SURFACE/

EQUIP

MENT

ASEPSIS

&FC

DH

UNIT P

ROCESS F

OR SET

UP/CLE

ANUP

(INCLU

DING H

ANDWASHIN

G & P

PE)

BY :

NI C

OL E

, S

TE

PH

AN

I E,

KA

TI E

, &

ST

EL L A

TOPICS TO BE DISCUSSED

1. Infection Control– Asepsis What is it? Why is it important?

2. Hand hygiene Importance Protocol

3. Personal Protective Equipment Importance Protocol

4. Foothill College Dental Hygiene Unit Set Up & Break Down Process Video Class Interaction

5. Legal & ethical issues

Image from: http://www.rdhmag.com/articles/print/volume-32/issue-11/columns/are-you-sick-and-tired.html

ASEPSIS

• What is it?• Free from microorganisms

• Why is it important?•Safety patient & clinician

Images from: http://www.dreamstime.com/royalty-free-stock-image-accumulation-bacteria-vector-illustration-isolated-white-background-image36282366

RATIONALE FOR THE PRACTICE OF ASEPTIC TECHNIQUE

• HAIs = primary concern

• 1.7 million HAIs annually•17% death (1)

• Approx. 20-40% of HAIs indirect contamination (1)

• Possible prevention proper disinfection of clinical contact surfaces…

CLINICAL SURFACES/EQUIPMENT ASEPSIS• Countertops, water faucet handle, & soap

dispenser

• Armrests

• Unit light handles & switch

• Computer monitor handle

• Bracket tray, handles, brackets, valves, & hoses – a/w syringe, saliva ejector, & high speed suction

• Rolling carts/tray countertops

Image from: http://www.bombayharbor.com/Product/42366/Dental_Unit_Dental_Chair.html

VARIETY OF SURFACE DISINFECTANTS

• Birex SE Concentrate (dual phenolic)• CaviCide Wipes (quaternary ammonium

compound) • Diluted Bleach (1:10 sodium hypochlorite)• DisCide ULTRA Disinfecting Spray (quaternary

ammonium compound)• Lysol Brand II IC Disinfectant Spray

(quaternary ammonium compound)• Sani-Cloth AF3 Wipes (quaternary ammonium

compound) **FCDH

Images from: www.ebay.com/itm/like/201097545382?lpid=82

COMPARABLE BACTERICIDAL ACTIVITY OF TWO

CHEMOSTERILIZERS• Hill WJ, Malveaux FJ, & Whitehurst VE

• Methods: Clinical surfaces microorganisms:

S. aureus, E. coli, S. faecalis, P. aeruginosa, or B. subtilis

Chemosterilizers surfaces & bactericidal effects observed Amerse (phenolic compound) & Zephiran

(quaternary ammonium compound)

• Results: Zephiran = effective in bactericidal effects vs.

Amerse Implications: Sani-Cloth wipes (quaternary

ammonium compound) = effective disinfectants

 THE PROCESS OF HAND WASHING How

Remove all jewelry Scrub hands, nails & forearms 1 minute When @ start of day During clinic

In between patients Before & after wearing gloves Soiled hands

Why Leading measure cross-transmission of microbes

http://www.convergencetraining.com/hand-washing-and-hygiene.html

HAND WASHING AGENTS

http://winndixiedeals.com/purell-for-25%C2%A2/

Hand SanitizerPurellAlcohol based 62% ethanol

Liquid Non-Antimicrobial SoapColgate-Palmolive Ammonium C12-15, Lauramidopropylamine Oxide

http://www.palmolive.com/ingredients

Liquid Antimicrobial SoapDial Triclosan

http://www.dollargeneral.com/product/index.jsp?productId=12580135

ALCOHOL BASED VS. LIQUID SOAPS

A field study on efficacy of waterless hand hygiene compared with hand washing with Soap (Pickering A, Boehm A, Davis J, Mwanjali M)

