Dental Lab Microbial Hazards

• Hand hygiene is an important infection control measure.
• Hand hygiene protects patients and healthcare workers.

Microbial Hazards

• Dental labs are high-risk environments due to microbial contamination from patient materials.
• Infection can spread through direct contact, indirect transmission, and airborne/droplet means as well as cross-contamination between workstations.

Common Microorganisms - Bacteria

• Streptococcus mutans causes dental caries and is found in saliva.
• This bacteria also inhabits dental impressions.
• Mycobacterium tuberculosis causes tuberculosis.
• Tuberculosis transmits through aerosols and contaminated instruments.
• Staphylococcus aureus (MRSA) causes skin infections and pneumonia.
• MRSA is often found on contaminated hands and surfaces.

Common Microorganisms - Viruses

• Hepatitis B (HBV) and Hepatitis C (HCV) cause liver infections and have a high transmission risk through blood, saliva, and dental tools.
• Human Immunodeficiency Virus (HIV) weakens the immune system, it transmits through blood-contaminated materials.

Common Microorganisms - Fungi and Prions

• Candida albicans is a fungus causing oral and systemic infections, often found on dentures and in moist environments.
• Prions cause Creutzfeldt-Jakob Disease (CJD), a rare, fatal neurodegenerative disease.
• Prions transmit via contaminated dental instruments.

Types of Hand Hygiene

• Handwashing effectively removes germs, dirt, and contaminants.
• Hand sanitizing quickly kills germs when soap and water aren't available.
• Surgical hand asepsis uses antiseptic solutions to reduce the number of germs on the hands before surgical procedures.

Role of Hand Hygiene

• Hand hygiene removes germs to prevent their spread.
• Limits the transmission of harmful microorganisms.
• Handwashing provides healthcare safety and reduces the spread of illness between people.

Importance of Hand Hygiene

• It is a cornerstone of infection prevention, dramatically reducing risks.
• Healthcare workers ensure patient safety through hand hygiene.
• Hand hygiene minimizes hospital-acquired infections, decreasing costs.
• Effective practices protect patients and the broader community.

Proper Handwashing Techniques

• Wet hands with clean, running water, warm or cold.
• Apply enough soap to cover all surfaces.
• Rub hands together for at least 20 seconds while ensuring all surfaces are cleaned.

Common Hand Hygiene Misconceptions

• Handwashing alone is not sufficient for infection control.
• Alcohol-based hand rubs are not as effective as soap and water.
• Wearing gloves does not replace the need for hand hygiene.
• Consistent hand hygiene practices can be difficult due to busy schedule constraints.

Pathogen Transmission

• Close contact increases infection risks.
• Pathogens spread through contaminated surfaces and a lack of hand hygiene.
• Transmission routes include airborne, droplet, and direct contact.

The Five Moments for Hand Hygiene

• Before patient contact: to protect the patient
• Before an aseptic task: to prevent infection
• After body fluid exposure: to protect yourself
• After patient contact: to protect yourself
• After contact with patient surroundings: to protect the environment
• Key moments during patient care are important to interrupt pathogen transmission.

Before Patient Contact

• Washing reduces germ transmission risk.
• Cleanliness ensures no harmful microbes are introduced.
• Protective measures are used to ensure safety.

Before Aseptic Tasks

• Handwashing is crucial before any procedure involving sterile equipment.
• Handwashing prevents microorganism introduction.
• Hand hygiene ensures patient safety.

After Body Fluid Exposure

• Hand hygiene is essential after any bodily fluids exposure.
• Washing minimizes contamination risk.
• The safety protocol is essential for healthcare professionals and patients.

After Patient Contact

• Washing prevents germ spread from the patient.
• Handwashing is an essential routine.
• Hand hygiene shows patient-centered care and wellbeing.

