be integrated within their everyday activity until it becomes engrained behaviour.
Driving forces
One of the major drivers for change has been patient perception. As their knowledge and awareness of patient safety and the transmission of infection increased, so did their expectations.
Safeguarding both the patient and staff alike are imperative for compliance and every practice must have a robust infection control policy in place. It is the responsibility of the individual dentist to ensure that all members of the team have the knowledge and skills to carry out the necessary procedures in order to be compliant.
As with most things, time, cost and changing attitudes and behaviour are the biggest challenges. There is a perception that compliance is an additional process on top of the existing myriad of duties practices have to perform, but by implementing the correct procedures and explaining how they can be efficiently integrated into the practices’ day to day activity, and not an extra task, there is hope for all. Of course, there will be initial capital costs and on-going costs but improved efficiency will prove its
worth.
General infection prevention advice
Personal protective equipment (PPE) is an essential part of barrier protection in infection control. Suitable PPE must be worn for specific jobs. HTM 01-05 states that appropriate PPE must be worn during decontamination procedures that present risk of inoculation or injury. This can include clinical and household gloves, aprons, facemasks, eye protection and adequate footwear. If any of these are of poor quality, easily torn or damaged, or too porous, then they are likely to be inappropriate.
Practices should choose products, equipment and processes that are effective – and don’t add time to tasks. The use of single-use items, such as clinical gloves, aprons and facemasks, which are changed and disposed of after each procedure, and between patients, is essential. Naturally this has some cost implications for practices so choosing reputable suppliers who reward you through guaranteed high quality products at reasonable costs makes sense.
During cleaning routines there is a risk to staff of contaminated fluids such as blood and saliva splashing onto the face, so proven and reliable facemasks and eye protection must be worn. Masks and gloves should be hypoallergenic and latex-free to prevent discomfort and skin irritation. If instruments are being processed in a vacuum autoclave, using self-sealing pouches to package them before processing would be recommended.
The cleaning and maintenance of dental equipment is crucial to any surgery’s daily routine. Three-inone tips should be disposable, as it is virtually impossible to clean the fine bore lumens of items like this. The use of high quality and low cost disposable tips with good air and water separation are effective and essential to minimise the risk of cross-contamination related to the reuse of metal tips.
Trained to comply
Any practice struggling to implement adequate infection control procedures should access suitable training and education for the whole dental team. In-house training with an expert who can look at how the practice operates and suggest and implement
changes with the whole team is highly recommended.
Moving forward, the best advice, and as recommended under the Code of Practice, is to nominate an experienced team member to take responsibility for infection control and decontamination, and regularly audit and review processes to continually look for where improvements can be made.