Basic Guide To Infection Prevention And Control In Dentistry

by Pankhurst, Caroline; Coulter, Wilson

• ISBN13: 9781405176620
• ISBN10: 1405176628
• Edition: 1st
• Format: Paperback
• Copyright: 2009-04-06
• Publisher: Wiley-Blackwell

Summary

This new title in the 'Basic Guide' series offers practical information for all members of the dental team on the prevention and control of infection; with clear explanations of the key issues and concepts, an orientation of the evidence base and legal framework as well as step-by-step guidance on the safe running of a dental practice.

Author Biography

Dr Caroline Pankhurst BSc BDS MSc Ph.D MRCPath, is a former Clinical Senior Lecturer at the Dental Institute of King's College, London and a Specialist in Oral Microbiology.

Dr Wil Coulter BSc, BDS, PGCert Ed, MSc, PhD, FRCPath, is a Consultant/Reader in Oral Microbiology in the School of Medicine and Dentistry Queens University Belfast and the Belfast Hospital Trust.

The authors are dentally qualified medical microbiologists and members of the Royal College of Pathologists with extensive experience in the field of infection control in dentistry. They have published a number of scientific studies in the field, the findings of which have been presented at numerous conferences. Drs Pankhurst and Coulter serve on government advisory bodies on infection control and decontamination, and teach dentists, nurses, therapists and hygienists at both pre- and post qualification level.

Table of Contents

Essentials of infection control	p. 1
Why do we need infection control in dentistry?	p. 1
Relative risk and risk perception	p. 2
Risk assessment and the management decision-making process	p. 3
How to perform a risk assessment in a dental practice	p. 4
Hierarchy of risk management control	p. 6
Infection control and the law	p. 7
Legal acts under which dental practice is conducted	p. 8
Published standards and guidance	p. 10
Team approach to prevention of infection	p. 13
References and websites	p. 15
Communicable diseases in the dental surgery	p. 16
How infections are spread	p. 16
Reservoirs and sources of infection	p. 17
Infectious disease by route of transmission in the dental surgery	p. 18
Emerging and re-emerging pathogens	p. 26
References and websites	p. 30
Further reading	p. 31
Occupational health and immunisation	p. 32
Provision of occupational health	p. 32
Building a culture of safety	p. 33
Organising staff health in your practice	p. 35
Immunisation requirements for dentistry	p. 37
Protecting women of childbearing age	p. 37
Who should be immunised against hepatitis B?	p. 41
Health clearance and the consequences of blood-borne virus infection	p. 43
Health clearance	p. 44
Health clearance for registration with the general dental council	p. 46
References and websites	p. 47
Sharp safe working in the dental surgery	p. 48
Why sharps prevention is important	p. 48
When do sharps injuries occur	p. 50
Preventable sharps injuries	p. 50
How to avoid having a sharps injury	p. 51
Use of safety devices	p. 52
How to avoid sharps injuries-sharp safe disposal	p. 54
Managing sharps injuries	p. 56
Occupational health risk assessment for BBV exposure	p. 57
Management of hepatitis C exposures	p. 58
Post-exposure prophylaxis	p. 60
Recording of sharps injuries	p. 61
Clinical governance and accident risk assessment	p. 62
References and websites	p. 62
Further reading	p. 63
Hand hygiene	p. 64
Hands as a source of infection	p. 64
Hands as a source of hospital-acquired infection	p. 65
Hand hygiene and teamworking	p. 65
Hand hygiene technique	p. 69
Hand care and prevention of irritant dermatitis	p. 73
References and websites	p. 75
Personal protection for prevention of cross-infection	p. 76
The role of gloves	p. 76
Choosing a suitable glove for the task	p. 78
Managing an allergy to NRL gloves	p. 78
Managing latex allergies in patients	p. 80
Masks, visors and goggles and the protection of mucous membranes and the airway	p. 81
Types of masks and when to use them	p. 81
Protection during cardiopulmonary resuscitation	p. 85
Protective eyewear and visors	p. 85
Protective eyewear	p. 86
Tunics and uniforms	p. 88
Protective barriers-plastic aprons and surgical gowns	p. 90
References and websites	p. 92
Further reading	p. 92
Sterilisation and disinfection of dental instruments	p. 93
Decontamination cycle	p. 93
Why has cleaning become so important?	p. 94
Legal requirements and technical standards for decontamination	p. 95
Where should instrument decontamination take place?	p. 96
Design of dedicated decontamination units	p. 97
Presterilization cleaning of dental instruments	p. 102
Cleaning of dental handpieces	p. 104
Mechanical cleaning with an ultrasonic bath	p. 105
Thermal washer disinfectors	p. 106
Instrument inspection	p. 108
Dental instrument sterilization	p. 108
Suitability of steriliser for different loads	p. 108
Steriliser installation and validation	p. 109
Selecting the correct temperature, pressure and time for sterilization	p. 110
Steam purity and maintenance of water reservoir chamber	p. 110
Maintenance of the steriliser water reservoir	p. 111
How do you know your steriliser is working?	p. 112
Loading the steriliser	p. 115
How to operate the steriliser	p. 116
Storage of wrapped and unwrapped instruments	p. 117
Single-use items	p. 119
Single-use instruments and vCJD	p. 121
Disinfection of heat-sensitive equipment	p. 122
Disinfection of dental impressions	p. 123
Further reading	p. 124
Dental surgery design, disinfection and managing aerosols	p. 125
Dental surgery design	p. 125
Surface cleaning and decontamination	p. 128
Management of aerosols and splatter	p. 135
Managing large blood or body fluid spillages	p. 137
References and websites	p. 139
Dental unit waterlines	p. 140
What are biofilms?	p. 140
Risk to staff and patient health from dental unit waterlines	p. 140
Methods to reduce the biofilm	p. 145
Control of legionellae in dental unit waterlines	p. 150
References and websites	p. 151
Further reading	p. 151
Health care waste management	p. 152
Legislation on hazardous waste disposal	p. 152
Types of waste	p. 153
What is hazardous waste?	p. 154
Hazardous waste regulations and the European waste catalogue code	p. 156
Amalgam waste and installation of amalgam separators	p. 160
Segregation and disposal of clinical waste	p. 163
Safe handling and storage of clinical and hazardous waste prior to disposal	p. 165
Transport of clinical waste	p. 166
References and websites	p. 167
Further reading	p. 167
Transport and postage of diagnostic specimens, impressions and equipment for servicing and repair	p. 168
Legal framework	p. 168
Collecting specimens	p. 168
Transport of specimens to the laboratory	p. 169
Transport restrictions	p. 171
Fixed pathological specimens	p. 172
Transporting impressions	p. 173
Equipment to be sent for service or repair	p. 173
Further reading	p. 174
Appendix	p. 175
Daily infection control clinical pathway	p. 175
Decontamination methods for specific instruments and items of dental equipment	p. 177
Hand and hard surface disinfectants and dental unit waterline biocides	p. 179
Further sources of information	p. 181
Index	p. 183
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