After Contact with Patient Surroundings

• Bedrails: frequent touch points harbor microbes
• Medical equipment: germs easily transfer to hands
• Tables and chairs: surfaces touch by multiple people may be contaminated

Proper Techniques

• Soap and water: wet hands, apply soap, rub together for at least 20 seconds, rise, and dry.
• Sanitizer: dispense enough product and rub until dry. Making sure the sanitizer covers all surfaces.

Handwashing vs. Hand Sanitizing

• Handwashing removes visible dirt and needs soap and water, which can be time-consuming in busy settings.
• Sanitizer quickly kills microbes and is more accessible.

Barriers to Effective Hand Hygiene

• Lack of time is a common justification.
• Sinks/sanitizers being out of reach prevents effective handwashing.
• Constant washing may cause skin irritation.
• Providers can forget hand hygiene because of the high pace of work.

Hand Hygiene Education and Training

• The education and training teaches proper techniques.
• Hand hygiene highlights the critical role in awareness.
• Hand hygiene encourages consistent practice in behavior modification.

Hand Hygiene During Emergencies

• Implement enhanced hygiene procedures by escalating protocols.
• Ensure availability of supplies by addressing supply shortages.
• Train staff to implement the right techniques through continuous education.
• "Monitoring Vigilantly" tracks compliance and adapts to needs.

Hand Washing

• Use running water to wet the hands.
• Lather well after applying soap.
• Scrub hands for at least 20 seconds.
• Make sure all soap has been removed when rinsing.
• Dry hands with a clean towel.

Hand Sanitizing

• Apply a generous amount of hand sanitizer to cover all surfaces of the hands.
• Rub hands together thoroughly, getting the palms, fingertips, and backs of the hands.
• Allow the sanitizer to air dry before touching any surfaces or objects.
• Do not switch hand washing for sanitizer when your hands are soiled.

PPE (Personal Protective Equipment) in Healthcare Settings

• Personal protective equipment (PPE) refers to specialized clothing, equipment, and accessories worn by employees for protection against infectious materials.
• PPE creates a barrier between the user and potential hazards.
• In healthcare settings, PPE protects staff and patients from spreading infectious diseases.
• Healthcare workers must wear appropriate PPE when contacting patients or handling contaminated materials to reduce exposure risk.
• Effective PPE usage in healthcare settings aims to improve personnel safety, reduce occupational risks, and promote compliance with best practices.
• Selection of PPE is influenced by the type of exposure, fit, durability, and suitability.

Types of PPE

• Includes gloves, gowns, plastic aprons, masks, face shields, and eye protection.

Gloves

• Crucial PPE that protects hands from exposure to hazardous, contaminated, and infectious agents.
• Gloves form a barrier that prevents microorganism and substance transfer between hands, patients, and the environment.
• Medical gloves, surgical gloves, and non-medical gloves are possible types selected according to use.
• Gloves may be sterile or non-sterile based on the task.
• Sterile gloves are required for surgical procedures.
• Non-sterile gloves are for patient care activities.
• Common glove materials are vinyl, latex, and nitrile, the choice depends on cost, durability, and potential allergies.
• Latex gloves are known for sensitivity and dexterity but can cause allergies
• Nitrile gloves are a good alternative to latex as they offer excellent barrier protection and resistance to punctures.
• Chloroprene gloves offer superior chemical resistance, often used for handling hazardous materials.
• Avoid touch contamination where possible, disposable gloves should never be washed or reused.
• Don't touch your face or adjust PPE with contaminated gloves.
• Work from “clean to dirty” areas, and change gloves if torn, soiled, or after each patient.
• The correct sequence for Donning PPE is Gown, Mask, Goggles and Gloves and the answer is "C - after the isolation gown"

Gowns or Aprons

• Protect the wearer's body and clothing from contamination by blood, body fluids, and other infectious materials.
• Gowns and aprons can be made from natural or synthetic materials and can be reusable or disposable.
• Proper donning, use, and removal are crucial for maintaining worker and patient safety.
• To properly don a gown, first you must select the correct type and size

Face Masks

• Essential for protecting the nose and mouth from fluid penetration.
• Masks should fully cover the nose and mouth with a seal to prevent infectious particle spread.
• Properly donning a face mask is crucial for effective protection against airborne pathogens.

