Infection Control Unit Protocol PDF

Infection Control Unit Ass. Prof. Dr. Rasha Wagih Infection control protocol (ICU) ICU  DENTAL ETHICS The moral duties and obligations of a dentist toward: 1. his / her patients. 2. professional colleagues. 3. society....

Infection Control Unit Ass. Prof. Dr. Rasha Wagih Infection control protocol (ICU) ICU  DENTAL ETHICS The moral duties and obligations of a dentist toward: 1. his / her patients. 2. professional colleagues. 3. society. ICU  Make a habit of two things: to help; or at least to do no harm (Hippocrates) To do To do Respe good 1 no 2 ct 3 harm Hones Confidentiali ty 4 ty 5 ICU  Chain of infection ICU ICU INSTRUCTIONS ICU  Outline Personal protective equipment (PPE). Post-exposure prophylaxis (PEP). Environmental surface cleaning. Sharp disposal. Instrument processing. ICU Personal protective Equipment (PPE) ICU ICU The most common causes of airborne aerosols are the high speed air motor handpiece, the ultrasonic scaler and the triplex syringe. The aerosols produced may be contaminated with bacteria from the oral cavity (saliva and dental plaque), as well as viruses from the patient’s blood ICU  Gown For routine dental treatment a short sleeved tunic is worn. (Full scrub +labcoat ) For surgical procedures/splatters non absorbent sterilized disposable surgical long sleeved gown is worn. On top of (Full scrub +labcoat ) Long sleeves of shirts should be rolled up above the level of the tunic sleeves. Contaminated laundry should be placed and transported in bags or containers labeled or colorcoded as hazardous. Standard precautions must be followed while handling contaminated clothing, including the use of protective gloves and other appropriate PPE should be worn. If the office utilizes an off-site facility, the laundry must be placed in marked bags or containers so the laundry facility knows to use standard precautions. Long & clean dental coats with BUC logo ICU ICU Gloves Types of gloves Examination gloves: Wear correctly fitting, non powdered gloves for all routine non surgical dental treatment. Surgical gloves: Wear sterile gloves for surgical treatments “examination gloves harbor pathogens that could contaminate an operative wound” Utility gloves: Wear heavy utility glove for instrument processing and environmental cleaning. After use they are disinfected and left to dry. Materials of Gloves The use of latex gloves can cause reactions among dental health professionals: Irritant contact dermatitisis Allergic contact dermatitis (delayed hypersensitivity) Latex allergy (Type I) If allergic to latex; use nitrile or vinyl gloves or cotton under gloves. ICU warning Gloves developed defects in 30 minutes-3 hours, depending on type of glove and procedure. Gloves can have small, unapparent defects or can be torn during use, and hands can become contaminated during glove. Investigators did not determine an optimal time for changing gloves during procedures ICU  Do not handle notes, radiographs, pens or non sterilizable dental equipment/materials or open drawers, cupboards or doors when wearing gloves. Remove gloves (and all other PPE) before leaving the clinical area. Never reuse gloves after taking them off – use a new pair. Do not wash gloves designated for treatment. Washing latex gloves with plain soap, chlorhexidine, or alcohol can lead to the formation of glove micropunctures. Always change them between patients or where tear. Maintain short fingernails, Eliminate hand jewelry except wedding ring, Eliminate hand bracelets and watch, ICU  How to remove gloves safely Grasp outside edge near wrist Peel away from hand, turning glove inside out Hold in opposite gloved hand Slide ungloved finger under wrist of remaining glove Peel off from inside, creating a bag for both gloves Discard ICU Masks ICU -cover both the nose and mouth; -be removed as soon as becoming moist or visibly soiled -be changed after 20 minutes in an aerosol environment; -be removed and discarded after every patient. Don’t -be touched by the hands while being worn; -be worn loosely around the ICU neck while the dental  Mandatory in clinics Masks be worn at all times to prevent contamination of the working area with the operator’s respiratory or nasal secretions/organisms. ICU  How to remove mask Untie the bottom then top tie Remove from face Discard ICU  Protective eye wear (optically clear, anti-fog, distortion-free, close-fitting and shielded at the sides) Eye glasses are not PPE ICU  Mandatory in clinics Goggles must be worn at surgical procedures and splatters equipment How to remove goggles/face shields Grasp ear or head pieces with ungloved hands Lift away from face Place in designated receptacle for reprocessing or disposal ICU  Sequence for Donning PPE Gown first Mask Goggles or face shield Gloves Sequence for removing PPE  Gloves  Face shield or goggles  Mask or respirator  Gowns Where to remove PPE  At door way, before leaving patient room or in anteroom ICU Post-exposure prophylaxis ICU  The risk of infection from contaminated needle:  HBV infection is 30%  HCV infection is 3%  HIV infection is 0.3% HBV can survive on environmental surfaces for at least 1 week. HBV, HCV, HIV are present in saliva but the risk of transmission from this fluid is low unless mixed with blood. HIV may be resistant to one or more of antiviral drugs. No vaccine or protective human immunoglobulin for HCV or HIV. ICU Instructions to manage a sharp injury 1.1 Don't suck the wound to make it bleed 2.2 Bleed