In addition, there should be visual cues to remind staff and patients of proper ways to prevent spread of respiratory pathogens. These include posters to Cover your cough, and to notify staff immediately if the patient has any respiratory symptoms (CDC, 2022e).
Self-Assessment Quiz Question #2 A dental hygienist has children at home who are sick. After several days of caretaking for their children, they too develop symptoms of a respiratory illness including sore throat, runny nose, and a fever. They notice these symptoms as they awaken on a workday with a schedule full of patients. The dental hygienist should: a. Come to work anyway as they do not want to leave their workplace shorthanded. b. Come to work with universal source control (i.e., wear a mask all day) c. Call their employer as soon as possible and stay home until symptoms reside. d. Work half a day so they can come home to rest in the afternoon. safer designs of instruments and devices to prevent exposure to contaminated sharps. Examples include anesthetic syringes with safety features, needle capping devices, and special containers for contaminated sharp instruments. Disposable syringes and needles, scalpel blades, and other sharp items should be placed in an appropriate puncture-resistant container located as close as possible to the area where the item is used. Work-practice controls are behavior-based and focus on conducting tasks in ways that reduce the likelihood of exposure (CDC, 2015). An example is the single-handed scoop technique for recapping of needles—never using two hands.
Sharps safety Sharp items that are contaminated with patient blood and saliva are considered potentially infective, and engineering controls and work practices should be established to prevent injuries. Dental hygienists and all team members must try to avoid occupational exposure to potentially infectious body fluids. Since many hygienists are now licensed to administer local anesthesia, their exposure risks due to needlestick injuries and other sharp objects are increasing. Fortunately, exposure risks in dentistry are rare and for the most part preventable. Engineering and work-practice controls help prevent exposure incidents. Engineering controls are generally technology based and incorporate Safe injection practices Safe injection practices are intended to prevent transmission of infectious diseases between patients and/or dental personnel during the preparation and administration of parenteral medications (CDC, 2016g). Since the dental
hygienist is typically not involved with the preparation or administering of intravenous or intramuscular injections, this information will not be covered in this course.
STERILIZATION AND DISINFECTION OF PATIENT-CARE ITEMS
they must be heat sterilized. Semicritical items are instruments that touch mucous membranes and have a lower risk of infection transmission during use. These items should also be sterilized using heat or processed with a high-level disinfectant if they are heat sensitive. Noncritical items merely contact intact skin and include such items as radiograph heads and blood pressure cuffs. These items pose the least risk of infection transmission during use and may be cleaned or, if visibly soiled, cleaned and then disinfected with an EPA-registered low- to intermediate- level hospital disinfectant. It is important to note that as more high-tech devices are introduced into the field of dentistry, limitations of the Spaulding classification become evident. Many items such as curing lights, intraoral radiology sensors, oral camera wands, and digital impression wands fall into the category of semicritical, yet these items are not able to withstand heat sterilization. In these instances, consult the manufacturer about appropriate barriers and instructions for disinfection and sterilization. To ensure safety and quality control, all instruments in the dental office should be processed in a designated central processing area that is divided into four sections: 1. Receiving, cleaning, and decontamination of instruments. 2. Preparation and packaging. 3. Sterilization. 4. Storage.
Instrument processing is cyclical journey that instruments go through to ensure they are safe for use on subsequent patients. The process requires multiple steps using specialized equipment and devices. Each dental facility should have individualized protocols in place for transportation, cleaning, packaging, and sterilization of instruments that may be contaminated. General guidelines include: 1. Cleaning and reprocessing reusable dental equipment according to manufacturer instructions. If the manufacturer does not provide such instructions, the device may not be suitable for multipatient use. 2. Having manufacturer instructions for reprocessing reusable dental instruments/equipment readily available, ideally in or near the reprocessing area. 3. Assigning responsibilities for reprocessing of dental equipment to dental personnel with appropriate training. 4. Maintaining sterilization records in accordance with state and local regulations. The Spaulding classification system differentiates infection risks associated with contaminated dental instruments. Patient-care items are categorized in the system as critical, semicritical, or noncritical, and methods of decontamination must be provided by the manufacturer (CDC, 2019b). Examples of critical dental hygiene items include periodontal scalers and probes. Because infection transmission risk is the greatest when using these items,
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