Goggles

• Protect the eyes from splashes, sprays, and other hazards.
• Fit snugly around the eyes, creating a barrier.
• Personal glasses don't provide the same protection and shouldn't be used.

Face Shields

• Critical PPE that protects the face, including eyes, nose, and mouth, from splashes, sprays, and respiratory droplets.
• Face shields must be fitted to provide coverage and protection.
• Face shields can often be cleaned and reused based on the manufacturer's instructions.
• Proper donning is crucial for safely protecting healthcare workers from exposure to splashes, sprays and airborne contaminates.

Respiratory Protection

• Essential to protect healthcare workers from inhaling infectious aerosols.
• Particulate respirators, half or full-face elastomeric respirators, and powered air-purifying respirators (PAPRs) make up respiratory PPE used in healthcare.

PPE Donning Sequence

1. Gown first: Creates a barrier and prevents contamination.
2. Mask or respirator: Protects nose and mouth from airborne pathogens.
3. Goggles or face shield: Safeguards the eyes from splashes or sprays.
4. Gloves last: Creates a barrier that prevents the spread of contaminants.

• When donning gloves select the correct glove type and size ahead of wearing, the correct answer is "3 - Select the correct glove type and size"

Key Points for PPE Use

• Donning before patient contact is important to prevent contamination spread.
• Remove carefully to avoid self-contamination, taking PPE off at the doorway or outside the patient’s room.
• Perform hand hygiene with either hand washing or use alcohol-based sanitizer immediately after removing PPE.

PPE Removal

• Areas of PPE include contaminated and clean areas.
• The outside front of PPE is "contaminated," as it has likely been in contact with body fluids, materials, or surfaces where infectious microorganisms may reside.
• The inside, outside back, and ties are the "clean" areas of PPE.
• The right answer to "Which area of PPE is considered contaminated?" is A - The outside front of PPE

PPE Removal Sequence

1. Remove gloves - so C - Remove gloves is the correct answer when asked "What is the first step in the sequence for safely removing PPE?"
2. Remove face shield or goggles.
3. Remove gown.
4. Remove mask or respirator.

Removing Face Masks

• Start by untying the bottom tie and proceed to the top tie for safe removal.

Removing Gloves

• Remove gloves properly to prevent the spread of germs and contamination.
• Safely remove gloves by sliding an ungloved finger under the wrist of the remaining glove.

Removing Isolation Gowns

• Begin by unfastening the ties or fasteners.
• Slowly peel the gown away from your neck and shoulders ensuring the contaminated outside is turned inward.
• Fold or roll into a bundle keeping the contaminated outside inward.
• Discard the rolled up or folded gown in an appropriate waste container.

Anteroom

• Where PPE should be removed.

PPE for Specific Procedures

• Different procedures require different levels of protection to ensure the health worker is safe.

Critical Care Considerations

• Prolonged use and specialized equipment.

Effect On Personnel

• Extended PPE use can lead to physical discomfort.
• PPE Can contribute to stress and burn out.

Infection Control

• Infection control is preventing the spread of infectious diseases.
• Policies and procedures protect patients, staff, and visitors from harmful microorganisms.

Importance of Infection Control

• Protects patients and promotes their well-being.
• Minimizes the risk of healthcare workers contracting infections.
• Reduces healthcare costs associated with treating infections.
• Prevents the spread of infectious diseases within the community.

Chain of Infection

• Critical in healthcare for preventing the spread of pathogens.
• The chain of infection is a model showing how infection spreads.
• Each link represents a step, and breaking any link can stop the spread.
• Six key interconnected components: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.
• Understanding these links to develop strategies to stop infection spread.

Infectious Agent

• Causes the infection, with examples including bacteria, viruses, and fungi.
• Identifying the agent is the first step for applying specific control measures.

