COMPLIANCE UPDATE Demember 2019
WHAT’S IN THE December ISSUE:
1. Tips when updating clinical cabinetry
2. Buying a new dental chair?
3. Quiz: what do these symbols mean?
4. HIQA publishes a guide to radiation inspections
5. Infection Control advice over Christmas break
6. Quiz: answers
7. Making New Year Resolutions – 5 tips
8. Dental Compliance upcoming presentations
Thinking of refurbishing clinical cabinetry in 2020?
Consider these infection control tips when planning your design
* Surgery work surfaces and walls must be wipeable, seamless and non-porous
* Do not use tiles as grouting harbours micro-organisms
* Avoid grooves/ledges in cabinetry, skirting boards, doors, or windows
* Cupboard handles must be large enough to easily clean – avoid button or cup shapes
* Windowsills are areas of clutter – instead design narrow, downwards sloping sills that don’t attract items
* Include a regulation-compliant, dedicated handwashing basin in each surgery
Avoid wall mounted cupboards because:
1. Top of cabinet requires regular (weekly) high dusting
2. High shelves are safety risks where objects are above the working height
3. Autoclaves sited underneath have ventilation and heat build-up problems
4. Countertops underneath cupboards require additional task lighting
5. Cupboards add oppressive, cluttered feeling to any room
Always leave sufficient space for sharps containers and solid-sided pedal-operated medical and general waste bins.
Finally, its worth having your final design assessed by a clinical expert in infection control.
Buying a new Dental Chair? CAVEAT EMPTOR (buyer beware!)
When considering the expensive purchase of a new dental chair the less stitching in the chair the better from an Infection Control stance point of view.
My rationale for this statement?
1. It is not possible to fully disinfect stitching
2. Damp & wet stitching harbours microorganisms
3. Infection Control Inspectors prefer non-stitched upholstery - seamless, wipable surfaces are always your most prudent option
In recent weeks HIQA issued:
"A guide to the inspection of services providing medical exposure to ionising radiation"
This is an extremely valuable document for practitioners, undertakings and practice managers updating the radiation compliance file for a HIQA inspection. There are now six radiation documents which HIQA have published that are advised reading for all dentists. Click here to view all six.
What do these symbols signify? Answers are at the end of the newsletter
Closing your dental surgery for the Christmas period . . . don’t forget to carry out these 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.
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 in a dark, cool place (preferably in a fridge)
4. Countertops: clear all items off 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 tagged/labelled, store in a rodent-free secure area
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 are not 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.
Opening the dental practice after the Christmas period? Take a few minutes to carry out these infection prevention and control safety checks:
1. Your most important check after any extended period of closure will be to the water-systems;
a. Flush the dental unit waterlines for 2-3 minutes prior to commencing a patient treatment session;
b. Even where it has been stored in a fridge distilled water should be used within 24 hours if its quality is to be guaranteed. In practices where water distillation units are in use this may necessitate using bottled sterile water until enough fresh distilled water has been produced on day 1 after the holidays;
c. Where Reverse Osmosis systems are in operation run the RO machine for at least 20 seconds at the start of the day. Now check the water quality using your conductivity meter;
d. Water in your taps and pipework may have stagnated over the holiday period. It is good practice to run sink taps for a minute or two. This includes your non-clinical areas such as staff kitchen and the bathrooms. Freshen up the bathrooms by flushing the toilets.
2. Regarding autoclave testing it a good idea first day back to run your weekly vacuum test on the cold chamber. Then, time permitting, the steam penetration test-cycle can run with either a Helix / Bowie Dick test. If time does not permit, the steam penetration test can be carried out during the first instrument sterilisation cycle.
3. Turn on the dental compressor and suction motor. Observe these items running for a minute or two to ensure they are operating correctly.
4. In clinical areas, such as the dental surgeries and decontamination areas, you should quickly look over the countertops and flat surfaces. If you think that dust has settled then carry out a quick wipe-down prior to repositioning stored items such as the dental curing light, amalgamator/capsule mixing machine, ultrasonic scaler etc. Check your stock levels of gloves, facemasks, paper hand towels etc.
5. Finally, run a critical eye over the general external and internal environment of your practice. Check that waste bins don’t need emptying, and that the waiting room, reception areas and public toilets are in order. (Christmas decorations that may have come loose or fallen down over the holiday period).
The above list is not exhaustive however I hope you find it a useful guide as you get back to work.
1. Caution Safety Risk
2. Wear Eye Protection
3. WEEE (Electrical item: do not dispose of in general waste)
Making New Year Resolutions ? Consider these 5 tips when planning your compliance goals for 2020
1. Codes: Know which codes and guidance document are relevant. I highly recommend that you have hard copies available which your dental team can readily access.
2. Evidence: Have documentary evidence which verifies that your clinical operating procedures are being adhered to. You should have a policy/statement of practice compliance, written standard operating protocols, a set of short check-lists / simple audit tools to demonstrate consistent adherence to key protocols.
3. Awareness: Have documentary evidence which clearly demonstrates that staff are fully aware of the clinical operating procedures and the practice governance structure (who’s responsible for what!).
4. Training: Have documentary evidence that team members receive regular in-house refreshers on standard operating procedures. Keep this simple, it does not need to be time-consuming. A 10-minute stand-up weekly meeting can do the trick.
5. Location: Have a designated location, known to dental team members, where practice policies, procedures, training records, checklists/audit records are filed ready for inspection. Then if an inspector arrives unannounced your practice will provide an excellent first impression of your dental compliance.
IDA Metro Branch ASM Friday 07 February 2019
Charlemont Hotel, Dublin
Dr Jane Renehan
Regulation: Something between a Hindrance & a Help
Walk The Talk 2020: Saturday 22 February
The Strand Hotel Limerick
Dr Jane Renehan - all-day workshop for dental team members (limited places)
"Coordinating Essential Dental Compliance"
Dental Compliance Ltd supporting dentists:
- in-house compliance risk assessments
- practice-specific solutions
- advice surgery refurbishment design
- practical advice
- personalised/prioritised compliance plan