Personal Protection PPE Infection Control Part 1 PDF

Infection Control: Part I Personal Protection of the Oral Health Care Worker (OHCW) in the dental environment Video clips to watch prior to the presentation  https://www.youtube.com/watch? v=O5P4D67Bls8 COVID -19 pandemic and PPE’s This presentation will focus on the...

Infection Control: Part I Personal Protection of the Oral Health Care Worker (OHCW) in the dental environment Video clips to watch prior to the presentation  https://www.youtube.com/watch? v=O5P4D67Bls8 COVID -19 pandemic and PPE’s This presentation will focus on the guidelines with regard to PPE prior to the COVID-19 pandemic. An additional presentation will be conducted on the current status with regard to PPE in the dental environment considering the COVID-19 Pandemic relevant to the level of functioning Methods or ways of Cross- contamination  Direct cross-contamination e.g From person A to Person B  Indirect cross-contamination e.g from person A via an item or object to person B  Examples every everyday life and dental environment Aerosol generating procedures  Aerosol-generating procedures are defined as medical procedures that can result in the release of aerosol from the respiratory tract. The criteria for these procedures are a high risk of aerosol generation and an increased risk of respiratory transmission Standard precautions According to the CDC “Centre for Disease Control”…. Consider ALL patients as contagious. Practice Standard precautions/ Universal precautions at all times for all patients- which implicate? Standard precautions Medical history each patient Immunization/ Vaccination Clinical attire  Overcoat  Masks / Facial shield  Protective eyewear  Hand hygiene & Gloves What are Universal precautions? Always wear Personal Protective Equipment (PPE)  Clinical attire  Overcoat  Mask  Protective eye wear  Gloves Immunization/ vaccination MMR Mumps, Measles and Rubella Hepatitis A and B Influenza Pneumococcal Varicella Meningococcal COVID-19 Vaccinations? Hepatitis B schedule  1 immunization  2= 30 days later/ 1 month  3=6 months later  Follow-up booster every 5 years  first To be confirmed by lab test  Test for HB s AG  Clinical scrubs and overcoat Clean uniform for each day/ or scrub Removed during lunch, tea breaks and out-of-practice Wearing clinical clothing over street clothes is not recommended Protective clothing Solid closed front/ No pockets Cover arms and fit closely around neck & wrists, cover knees Gloves fit over cuffs of gown Buttons, zippers, minimum Disposable outer gowns to protect uniform Removing of gown: fold contaminated side inward Hair and head covering Hair worn off the shoulders Fastened at the back No hair in face Long hair to be covered with a head cover- disposable Facial hair to be covered with a mask and face shield FACE MASKS Face mask Why? Prevent cross contamination Via droplets, splatter  Saliva  Blood  Saliva and blood  Positioned first when preparing for clinical activities Secondly place eyewear Followed by hand washing and gloving Use of masks Place a new mask for each patient Replace with same patient if:  Contamination occurs with blood and /or saliva  Session longer than 2 hours Placement: Always wash hands Dry Hold mask on ear loops Do not touch mask (inside or outside) Don gloves after masks has been placed Never dangle mask on ears after treatment Never slip under chin /neck with after treatment  Keep mask on after completion of a procedure – aerosol contamination Keep mask on during decontamination of surgery Never touch the outside of the mask Incorrect placement of mask Face shield Face shields  Use when performing aerosol-generating procedures  Such as working with  Fast handpiece  Slow handpiece  Water and air spray (triplex or 3 in 1)  Piezo or ultrasonic scaling Protective eyewear Protect eyes from: Infectious droplets and splatter (Hep B) Dangerous flying objects (amalgam, tooth) Who needs to wear Protective eyewear? Compulsory for All dental team members All patients Protective eyewear Eye wash stations In case of splashes Not water from tap Sterile/distilled/saline Eye wash station In case of eye splash  Stop dental procedure  Inform patient- same procedure for testing for HIV and Hep B as for needle stick injury  Find water reservoir – only distilled water to be used to flush eye/s  Continue to flush the eye for 15 -20 minutes or longer.  Do not use tap water  Seek medical attention HAND HYGIENE Hand Hygiene Resident bacteria Transient bacteria Why wash hands?  Reduce amount of bacteria on skin  Prevent transient bacteria becoming resident  Prevent cross contamination Facilities Always use  Anti-microbial soap liquid e.g. Hibiscrub- (chlorexidene digluconate) Betadene hand soap Dettol hand soap  Triclosan containing  Prolonged antimicrobial effect Anti-microbial/ anti-bacterial soap dispensers Always rinse out all soap residue from soap dispensers Let the soap dispenser dry completely Refill with fresh anti-microbial liquid soap Hand hygiene Soap Do not use a bar of soap Potential vehicle – cross contamination Always use an anti-microbial liquid soap Scrub brushes Plastic or rubber bristles Scrub hands and nails very gently Do not lacerate ( port of entrance for Micro- organisms.) Disinfect or sterilize brushes daily (Dispose) Nail care- protocol Short nails No nail varnish No false nails, overlays No jewellery  Towels Never use cloth towels to dry hands  Disposable paper towels only Sink Water supply should be electronic or foot control If not available open/ close taps with a paper towel Clean the brim of the sink with anti-microbial soap Never not touch inside the basin/sink Do not lean against the sink Hand hygiene -types Routine hand washing: water and non antimicrobial soap Antiseptic hand washing: water and anti- microbial soap Chlorhexidene, Iodpohors, tri-closan Antiseptic hand rub/ hand sanitizer: alcohol based hand rub 60%-95% ethanol or isopropanol Surgical antisepsis: 10 minute scrub HAND HYGIENE HAND WASHING Remove rings, bracelets, watches,  short nails Irritants accumulate under rings Wash with antibacterial soap WashPovidone or Chlorexidene before, after each patientGluconate. and when touching object during treatment Protocol-hand washing Beginning of day: 2 X 15 seconds washing Washing: between fingers, rubbing each finger and thumb Cleaning beneath fingernails Final rinse with cold water-close pores Dry hands completely- paper towels Paper towel to turn off the tap Protocol hand washing (continue) Minimal 15 sec wash before and after each patient  Before donning and removing gloves  Breakages of gloves  Moving out and returning to clinic Skin irritation may occur Antiseptic hand rub First wash away visible dirt Dry hands with paper towel Decontaminate hands with alcohol rub Apply to palm of one hand and rub hands together Rub hands vigorously – hands are dry Types of gloves available Latex gloves (non-sterile and sterile) Vinyl gloves ( non-sterile and sterile) Over gloves (non-sterile) Utility gloves( non-sterile) HAND HYGIENE Change gloves:  After each patient  If breakage occur during treatment  When you detect micro leakages Procedures for gloving Place mask and eyewear Wash hands then glove Glove placement in front of patient Place glove over cuff of clinical wear. Avoid contamination – do not touch face, mask clothing Replace when torn, cut or punctured Over gloves Thin plastic glove to place over clinical gloves Use to write, opening a draw or touching file Gloves (continue) Removing of gloves: Demonstration Thank you  Questions?