Reservoir

• Where pathogens live, can be humans, animals, or surfaces.
• Controlling reservoirs reduces spread, often done through sanitation.
• Humans may be carriers and show no symptoms.
• Livestock or pets can harbor pathogens.
• Surfaces like tables, doorknobs, and equipment can be reservoirs.
• An example of a reservoir for pathogens is Human skin.

Portal of Exit

• Allows pathogens to leave, such as through respiratory droplets or blood.
• Covering coughs and proper waste disposal are important.
• Respiratory Tract: coughing and sneezing spread droplets.
• Blood: invasive procedures may spread bloodborne pathogens.
• Gastrointestinal Tract: feces can transmit pathogens.
• The respiratory tract is a portal of exit for pathogens as it is true.

Mode of Transmission

• Pathways of spread can be direct or indirect.
• Direct contact includes touching or droplet spread.
• Indirect contact involves contaminated surfaces or vectors.

Portal of Entry

• How pathogens enter the host.
• Mucous membranes or broken skin are common.
• Covering wounds and practicing hygiene reduces risk.
• Respiratory, skin and mucous membranes are examples of how pathogens gain access.

Susceptible Host

• Susceptibility depends on immunity and health.
• Immunocompromised individuals are at higher risk.
• Vaccination and healthy habits build resistance.
• Factors influencing a person's susceptibility to infection: Age, Health and Immunity

Key Component of Chain of Infection

• Age, health, and immunity influence susceptibility to infection.
• Height is not a factor influencing a person's susceptibility to infection.
• Environmental hygiene is not a key component of the chain of infection.

Standard Precautions

• Infection control practices that apply to all patients, regardless of their suspected or confirmed infection status.
• Principles include: hand hygiene, PPE, environmental cleaning and disinfection, and safe injection practices.

Principles of Standard Precautions

• Hand Hygiene: washing hands frequently with soap and water or alcohol-based hand rub.
• PPE: wearing gloves, gowns, masks, and eye protection.
• Environmental Cleaning and Disinfection: maintaining a clean and disinfected environment.
• Safe Injection Practices: following procedures for administering injections to prevent needlestick injuries.

Enhanced Emphasis on Hand Hygiene

• Hand hygiene is the single most important infection control measure.
• Alcohol-based hand rubs are an effective alternative when soap and water are unavailable.

Sharps Safety

• Sharps safety practices aim to prevent needlestick injuries and ensure proper disposal of sharps.

Environmental Cleaning and Disinfection

• Crucial for eliminating infectious microorganisms from surfaces and equipment.

Cleaning and Disinfection

• Cleaning removes visible dirt and debris, while disinfection eliminates most microorganisms using chemical agents.

Cleaning Supplies and Equipment

• Used in healthcare settings to ensure proper cleaning and disinfection.

Handling Textiles and Laundry

• Textiles and laundry pose a potential risk for infection transmission.
• Requires proper handling and disposal.

Waste Management

• Practices in healthcare settings focus on safe disposal of various types of waste.
• Prevent infection and environmental contamination.

Transmission-Based Precautions

• Additional infection control measures used when a patient is known or suspected to have a specific infectious disease.

Contact Precautions

• Used for patients with infections spread through direct or indirect contact.

Droplet Precautions

• Used for patients with infections spread through respiratory droplets (coughing, sneezing, talking, suctioning).

Airborne Precautions

• Used for patients with infections spread through airborne droplets.
• Particles remain suspended in the air for longer periods.

Outbreak Management

• Involves a coordinated response to a cluster of infections in a specific population or location.

Occupational Health and Safety

• Programs in healthcare settings focus on protecting healthcare workers from infections and other hazards.

Exposure Prevention and Post-Exposure

• Required, healthcare workers must be aware of exposure risks.
• Follow established protocols for post-exposure management.

Immunization and Screening

• Programs contribute significantly to infection control.
• Prevents the occurrence or spread of infectious diseases.