Infection Control Policy
This infection control policy statement is fully compliant with the essential quality requirements (EQR) of HTM 01-05 and must be adhered to at all times.
Infection control is essential for the safety of our patients, our families and us. All team members receive training in all aspects of infection control that will be updated at regular intervals and when any changes to current thinking occur. No team member may carry out procedures or operate equipment unless they have received appropriate training.
Mrs Natasha Damji is the designated Infection Prevention and Control lead (IPC) and is responsible for ensuring this policy is kept up to date.
The IPC lead is also responsible for all matters relating to infection control and for ensuring that this is discussed regularly at practice meetings. All team members should ensure they understand it fully, and if any part is unclear, they should ask the IPC lead for clarification.
All team members must be immunised against hepatitis B and a record of their hepatitis B seroconversion is held by Mrs Natasha Damji. For those team members who do not seroconvert or cannot be immunised, medical advice and counselling will be sought. In these cases, it may be necessary to restrict clinical activities.
This practice provides all team members with protective clothing, gloves, and masks that must be worn during all operative procedures and during all decontamination processes. Surgery clothing must not be worn outside the practice.
Hands must be washed at the beginning and the end of each session with antibacterial soap. Before donning and after removing gloves, hands must be disinfected using unodent alcohol-based hand-rub. A new pair of gloves must be used for each patient and any glove that becomes damaged must be replaced.
All re-usable instruments must be decontaminated as soon as possible according to the practice decontamination protocols before they are reused on a patient.
All re-usable instruments that have been potentially contaminated (whether selected for use or not) must be fully reprocessed.
Single use items must be discarded and never re-used.
Sterilised instruments must be stored in a manner that ensures they do not become contaminated, either on covered trays and/or in pouches. Storage of sterilised instruments must not exceed the following storage times:
- Wrapped instruments 1 year
- Unwrapped instruments in a non-clinical area 1 week
- Unwrapped instruments in a clinical area 1 day
Working areas that are touched or have instruments placed on them during treatment must be kept to a minimum, clearly identified and, after each patient, cleaned with hard surface detergent and disinfected using mikrozid low alcohol universal wipes.
Safer sharps incorporating protection mechanisms must be used where practicable. Two-handed recapping of dental needles can easily result in a sharps injury. Needles must therefore not be recapped using this method by any member of the team unless the recapping is itself required to prevent injury. If this is the case our risk assessment will identify this.
The use of needle blocks to remove and hold the needle cap and so allow safe one-handed recapping is an example of how to control the risks associated with needle re-capping.
Needles, scalpel blades, LA cartridges, burs, endodontic files, matrix bands and any other sharp items must be disposed of into the yellow sharps container. Sharps containers must be labelled and must never be more than 2/3 full. They must always be located at the point of use and when sharps containers are 2/3 full, the container should be locked and marked with the date of closure. The locked sharps container must be stored in the labelled sharps cupboard in the corridor which is a locked facility accessible to staff members only.
Orange sacks must be securely fastened (ideally using the ‘swan-neck’ method) and when 3/4 full they must be labelled and stored in designated locked bin outside the building which is kept locked and is not accessible to the general public/passers-by.
All impressions must be rinsed in water until visibly clean and disinfected by immersing in Perform Impression disinfectant for no more and no less than 10 minutes. Impressions must then be rinsed again in water and labelled with the date and a statement confirming they have been disinfected. All technical work being returned to the laboratory should also be disinfected and labelled and logged in the labwork book kept in the decontamination room.
In the event of an inoculation injury from a sharp, the wound should be encouraged to bleed, washed thoroughly under running water and covered with a waterproof dressing. The incident should be reported immediately to the IPC Lead, and the Principal Dentist to assess whether further action is needed.
In the event of an inoculation injury caused by splashes with a potentially contaminated substance to the eye or an open lesion, wash copiously with water and report the incident to the IPC lead and the Principal Dentist.
All inoculation injuries must be recorded in the accident book, which is kept in unlocked cupboard in the office and once record is completed, transferred to locked, fireproof cabinet 1 in the record storage area.
Any spillages involving blood, saliva or mercury must be dealt with according to the practice accidental spillages policy and the COSHH regulations and reported to Mrs Natasha Damji.
Patients with active cold sore lesions
At Sherwood Park Dental Practice we do not treat patients with infectious cold sore lesions i.e. during the vesicle or ulcer stage unless the patient requires urgent treatment.
The Herpes Simplex Virus is highly infectious and poses a risk to the treating clinicians and supporting team members, as well as causing pain and discomfort to the patient, delayed healing and the possible spread of the infection.
All appointments should be delayed until the lesion has healed, that is unless the patient is in urgent need of treatment. Should the patient require urgent emergency care this will be risk assessed on a case-by-case basis.
In the event of needing to provide urgent treatment, the production of aerosols by ultrasonic scalers and high speed hand-pieces should be avoided and full PPE should be worn covering all exposed skin.
Sepsis is a life-threatening condition that can arise when the body’s abnormal immune response to an infection causes organs to start failing.
Sepsis claims 44,000 lives per year (The UK Sepsis Trust).
The NICE guidance on sepsis was implemented in July 2016.
At our practice, it is our policy to always consider sepsis if a dental infection does not respond to conventional antibiotic therapy or when an infection cannot be drained directly.
We look out for the following symptoms:
- Altered mental state.
- Muscle pain.
- A failure to pass urine in the previous 18 hours.
- Breathlessness and increased breathing.
- Increased heart rate but low blood pressure.
- A non-blanching rash and cyanosis of the skin, lips or tongue.
We are aware that in dental practice, sepsis can arise from a bacterial infection due to a dental condition or a treatment that has been carried out.
At Sherwood Park Dental Practice, we are also aware that sepsis may present itself without a dental cause and any patient attending with the symptoms described above would be identified and informed of the possible diagnosis and advised of the urgent need to seek appropriate treatment.
It is our policy at Sherwood Park Dental Practice to refer any patient that we suspect may be suffering from a case of sepsis immediately to our local Accident and Emergency department at St Helier Hospital. We are aware that in some circumstances e.g. a patient whose condition is deteriorating rapidly, it may be appropriate to refer via ambulance. In that situation we would dial 999.
At Sherwood Park Dental Practice, we would ensure that the clinical records for any patient referred with a suspected case of sepsis are completed contemporaneously, with all the relevant information including signs, symptoms, management, referral process used, means of transfer, treatment in secondary care and follow up.
Our ‘out of hours’ telephone message clearly states that any patient suffering from a dental infection that is making them unwell, should seek immediate assistance from the local Accident and Emergency department.
All team members must observe confidentiality at all times in respect of any and all information relating to patients.
This Policy was reviewed and implemented on 15/03/2021.