Healthcare Consideration: Tip : To help in the role of the infection control coordinator, the hygienist or other team member may consider becoming certified in dental infection prevention. Certification demonstrates an advanced level of knowledge, standardization and proper education, and credentials to validate competency in infection prevention and control (OSAP, 2022). In addition, the Organization for Safety, Asepsis, and Prevention (OSAP) is an invaluable resource to the infection control coordinator including education and training, toolkits, conferences, and networking. OSAP is the only dental membership association for oral healthcare professionals that focuses exclusively on dental infection prevention and patient and provider safety (OSAP, n.d.). Education and training Initial and ongoing education and training are critical to ensure that dental personnel understand and follow infection control policies and procedures that are job or task specific. The policies, procedures, and guidelines contained in the office-specific plan must be clearly written, in language that personnel can understand. Training should occur upon initial assignment and should be updated when new diseases emerge and as infection control guidelines evolve. Updates should occur at least annually, whenever an employee’s tasks change and increase their risk of occupational exposure, and after an exposure incident occurs. It should be documented that all members of the Infection transmission Diseases can be spread through direct contact (with blood, oral fluids, or patient materials), indirect contact (with contaminated instruments, equipment, environmental surfaces), droplets (microorganisms generated and propelled a short distance by coughing, sneezing, or talking) or aerosols (airborne microorganisms that can remain suspended in the air for long periods). Historically, CDC guidelines focused primarily upon preventing transmission of bloodborne pathogens in the dental setting. However, the COVID-19 pandemic highlighted the need to address infections spread through other transmission routes such as droplets and aerosols. Transmission of infection through any of these routes requires that all the following conditions are present: ● A pathogen in adequate numbers and of sufficient virulence to cause disease. ● A source or reservoir that allows the pathogen to survive and multiply. ● A mode of transmission from the source to the host. ● A portal of entry through which the pathogen can enter the host. ● A susceptible host (one who is not immune). When all these conditions are present and a pathogen is successfully transmitted, it is termed the chain of infection (see Figure 1). The goal of infection control is to break one or more links in this chain (CDC, 2016a).
Healthcare Consideration: Tip : To help with early detection and management of potentially infectious persons at initial points of patient encounter, CDC provides a COVID-19 Facility Access Tool that provides a screening questionnaire for all who enter the healthcare facility (CDC, 2022c).
dental practice have been informed of, and trained on, any updated practices and procedures. Training records should be maintained according to state and federal requirements. Healthcare Consideration: Tip : CDC provides a free web-based, interactive, and self-paced online training called “Foundations: Building the Safest Dental Visit “designed to help adherence with infection control practices (CDC, 2021d). Basic Expectations for Safe Care learning modules (CDC, 2021c) may also be used to train new personnel or to ensure compliance with all personnel.
Figure 1: Chain of Infection Transmission
Note . From CDC/NIOSH Chain of Infection Components. https://www.cdc.gov/niosh/learning/safetyculturehc/module-2/3.html
STANDARD AND TRANSMISSION-BASED PRECAUTIONS
1. Hand hygiene. 2. Use of personal protective equipment. 3. Respiratory hygiene/cough etiquette.
Standard precautions are the minimum infection control practices that apply to all patient care regardless of the suspected or confirmed infection status of the patient (CDC, 2016a). Standard precautions are designed to protect dental personnel and prevent the spread of infections among patients. The elements of standard precautions include:
4. Sharps safety (engineering and work practice controls). 5. Safe injection practices (i.e., aseptic technique for parenteral medications). 6. The delivery of sterile instruments and devices. 7. Clean and disinfected environmental surfaces.
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