Compliance Proofing Dental Practice December 2020

COMPLIANCE UPDATE AND CLOSING DOWN SURGERY HINTS AND TIPS

WHAT’S IN THIS ISSUE:

  1. Annual Reminder: Pre-Christmas closing down tips
  2. X-Ray Testing:  Acceptance and Performance in a Nutshell
  3. Amalgam Seperators: Legislation Change 01 Jan 2021

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1. Pre-Christmas Closing Down Tips

Don’t forget to carry out essential last-minute infection control safety checks:

    1. Dental chair and cart/delivery system: remove handpieces and 3-in-1 tips; flush, dry and wipe down the water lines, and clean down all surfaces including the base of the chair and all arms of the overhead dental light
    2. Suction: remove salivary ejector and suction tip, flush suction lines, clean surface/bowls/manifolds, and change filters
    3. Water: empty the water distillation unit, clean, disinfect and dry all water storage bottle, place these empty bottles in a dark, cool place (preferably in a fridge)
    4. Countertops: clear all items from the countertops, store these in a dust-free clean area such as a cupboard; wipe clean all surfaces.
    5. Waste: remove and replace clinical and general waste bags, seal and tag/label, store in a rodent-free secure area. Partially close over the sharps bins lids
    6. Consumables: restock all items in preparation for reopening after the holiday period
    7. Electrical Equipment: switch off all electrical equipment especially pressure vessels such as autoclaves and dental compressors
    8. Office Equipment: Log off the computer, turn off the monitor, wipe down the keyboard, wipe down the phone, and tidy the desk/administration area. Ensure all items which can be switched off – not left on stand-by over the holiday period

Allow extra time on the first day back at work to open-up the surgery and carry out the necessary checks and tests to start operating in a safe manner

While this advice is designed to assist, you should always check the manuals/instruction sheets specific to your equipment items and products

2. X-ray Testing: Acceptance and Performance in a Nutshell

In general terms, Acceptance Testing is what we used to call “commissioning” i.e. the test which your RPA/MPE performs on a new x-ray machine prior to it being approved for use and brought into service.

Under current legislation, both the RPA and the MPE (which could be one and the same person) have a series of tests to carry out

  1. RPA tests are listed on page 14, section 4.3.3 of the EPA code
  2. MPE criteria are discussed in fairly broad terms in the HIQA document. In summary, these criteria for the most part focus on optimisation of exposures to reduce dose to the patient – ALARA.

Records of these tests must be kept for at least 5 years, even after equipment disposal

Radiation legislation states that there should be records of acceptance testing of each new item of radiological equipment installed after 08 January 2019. This date should be entered into the practice’s X-ray Equipment Register

Performance Testing is carried out as part of the Quality Assurance testing (QA) undertaken by the RPA and MPE at least every 2 years for most x-ray equipment.

CBCT equipment manufacturers usually recommend an annual QA (check the operator manual).

Records of regular performance testing are required from 08 January 2019 for all radiological equipment.

3. Amalgam Separator Legislation Change: 01 Jan 2021

From 01 January 2021, all amalgam separators in use must provide a retention level of at least 95% of amalgam particles. Compliant separators will have the ISO 11143 EU standard (or equivalent) noted on their exterior body.

Dental practices shall ensure that their dental amalgam waste, including amalgam residues, participles and fillings, and teeth, or parts thereof, contaminated by dental amlagam, is handled and collected by an authorised hazardous waste management operator.

Documentary evidence regarding your hazardous waste operator should be included with your Clinical Waste policy and related collection documentation.

Separators must be maintained in accordance with manufacturers’ operating instructions. Usually, this means at least an annual service of the suction system or replacement of a separator unit.

Dental Practices which do not place or remove amalgam?
Dental Compliance Ltd advises as part of your annual clinical waste risk assessment, each practice should include a question on the possibility of amalgam particles being present in your waste.

Even practices where amalgam has not been used as a restorative material for many years may still be removing legacy amalgam fillings for their patients. If you are at risk of producing even the smallest amount of waste amalgam you are required to have an appropriate waste management system.

Local Authorities are the Competent Authority appointed for monitoring compliance requirements for dental facilities and handling of amalgam waste. Due to COVID restrictions, Local Authorities have developed a self-declaration form in order to avoid unnecessary inspections at the present time.

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in-practice courses for dental teams
Infection Control | Radiation | Health & Safety in Dental Practice