the wound gently under running water 3.3 Wash with soap and water 4.4 Dry the wound and protect with a plaster 5.5 Identify source of contamination for example, patient details 6.6 Seek urgent medical advice (for example from your Occupational Health Service or Accident and Casualty Service) to assess the risk and take appropriate action. Effective prophylactic medications are available 7.7 Document and report the incident locally to your employer  Don’t forget You should seek urgent medical advice to reduce the risk of getting an infection: Contact your employer's Occupational Health service Emergency phone number is available at cinics Comments taken from sharp injury ICU Will I need any treatment? If your healthcare professional thinks you're At low risk of infection, you may not need any treatment. At higher risk of infection, you may need: antibiotic treatment – for example, if you have cellulitis (infection of the skin) vaccination against hepatitis B treatment to prevent HIV If there's a high risk of infection with HIV, your healthcare professional may consider treatment called post-exposure prophylaxis (PEP). ICU Assessing your injury The healthcare professional treating you will assess the risks to your health and ask about your injury how and when it happened, or who had used the needle. Samples of your blood may need to be tested for hepatitis B and C or HIV.. samples of the other person's blood if they give their consent. ICU ICU Environmental surfaces ICU  Wrapping of surfaces possibly touched by contaminated gloves (light handle, bracket table handle, ….). Other surfaces: cleaning then disinfection by environmental protection agency (EPA) solution. ICU All the following surfaces needs to be covered with wrapping/ sleeves: Light Handles Airway syringe Hand piece Nodules Suction tips Nodule Tray handle + Control panel Head rest + Hand rest + spittoon Dentist chair handles + back rest ICU Waste disposal General rules (A. dealing with sharps) ICU ICU General rules (B. Sharps container) ICU  All needles and anesthesia should be thrown in a safety box ICU  Sharps containers must comply with the to specific standards. sharps containers should never be placed on the floor, window sills or above shoulder height, should be placed on a level stable surface & out of the reach of patients at all times. Never press down on the contents of the container to make more room. Never attempt to retrieve items from the sharp containers. All sharps must be placed into an approved sharps container When three-quarters full, the container should be securely closed (Never overfill sharps containers) - on no account should attempts ICU be made to reopen a Instrument processing ICU Autoclave should be checked weekly by the use of biological indicator ICU Step by Step Instrument handling ICU  Patient INSTRUME treatme NT Storage nt Contamina PROCESSIN of package ted instrument G CYCLE s s Sterilizatio Presoaki n ng Seali Cleani ng ng Packagi Rinse & ng Dry ICU  What is not clean can not be sterilized 1.Wipe instrument tip with wet cotton to minimize adherence of debris and facilitate cleaning. 2.Remove items from the operatory and transport to central sterilization unit in cassettes or pouches. 3.Place the instruments, in a detergent holding solution in sealed containers if they cannot be cleaned immediately. 4.The instruments must be cleaned by brush and dried before sterilization. ICU  STERILIZATION C A R D S 1 1- You will not be allowed to take your instruments from sterilization room without this card 2- every student will have fixed card number 2 according to his serial ID 3- sterilization outside the university is not 3 allowed 4- the time of delivery of instrument to sterilization room ICUwill be recorded You are not allowed to enter clinic without your university ID ICU Only dental Personal bags are not organization bag are allowed allowed ICU Please silence your cell phone Urgent calls outside the clinic ICU Tie your Cut your hair nails Boys & ICU Not allowed ICU  Mas Gloves ks More than one set Clean dental Full set of napkins not sterilized used before Wrapping the instruments and unit materialsICU Make sure your spittoon is clean ICU ICU ‫نموذج ضبط مخالفة‬ ‫للطالب‬ ‫اسم‬ ‫‪:-------------------------------------------------------‬الطالب‬ ‫‪ID :‬‬ ‫‪----------------------------------------------------------------‬‬ ‫رقم‬ ‫‪:-------------------------------------------------------‬العياده‬ ‫القسم‬ ‫‪:---------------------------------------------------‬المختص‬ ‫نوع المخالفه‬ ‫‪-----------------------------------------------------------------‬‬ ‫‪ :‬اسم الممرضة‬ ‫‪-------------------------------------------------‬‬ ‫االداري المسئول عن‬ ‫‪ :-------------------------------------‬العيادة‬ ‫‪ :‬اجتماع اللجنه‬ ‫مجلس تاديب‬ ‫‪ICU‬‬ Clinic application rules: Enter clinic following :  Gown/lab coat  Mask ready any time to be asked for  Gloves changed between patients and no going around with gloves  No hats or caps or sitting talking in clinics  No mobiles unless photo taken or concerned with ur work  Trays to be taken for work and returned  Rapping and derapping is mandatory  Safety boxes are for penetrating instruments  Red bags for all clinic utensils  Attendance will be twice in clinic  Not allowed to walk out without permission  Any case taken for treatment should be accepted by the supervisor first  No work allowed unless under supervision  Diagnosis and perio is during the whole hours  No point it is obligatory ICU ICU