Hand Sanitizer

• T-tests E. coli & fecal streptococci concentrations on both hands

• Mean reductions 0.66 log – E. coli• Mean reductions 0.64 log – fecal

streptococci

Hand Washing • T- tests E. coli and fecal streptococci on

both hands concentrations on both hands. • Mean reductions were 0.50 log – E. coli• Mean reductions were 0.25 log – fecal

streptococci

Hand sanitizer significantly better than soap & water

IMPORTANCE IN HAND WASH TRAINING

Hand hygiene = best measure A cross-sectional study of medical and nursing students from Navodaya Medical College, India

Study Focuses:

Knowledge

Attitude

Practice

Study Results:

Knowledge:

Moderate

Attitude:

Moderate/Poor

Practice:

Moderate/PoorConclusion: compliance cross-contamination safety

WHAT IS PERSONAL PROTECTIVE EQUIPMENT?

• Health & safety precaution • Attire & equipment blood &

body fluid• PPE for dental healthcare

workers:Protective eyewearSurgical masksGownsGloves

PURPOSE OF PPE• Eye protection: w/ side shields

• Protects eyes impaction & spatter

• Masks: Protects nose & mouth spatter

• Gowns:Protects skin & scrubs blood borne pathogens

• Gloves:Protect hands body fluids & risk of puncture

ORDER OF DONNING PPE

1. Gown

2. Mask

3. Safety glasses

4. Wash hands/sanitize

5. Gloves

UNIT S

ET U

P/BREA

K DOW

N

VIDEO

http://youtu.be/TAI0wNjl5kA

FOOTHILL COLLEGE DENTAL HYGIENE UNIT SETUP & BREAKDOWN SUMMARY

• BEFORE seating client•Wash/disinfect hands•PPE Disinfect unit•Apply barriers• AFTER discharging client•Wash/disinfect hands •PPE•Remove barriers•Disinfect unit

SPOT THE DIFFERENCE

A . B .

LEGAL/ETHICAL ISSUE

• Legal• OSHA: Legally employer provide PPE

@ no cost • Dental Board of CA: Minimum

Standards for Infection Control1.Standard precautions 2.Regulation posted in each dental

office

LEGAL/ ETHICAL ISSUE

Ethics- Violate Nonmaleficence;

"do no harm”Ethical Dilemma- What would

you do?? 

 

 Image is from http://americanhumanist.org/HNN/details/2014-02-the-ethical-dilemma-help-i-officiated-a-wedding-that

CITATIONS1. Palenik CJ. The effect of long-term disinfection on clinical contact surfaces. JADA. 2012 May;

143(5):472-477.2. Hill WJ, Malveaux FJ, Whitehurst VE. Comparable Bactericidal Activity of Two

Chemosterilizers. J Dent Res. 1974 Mar;53(2):338-342.3. Darby ML, Walsh MM. Dental Hygiene Theory and Practice. Fourth ed. Bowen DM, editor. St.

Louis (MO.): Elsevier; 2014. P. 109-111.4. Spragge P. Foothill College Dental Hygiene Program Assessment Procedures in Dental

Hygiene. 2014. P. 1.5-1.6  5. Pickering AJ, Boehm AB, Mwanjali M, Davis J. Efficacy of Waterless Hand Hygiene Compared

with Handwashing with Soap: A Field Study in Dar es Salaam, Tanzania. The American Journal of Tropical Medicine and Hygiene. 2010; 82(2):270-278. doi:10.4269/ajtmh.2010.09-0220.

6. Nair SS, Hanumantappa R, Hiremath SG, Siraj MA, Raghunath P. Knowledge, Attitude, and Practice of Hand Hygiene among Medical and Nursing Students at a Tertiary Health Care Centre in Raichur, India. ISRN Preventive Medicine. 2014 Feb 6; doi 10.1155/2014/608927. eCollection 2014.

7. Porter K. Using personal protective equipment effectively [Internet]. December 2009; 5(12) 687-689. Available from: Dentistry & Oral Sciences Source, Ipswich, MA. Accessed Oct. 2014.

8. Regulation [Internet]. Dental Board of California. Available from: http://www.dbc.ca.gov/lawsregs/regulations/ch1_article1.shtml#1005

9. PPE Factsheet [Internet]. Occupation Safety and Health Administration. Available from: https://www.osha.gov/OshDoc/data_General_Facts/ppe-factsheet.pd