Over the last decade we have seen great improvements in the area of decontamination and infection control in dental practices. This is partly due to the welldocumented requirements of HTM 01- 05 and the fact that these regulations suggest that every practice should have a nominated lead member of staff responsible for infection prevention procedures.
Failure to comply with regulations could, in the worse case scenario, lead to a practice being closed for a period of time. Because of this it is really important that the whole dental team, not just the decontamination lead, is suitably trained and aware of not only their own responsibilities but also those of their colleagues. Section 9.1 of HTM 01-05 requires that “all staff involved in decontamination are suitably trained and have their roles and responsibilities defined…”
Although HTM 01-05 is not prescriptive about the system a practice should operate to ensure compliance, it does offer guidance as to which roles should be filled, two of which are the nominated decontamination lead and the designated person – these roles can be filled by the same individual. However, there is no indication that the person filling these roles needs to hold a specific qualification, nor that they should have received any prescribed training. They are simply
required to have “the experience and authority to perform this task”. In other words they need to be suitably trained to ensure all systems, procedures and records are in place, that all members of staff are trained and competent, and compliance with regulations are evidenced and audited every six months.
This leads us to ask an important question. How does a nominated decontamination lead prove they are fully competent to fulfil the requirements of HTM 01-05?
In many practices the dental nurse or hygienist is the automatic choice for the role of decontamination lead, in others the practice manager takes on this responsibility, either of these have knowledge of how the practice operates and the role of infection prevention within it. However, it is becoming more commonplace for practices to employ people specifically to run their decontamination processes, many of whom have little experience of dental practices and who, because they are not fulfilling a clinical role, do not need to be registered with the GDC. This indicates that there is a potential difference in the level of training and knowledge in the position of the decontamination lead from practice to practice.
Good training and education is fundamental to having a successful career in any profession, and dentistry is no different. I firmly believe that understanding aids learning – so it follows that to understand why surfaces and instruments should be cleaned and sterilised in certain ways, it is important to learn not only about the functionality
of cleaning equipment and products, but also to understand something about the science of bacteria and viruses and why they pose such a threat in the dental environment. Not only does this help the decontamination lead to do the best job they can, it also allows them to disseminate knowledge throughout the practice team, educating them in best practice procedures.
This sort of intra-practice training is vital to ensure best practice and the need for the whole team to be aware of the importance of decontamination is referenced in section 1.22 of HTM 01-05: “Training and education in the processes of pathogen control, decontamination, cleaning and hygiene (including hand hygiene), exposure to blood-borne viruses, and infection risk reduction, including waste disposal, should be part of staff induction programmes.”
Access to training for decontamination leads, however, can be a challenge and although there are a number of courses available many lack the detail and substance to properly educate on every aspect of infection prevention. Courses offering verifiable core CPD are of course extremely relevant for those members of the team registered with the GDC, but for the increasing numbers of unregistered individuals with decontamination responsibilities, other forms of accreditation have significant value. For example City & Guilds accreditation provides important third party validation of the quality of training received, providing a recognised qualification through which individuals
can demonstrate their knowledge and which is transferable when different roles are undertaken. That is why Dentisan has recently invested in a new purpose-built Centre for Decontamination Education in Derby. This centre will be the venue for a oneday City & Guilds accredited course which covers both the theory and practice of decontamination and I hope will provide an important contribution to better understanding throughout the profession.
Decontamination education is much more than just learning about how to keep a practice and everything within it clean and functional, it is fundamental to everything a practice does to maintain the health and wellbeing of patients and staff. Understanding the reasons behind the need for decontamination through thorough and enjoyable training can really benefit the practice as a whole because, after all, your decontamination procedures are only as good as your training.