INFECTION CONTROL DR SALWAN

1. INFECTION CONTROL DR SALWAN

2. MANAGEMENT OF WORK RELATED INJURIES • ALL DENTAL OFFICES WILL HAVE WORK RELATED INJURIES • GOOD NEWS IS IN DENTAL OFFICE THEY ARE NOT HAPPENING AS OFTEN AS OTHER WORK PLACES. • THERE IS A PROTOCOL TO FOLLOW IN CASE OF A INJURY • THESE PROTOCOLS ARE REGUALTED BY GOVERNMENT

3. INJURY PREVENTION AND MANAGEMENT • IN DENTAL OFFICE GREATEST RISK OF TRANSMISSION OF BLOODBORNE INFECTION IS WHEN SKIN IS PENETRATED BY • CONTAMINATED NEEDLE, BURS, SCALPELS, BROKEN GLASS, DENTAL WIRES, PESO REAMERS, ENDO FILES

4. INJURY PREVENTION AND MANAGEMENT • SHARP INJURIES CAN BE PREVENTED IN DENTAL SETTING THROUGH • ADMINISTRATIVE CONTROL • ENGINEERING CONTROL • WORK PRACTICE CONTROL

5. ADMINISTRATIVE CONTROL • THESE ARE THE SAFETY RULES ADMINISTRATED BY THE EMPLOYERS THROUGH: • HBV VACCINATION • INITIAL JOB ORIENTATION • PERIODIC TRAINING • CONTINUING EDUCATION

6. ADMINISTRATIVE CONTROL • A WRITTEN PROCEDURE MANUAL OF INJURY PREVENTION AND MANAGEMENT ( ANNUAL UPDATES ) • UNIVERSAL ( STANDARD) PRECAUTIONS • PERSONAL PROTECTIVE EQUIPMENT • HAZARD LABELS AND SIGNS

7. ADMINISTRATIVE CONTROL • DESIGNATE AN EMPLOYEE FOR INJURY RELATED SUPPORT AND ASSISTANCE TO OTHER EMPLOYEES • SHARPS INJURY LOG • INITIAL / ANNUAL EMPLOYEE TRAINING LOG

8. SHARP INJURY LOG THIS LOG MUST BE MAINTAINED IN A WAY THAT ENSURE EMPLOYEE PRIVACY AND MUST CONTAIN MINIMUM: • TYPE AND BRAND OF DEVICE INVOLVED IN THE INCIDENT • LOCATION OF THE INCIDENT • DESCRIPTION OF THE INCIDENT

9. EMPLOYEE TRAINING LOG EMPLOYEE TRAINING RECORDS MUST INCLUDE: • INITIAL TRAINING DATE • ANNUAL TRAINING DATES • CONTENTS OF THE TRAINING • NAME AND QUALIFICATIONS OF THE TRAINER

10. DCW 7 FORM NOTICE BOARD

11. DCW 7 SPANISH NOTICE BOARD

12. TIME OF HIRE PAMPHLET

13. FACT SHEET AT THE TIME OF HIRING

14. MPN 1 FORM

15. MPN 2 FORM

16. TIME OF HIRE

17. PREDESIGNATION OF PERSONAL PHYSICIAN

18. ENGINEERING CONTROL • DESIGN TO MINIMIZE THE RISK OF SHARP INJURIES AND BLOODBORNE PATHOGENS • RUBBER DAM • NEEDLE RECAPPING • SHARP CONTAINERS • ULTRASONIC CLEANERS • NEEDLELESS INJECTIONS

19. ENGINEERING CONTROL BEFORE USING A SAFETY DEVICE WITH PATIENT AND EMPLOYEE ITS ADVISED TO “ BENCH TEST” TO ENSURE ITS USE WILL NOT COMPROMISE WORKER OR PATIENT SAFETY. TRAIN EMPLOYEES IN ITS PROPER USE AND DISPOSAL

20. WORK PRACTICE CONTROL • THIS IS BEHAVIOR BASED, AND INVOLVE CHANGING PROCEDURES TO REDUCE LIKELIHOOD OF INJURY • USE INSTRUMENT INSTEAD OF FINGERS • PASSING INSTRUMENTS WITH SHARP END TOWARDS YOURSELF • ANNOUNCING INSTRUMENT PASSING • SAFE NEEDLE HANDLING ONE HANDED SCOOP • REPLACING SHARP CONTAINERS BEFORE THEY ARE FULL • HAVE A BUFFER ZONE FOR PASSING INSTRUMENTS

25. SHARP DISPOSAL SHARPS CONTAINER SHOULD BE USED TO DISCARD • DISPOSABLE NEEDLES • BROKEN CARTRIDGES • BURS • SCALPELS • ORTHO WIRES • BROKEN INSTRUMENTS • SUTURE NEEDLES • ENDODONTIC FILES • BROKEN GLASS VIALS

26. SHARP CONTAINERS • IT SHOULD BE RED IN COLOR WITH BIOHAZARD SYMBOL. • LARGE ENOUGH TO HAVE STABLE BASE • MADE OF STURDY PLASTIC AND LEAK PROOF MATERIAL • CONTAINER IN EACH TREATMENT ROOM • MUST BE REMOVED ONCE FILLED UPTO 3/4TH THE CONTAINER • MUST BE DISPOSED OFF ACCORDING TO STATE REGULATIONS

27. POST EXPOSURE MANAGEMENT IF AN EMPLOYEE HAS A SHARP INJURY OR EXPOSED TO BLOODBORNE PATHOGENS • WASH WITH SOAP AND WATER AND FLUSH MUCOUS MEMBRANE • REPORT EXPOSURE TO SUPERVISOR • IDENTIFY THE SOURCE PATIENT ( IF POSSIBLE ) • EMPLOYER MUST PROVIDE FOLLOW UP INSTRUCTIONS AND REFERRAL TO MEDICAL PROVIDER

