Infection Control (Sphinx University)

Infection Control Aliaa Khalaf Abd Ellatief Mohamed BSc., MSc. Of OMFS Faculty of dentistry, Cairo University. Assistant Lecturer of Oral & Maxillofacial Surgery Faculty of dentistry, Sphinx University. Environmental Infection Control Different microorganisms survive...

Infection Control Aliaa Khalaf Abd Ellatief Mohamed BSc., MSc. Of OMFS Faculty of dentistry, Cairo University. Assistant Lecturer of Oral & Maxillofacial Surgery Faculty of dentistry, Sphinx University. Environmental Infection Control Different microorganisms survive on environmental surfaces for widely varying amounts of time Factors including survival include temperature, humidity, and the presence of blood and saliva Removal and/or killing of microorganisms before treatment of the next patient are thus required There are 2 types of dental environmental surfaces: 1. Clinical contact surfaces: Clinical contact surfaces are touched frequently with gloved hands during patient care, or may become contaminated with blood, saliva, or other potentially infectious material and then come in contact with instruments, devices, hands, or gloves. 2. Housekeeping surfaces: Housekeeping surfaces (e.g.; walls, and sinks ) do not come in contact with hands or devices used in dental procedures.  Proper treatment of clinical surfaces is required before they become involved in the care of the next patient Treatment of housekeeping surfaces can occur at the end of the day For environmental surface asepsis we can apply two approaches. 1- With the use of surface covers 2- Preclean and disinfect surfaces after contamination and before reuse Dental practices usually employ a combination of both Surface covers: - It is used to cover surfaces to reduce the exposure of workers to chemicals. Plastic-barrier sticky tape is frequently used to protect smooth surfaces such as touch pads on equipment, electrical switches on chairs, or X- ray equipment. Pre-cleaning and disinfection: Proper pre-cleaning is essential to reduce the bio-burden present initially, so that disinfection will have a better chance to kill a reduced number of residual microorganisms. The practitioner should always wear ( Personal Protective Equipment ) PPE when disinfecting surfaces and equipment Proper use will minimize worker contact with both contaminants and chemicals. After properly pre-cleaning, surfaces are ready for disinfection Disinfection and sterilization of patient care items DISINFECTION - it is a process which reduces the number of viable microorganisms to an acceptable level but may not inactivate some viruses and bacterial spores. STERLIZATION - it is the process of destruction or removal of all microorganisms including spores (reproductive bodies) of the hardiest bacteria and fungi. - This process is facilitated by initial removal of material by cleaning and the use of an ultrasonic device. Cold sterilization: For items that would be damaged by the high heat involved in other sterilization processes, a non heated liquid sterilization procedure is used. This involves soaking the contaminated object in a chemical solution, such as glutaraldehyde , for about 10 hours Disinfectants versus Antiseptics: Disinfectants are chemicals that are applied to inanimate surfaces (such as dental equipment). Antiseptics are antimicrobial agents that are applied to living tissue Disinfectants and antiseptics should never be used interchangeably because tissue toxicity and damage to equipment can result Disinfectants are classified as high, intermediate and low relative to their effect on different microorganisms. The “Perfect Disinfectant?” An ideal surface disinfectant should: Have a rapid kill of a broad spectrum of bacteria, Have residual activity Be non-toxic and non-allergic Not damage surfaces to be treated Be odorless, inexpensive, and be simple to use Be active in the presence of organic matter Should be active in any pH Should have long shelf life Unfortunately, no single disinfectant on the market today meets all these criteria Patient care equipment: Dental instruments: my be classified as : 1- Disposable 2- Reusable Spaulding classification into three categories 2- Semi- 3- Non 1- Critical critical critical instruments instruments instruments 1- Critical instruments: Are instruments that penetrate soft tissues or bone. Critical instruments must be heat sterilized between each use or disposable items (e.g. Scalpel) are used. E.g. -Periodontal probes, periodontal scalars - Explorers. - Surgical instruments, and surgical dental burs. 2- SEMI-CRITICAL INSTRUMENTS: Instruments that do not penetrate soft tissue or bone but contact oral tissues These instruments should also be heat sterilized or high-level disinfect after each use Examples are - Mouth mirrors - Handpieces - Restorative instruments - Impression trays 3- Non-critical instruments: Contact intact skin Clean and disinfect using a low to intermediate level disinfectant. Those items, which do not come into contact with body fluids Have a relatively low risk of transmitting infection Examples are - Light cure tips - Switches on dental chairs - X-ray heads, face bows, pulse oximeter - blood pressure cuff 1-Use surface barriers to protect clinical contact surfaces, particularly those that are difficult to clean …..Change surface barriers between patients. 2- Clinical contact surfaces and dental equipment that are not covered should be cleaned and disinfected with a hospital level disinfectant (activity against HIV, HBV, and Mycobacterium tuberculosis) after each patient. Sodium hypochlorite (household bleach) is an effective and economical surface disinfectant Safe waste disposal A. General waste or non-hazardous waste: is waste that poses no risk of infection as papers, boxes, or hand towels B. Bio-hazardous waste: includes items that are contaminated with infectious or potentially infectious substances such as blood or saliva and poses a risk to humans or the environment Guidelines for proper waste disposal: 1. Infectious waste should not be mixed with general waste 2. Black bags are used for general waste while leak proof red bags are used for infectious waste 3. Bags must not be overfilled (maximally 2/3 full). 4. Personnel must wear heavy duty gloves while handling waste bags Dealing with sharp items: Used disposable needles must NOT be bent, broken, recapped by two hands, removed from disposable syringes, or otherwise manipulated by hand before disposal Scoop technique (one hand technique) could be used for recapping of used syringes. In which the uncapped needle is slid into the needle sheath lying on the instrument tray or table Sharp subjects should be placed in puncture resistant container. This sharps containers must be: 1. Color-coded or labeled 2. Tightly closable 3. Leak proof on the sides and bottom 4. Placed as close as feasible to the location where the sharps are in use Thank YOU