Infection Control (PDF)

infection control ‫جامعة بنى سويف‬ DR.Yousef Hanafy Dental personnel and patients are at increased risk for acquiring tuberculosis , herpes viruses , upper respiratory infections , and hepatitis strains A through E.  After the recognition of acquired im...

infection control ‫جامعة بنى سويف‬ DR.Yousef Hanafy Dental personnel and patients are at increased risk for acquiring tuberculosis , herpes viruses , upper respiratory infections , and hepatitis strains A through E.  After the recognition of acquired immunodeficiency syndrome (AIDS) in the 1980s,The primary goal of infection control procedures is to prevent cross-contamination and disease transmission an operator's hands become contaminated by contact with a patient's mouth and saliva contaminated films and film holders The operator also must adjust the x-ray tube head and x-ray machine control panel settings to make the exposure. These actions lead to the possibility of cross-contamination  universal Precautions are infection control practices designed to protect workers from exposure to diseases spread by blood and certain body fluids, including saliva. Under standard precautions all human blood and saliva are treated as if known to be infectious To protect against cross-contamination for all individuals many patients are unaware that they are carriers of infectious disease or choose not to reveal this information  ( PPI ) effective means to shield the operator from exposure to potentially infectious material, including blood and saliva. Hand hygiene is most important to prevent spread of infections. After the patient is seated wash hands using plain Alcohol-based hand rubs antimicrobial soap are also effective  ( PPI ) Disposable gloves should be worn in sight of the patient if the operatory arrangement permits The operator should always wear gloves when making radiographs or handling contaminated receptor barriers or associated materials such as cotton rolls and receptor holding instruments  ( PPI ) Operators should wear protective clothing that covers clothes and skin to protect against potential contamination disposable gown or laboratory coat  ( PPI ) Eyewear, a mask, or a face shield must be worn if splash exposure to bodily fluids is anticipated Eyewear face shield mask  Clinical contact surfaces Clinical contact surfaces are surfaces that might be touched by gloved hands or instruments that go into the mouth. These include the x-ray machine and control panel, chair-side computer, beam alignment device, dental chair and headrest, protective apron, thyroid collar, and surfaces on which the receptor is placed chair-side protective apron, x-ray machine control panel computer thyroid collar  Noncritical items These are objects that may come in contact with saliva, blood, or intact skin but not oral mucous membranes The goal of preventing cross-contamination is addressed by disinfecting all such surfaces and by using barriers to isolate equipment from direct contact.  Barriers made of clear plastic wrap should cover working surfaces that were previously cleaned and disinfected. Barriers protect the underlying surface from becoming contaminated and should be changed when damaged and routinely after each patient  Barriers Although barriers greatly aid infection control, they do not replace the need for effective surface cleaning and disinfection failure of mechanical barriers is common during the daily activity of treatment. Whenever this happens, surfaces that become accidentally exposed must be cleaned and disinfected Operators should avoid touching walls and other surfaces with contaminated gloves  Clinical contact surfaces Any clinical contact surface that is contaminated or potentially contaminated should be disinfected High-level disinfectants are used for chemical sterilization and should never be used on clinical contact surfaces Intermediate-level disinfectants effective killer of tuberculosis and capable of preventing other infectious diseases, including hepatitis B virus and HIV. Low-level disinfectants without tuberculocidal activity but inactivate hepatitis B virus and HIV.  Clinical contact surfaces new plastic barrier is placed The exposure control console should over the chair and headrest be covered with a clean barrier  Clinical contact surfaces Hanging apron is sprayed with plastic barrier is slipped disinfectant and then dried and over the x-ray tube head covered with a garment barrier Clinical contact surfaces The gloves should be removed before the cassette is removed from the machine for processing because the cassette and film remain extraoral and should not be handled with contaminated disposable gloves.  Clinical contact surfaces After patient exposures are completed the barriers should be removed contaminated working surfaces (including surfaces in the darkroom) and the apron should be sprayed with disinfectant The barriers should be replaced in preparation for the next patient  Sterilize Nondisposable Instruments semicritical items instruments that are not used to penetrate soft tissue or bone but do come in contact with the oral mucous membrane. It is best to use receptor-holding instruments that can be sterilized, preferably by steam under pressure (autoclave) no contact with oral non-critical mucosa (no blood) contact with oral mucosa semi-critical (no blood no invasion) fully-critical contact with oral mucosa (there is blood and invasion)  Sterilize Nondisposable Instruments After using these instruments Each instrument should be cleaned with hot water and soap to remove saliva and debris. The cleaned components are then loaded into plastic or paper pouches and sterilized in an autoclave After sterilization, the instruments should be kept in pouches for storage After use, instruments should be replaced in the pouch to reinforce cleanliness in the area. The same sterilization pouch should be used to transport the contaminated instruments back to the cleaning and sterilizing areas.  Sterilize Nondisposable Instruments Sensors for digital imaging cannot be sterilized by heat, so it is important to use a barrier to protect them from contamination when placed in the patient's mouth autoclave sterilize instrument by heat and pressure Sterilize Nondisposable Instruments Film-holding instrument with barrier wrapping to protect sensor and cord from saliva  To prevent contamination of films before exposure -Prepackage Films : Films for each procedure (like a full-mouth or interproximal series) should be prepackaged in envelopes or paper cups in the central preparation room. -Film-Holding Instruments: put films with the necessary film-holding instruments. -Extra Films: Keep a small supply of extra films in the preparation room for unexpected needs, but only staff with clean hands or gloves should handle them. -No Contaminated Gloves : Do not retrieve films with contaminated gloves. Only staff with clean hands or clean gloves should handle the films. + with barrier  after exposure -Disinfect the Packet: After the film is exposed in the patient’s mouth, immerse the packet in disinfectant. -Dry the packet: Dry the packet with air -Open in a Lighted Area: Open the barrier envelope in a well-lit area. -Place on Clean Surface: Drop the film onto a clean surface or into a clean cup. -Transfer for Processing: Move the film to darkroom for development by clean cup or container. to processing dark room  Dental film with a plastic barrier to protect film from contact with saliva. During opening, the plastic is removed and the clean film is allowed to drop into a container  To prevent contamination of films before exposure -Prepackage Films : Films for each procedure (like a full-mouth or interproximal series) should be prepackaged in envelopes or paper cups in the central preparation room. -Film-Holding Instruments: put films with the necessary film-holding instruments. -Extra Films: Keep a small supply of extra films in the preparation room for unexpected needs, but only staff with clean hands or gloves should handle them. -No Contaminated Gloves : Do not retrieve films with contaminated gloves. Only staff with clean hands or clean gloves should handle the films. + without barrier  after exposure -Remove Gloves: After all films are exposed, the operator should remove their gloves. -Take Films to Darkroom directly : Bring the container of contaminated films to the darkroom. -Set Up Clean Surfaces: Place two towels on the darkroom work surface. Put the container of contaminated films on the first towel. -Remove packet and Place Film: Take the exposed film out of its packet and place it on the second towel. -Discard Packaging: Discard the film packaging onto the first towel along with its container.  (A) FILM PACKET IS OPENED, AND LEAD FOIL AND BLACK PAPER ARE SLID FROM COVERING (B) LEAD FOIL IS ROTATED AWAY FROM BLACK PAPER AND DISCARDED (C) BLACK PAPER WRAPPING IS OPENED FROM FILM  (D) FILM IS ALLOWED TO FALL INTO A CLEAN CUP Thank you! DR.Yousef Hanafy