The testing, monitoring and validation of decontamination equipment and processes is a vital part of any practice’s infection control policy. Not only does this ensure that equipment is functioning according to pre-set parameters, but it also means that the required data can be properly recorded by those responsible, to ensure compliance with HTM 01-05, CQC, SDCEP and other relevant local guidelines.
This monitoring of decontamination processes is now required across the dental industry. A comprehensive list of what needs to be monitored, how often, and by whom, as well as details of the required documentation is freely available in the guidelines, all of which provides further evidence of
compliance for practices.
Although this may seem to be yet another layer of administration for an already overburdened profession, this documentation provides necessary
evidence of completed and successful decontamination and a failure to provide it for any specified item indicates an omission of that item. To maintain a routine testing schedule simply requires organisation planning and education of those involved in the monitoring process. Documentation of the full details and results of daily, weekly, quarterly and yearly tests must be kept. Failure to carry out routine tests and maintenance tasks can compromise safety and have legal and insurance implications for the practice
owner and/or manager.
Despite the demands of monitoring and recording there are a number of easy-to-use products now available that help make these tasks easier and provide everything a practice needs to fully audit the performance of washer disinfectors, ultrasonic baths and autoclaves on a daily, weekly and quarterly basis.
For example, it is recommended in HTM 01-05 that for vacuum autoclaves a steam penetration test is carried out on a daily basis, using either a Helix Device or Bowie and Dick. This SPT (steam penetration test) checks that the steam is able to reach the wrapped instruments at the required temperature, for the required time, and is therefore adequately sterilising the instruments.
There are two main versions of SPTs:
a Bowie and Dick is a single use card (class 2 indicator) that provides a clear, accurate colour change, which is easy to interpret and record. The Helix Device, on the other hand, is a reusable device used in conjunction with a single use chemical indicator strip that changes colour from pink to black, thereby demonstrating the correct sterilisation conditions have been met. This also provides a permanent record of compliance.
Water quality
The quality of both input and output water in dental unit water lines is another area that needs to be regularly monitored to ensure the quality of water going through dental unit water lines and into patients’ mouths is within the limits specified in the guidance (HTM01-05 section 6.79 requires water quality of >200 cfu/ml). If water quality is not regularly checked and treated, this can lead to a build-up of biofilm within the unit, causing water quality to fall below prescribed limits. Regular
treatment with an alcohol free, pH neutral biofilm remover will provide effective protection against the bacteria that make up biofilm and inhibit its regrowth.
Water testing kit
To help practices monitor water quality in their DUWLs, there is now a testing kit and monitoring service available. The water testing kits enable practices to take a small sample of both input and output water (from their DUWLs) and have each of these tested by a third party laboratory to assess contamination levels. Dentisan’s laboratory provides such a test and since its recent launch has tested water from over 40 practices, each of which now either has evidence that their water quality is within safe limits, or is taking remedial action and will submit further samples for future testing. These tests not only provide
peace of mind for those responsible for decontamination compliance, but also the report produced provides clear evidence that water quality is being taken seriously by the practice.
Be compliant
The accurate and consistent monitoring of dental equipment is vital in today’s regulatory and compliancepreoccupied society, but is ultimately driven by a desire to safeguard patients and treat them in a clean, and where required, sterile environment. The traceability of instruments and the ability to track individual usage to a particular procedure is currently only used in surgical and medical spheres, however it is surely only a matter of time before these regulations impact in some way on the dental profession.
With the requirements for cleaning and sterilisation procedures now stricter than ever, there is undoubtedly an added pressure on decontamination leads to remain vigilant in all aspects of compliance and any contribution that can be made to easing this workload is welcome. Maintaining the correct level of testing and monitoring for all equipment provides clear evidence that a dental practice is compliant and carrying out their duty of care appropriately, helping to safeguard both patients and staff alike.