Advanced Infection Control

Outline

Recommended Infection-Control Practices for Dentistry

  • Confirmed Transmission of HBV and HIV and Dentistry

  • Vaccines For Dental Health-Care Workers

  • Protective Attire and Barrier Techniques

  • Handwashing and Care of Hands

  • Use and Care of Sharp Instruments and Needles

  • Sterilization or Disinfection of Instrument

  • Cleaning and Disinfection of Dental Unit and Environmental Surfaces

  • Use and Care of Handpieces, Antiteraction Valves, and Other Intraoral Dental

  • Devices Attached to Air and Water Lines of Dental Units

  • Single-Use Disposable Instruments

  • Handling of Biopsy Specimens

  • Disposal of Waste Materials

Bloodborne Disease Transmission

  • Universal Precautions for Prevention of Transmission of HIV and Other Bloodborne Infections

    • Gloving, Gowning, and Other Protective Barriers as Part of Universal Precautions
  • Needlestick Precautions

  • Disinfection and Sterilization Practices

  • Management of Occupational Exposures to Bloodborne Pathogens

Recommendations for Preventing Transmission of HIV and HBV to Patients During Exposure-Prone Invasive Procedures

  • Transmission of HBV During Invasive Procedures

  • Hepatitis B Immunization

  • Transmission of HIV During Invasive Procedures

Instrument Processing

Percutaneous Injury Prevention

Dental Unit Waterlines

  • Statement from CDC Regarding Biofilm and Dental Unit Water Quality

Learning Objectives

After completing the course, you'll be able to:

 

  1. Define universal precautions and emphasize their application in dental practice.
  2. Explain the importance of hepatitis B vaccination for all DHCWs who have direct or indirect contact with patient's blood and/or saliva. Describe hand washing and hand care techniques for DHCWs.
  3. Explain the correct use of personal protective equipment such as gloves, surgical masks, protective eye wear, protective clothing and utility gloves in a dental office.
  4. Describe proper instrument sterilization techniques.
  5. Develop an effective environmental surface and equipment asepsis protocol keeping in mind touch surfaces, transfer surfaces and splash/spatter surfaces.
  6. Describe appropriate waste disposal methods for regulated and unregulated items.
  7. Outline radiographic asepsis procedures.
  8. Develop policy and procedures for the treatment of dental patients with active or suspected infection with tuberculosis.
  9. List the 3 conditions that have to be present in the "chain of infection" in order to cause an infection.
  10. Describe proper procedures for the use and handling of toothbrushes among patients.
  11. List the 3 conditions that have to be present in the "chain of infection" in order to cause infection.
  12. Discuss the epidemiology of bloodborne disease transmission and the potential for HIV, HBV and HCV transmission.
  13. Discuss barrier precautions to be used to minimize infection.
  14. Demonstrate the proper use of gloves, eyewear, gowns and other protective equipment.
  15. Discuss the precautions a dental health care worker should take to prevent injuries caused by needles and other sharp instruments.
  16. Describe procedures for the processing of contaminated dental instruments from the point of retrieving the instruments from chairside to the presentation of sterile instruments at the point of reuse.
  17. Outline procedural steps for instrument processing including: transport, cleaning, packaging, sterilization, storage, delivery, and quality assurance program.
  18. List 4 heat sterilization methods–steam autoclave, dry heat (oven-type), dry heat (rapid heat transfer) and unsaturated chemical vapor–with the advantages and precautions of each method.
  19. Properly decontaminate critical, semicritical and noncritical items using salient sterilization methods.
  20. Select appropriate chemical germicides with FDA and EPA classifications to disinfect contaminated environmental surfaces.
  21. Identify proper sterilization methods for handpieces.
  22. Follow the proper procedure for the disposal of sharp instruments and infectious waste.
  23. Follow practice recommendations for health-care facilities implementing the U.S. Public Health Service Guidelines for management of occupational exposures to bloodborne pathogens.
  24. Define an occupational exposure that may place a worker at risk for HIV or HBV infection.
  25. Identify factors that may determine the overall risk for occupational transmission of a bloodborne pathogen and quantify the risk of infection following an exposure.
  26. List the things to do following an exposure to the blood of a patient.
  27. Quantify the risk of infection for HBV, HCV and HIV after an occupational exposure to the blood of a patient.
  28. Describe the treatment for the exposure including vaccination and drugs.
  29. Implement the six recommendations made by the CDC to minimize the risk of HIV or HBV transmission.
  30. Recognize the importance of making available to all employees the hepatitis B vaccine and vaccination series to all employees who have occupational exposure to bloodborne pathogens.
  31. List 3 circumstances under which it is not necessary to make available the hepatitis B vaccination series to employees.
  32. Describe the post-exposure evaluation and follow-up plan that complies with OSHA standards.
  33. Describe actions strategies to prevent percutaneous injuries in a dental office using administrative, engineering, work practice and personal protective equipment controls.
  34. Identify essential elements of the confidential medical evaluations and follow-up after an occupational exposure to blood or OPIM.
  35. Describe the procedures to follow for source individuals involved in an exposure incident who consent to testing and those who do not give consent.
  36. Describe action strategies to prevent percutaneous injuries in a dental office using administrative, engineering, work practice and personal protective equipment controls.
  37. Describe and provide a rationale for the use of methods to improve and maintain the quality of water used in dental treatment.
  38. Explain why low-temperature water heating systems in dental units should not be used.
  39. Take 4 recommended steps to provide quality water for dental treatment and ensure a safe and healthy environment for patients and staff.
  40. Define various terms used in infection control in dental unit waterlines.
  41. Discuss the formation of biofilm in waterlines and the potential for infection in a dental unit.
  42. Enunciate ADA's goal for bacteria levels in dental treatment water.
  43. Discuss the risk of contamination from an infected patient to other patients from cross-connections in dental units.
  44. Explain the possibility of contamination of public water supplies with bloodborne viruses such as HBV and HIV.
  45. Describe the procedures to be used in a dental office during boil-water advisories.
  46. Describe the steps that should be taken after the boil-water advisory is canceled.

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.