28. POST EXPOSURE MANAGEMENT CDC RECOMMENDATION FOR TESTING, MEDICAL EXAMINATION,PROPHYLAXIS AND COUNSELING PROCEDURE • WITH THE SOURCE PATIENT’S CONSENT TEST BLOOD OF PATIENT AND SHARE THE RESULTS WITH EMPLOYEE

29. POST EXPOSURE MANAGEMENT 2.WITH EMPLOYEE’S CONSENT SEND FOR IMMEDIATE BLOOD TEST OR STORE BLOOD FOR 90 DAYS IN CASE OF DELAYED DECISION TO TEST 3.THE EXPOSED EMPLOYEE CAN REFUSE ANY MEDICAL EVALUATION.DOCUMENT AND GET IS SIGNED BY EMPLOYEE AND WITNESS 4.ABOVE PROCEDURES ARE NOT REQUIRED IF INJURY IS CAUSED BY STERILE SHARP

30. CAL/OSHA DOCUMENTATION ALL INCIDENTS MUST BE REPORTED AND DOCUMENTED WITH FOLLOWING INFORMATION • DATE / TIME OF EXPOSURE • TYPE OF FLUID( BLOOD, SALIVA, TISSUE) • TYPE OF EXPOSURE ( PERCUTANEOUS, SKIN, MUCOSA CONTACT) • CIRCUMSTANCE SURROUNDING ( DURING PROCEDURE, INSTRUMENT CLEANING ETC.) • WHETHER SHARP INVOLVED ( COMPLETE SHARP INJURY LOG)

31. POST EXPOSURE MANAGEMENT • IF PERMITTED BY LAW IDENTIFY SOURCE PATIENT • WITH CONSENT TEST THE PATIENT FOR HBV, HCV AND HIV STATUS • DO NOT TEST THE PATIENT IF HBV, HCV AND HIV STATUS IS KNOWN • IF PATIENT DECLINE TESTING DOCUMENT IT IN EMPLOYEE’S MEDICAL FILE

32. POST EXPOSURE MANAGEMENT • IF EMPLOYEE REFUSES THE MEDICAL EVALUATION, DOCUMENT IT IN EMPLOYEE’S MEDICAL FILE • RETAIN THE MEDICAL CARE PROVIDER’S WRITTEN OPINION IN THE EMPLOYEE’S MEDICAL FILE. • EMPLOYEE’S MEDICAL FILES ARE CONFIDENTIAL AND MAINTAINED PER CAL/OSHA REGULATIONS

33. POST EXPOSURE MANAGEMENT CONTACT YOUR WORKMANS’ COMPENSATION INSURANCE COMPANY • BY PHONE • FAX • ONLINE • E-MAIL MOSTLY ALL OPTIONS ARE AVAILABLE 24/7

34. FILE A WORKMANS’ COMPENSATION CLAIM • EMPLOYEE TO FILL EMPLOYEE SECTION OF DCW 1 FORM • MAKE A COPY AND GIVE IT TO EMPLOYER • EMPLOYEE HAS RIGHT TO RECEIVE UPTO $ 10,000 IN MEDICAL CARE WHILE EMPLOYER DECIDE TO DENY OF ACCEPT THE CLAIM

35. DCW 1 FORM

36. INJURY REPORT

37. SUPERVISOR’S ACCIDENT REPORT

38. E-MAIL: pdsociety@aol.com GET READY FOR MORE FUN

39. WATERLINES QUESTIONS THE WATER ALREADY HAS BACTERIA, SO WHY DO WE NEED TO DO ANYTHING PATIENT MOUTH IS FULL OF BACTERIA WHAT’S THE BIG DEAL ?

40. WATERLINES • DENTAL CLINIC UNDER INVESTIGATION

41. WATERLINES IN DENTAL OFFICE STUDY HAS SHOWN RELATIVELY LOW LEVEL OF MICROBIAL ENTER THE DENTAL UNIT FROM CITY WATER BUT HIGHER LEVEL OF MICROBIAL LEVEL ARE FOUND IN WATER EXIT THE DENTAL UNIT

42. BIOFILM • FREE FLOATING MICROORGANISM ENTER DENTAL UNITS • ATTACH TO INNER WALLS OF DENTAL UNIT TUBING • MAKE PROTECTIVE LAYER OF PROTEIN • POLYER LAYER PROTECT MICRO-ORGANISM AND THEY REPRODUCE • INCREACE IN MICROORGANISM EXITING DENTAL UNIT

43. PATHOGENS IN DENTAL UNIT WATER • PSEUDOMONAS AERUGINOSA • LEGIONELLA SPECIES • MYCOBACTERIUM SPECIES • FUNGI • PROTOZOE • ALGAE

44. STANDARD OF DRINKING WATER • DRINKING WATER 500 CFU/ML • ADA STANDARD 200 CFU/ML • OUT SOURCE OF DENTAL UNIT NORAMALLY 100,000-200,000 CFU/ML • IT CAN BE UPTO 10 MILLION CFU/ML

45. IMPROVING WATER QUALITY MAKE SURE PRODUCT AND PROCEDURE WE USE IS SAFE FOR • PATIENTS • DENTAL TEAM • DENTAL UNIT • EASY TO PERFORM • EASY MAINTENANCE AND MONITORING

46. IMPROVING WATER QUALITY • INDEPENDENT RESERVOIRS • FILTERS • CHEMICAL TREATMENT • GETTING WATER QUALITY TESTED

47. INDEPENDENT RESERVOIRS

48. FILTERS • AQUASAFE PALL CORP 800-645-6578 • CLEARLINE SCITECH DENTAL 800-524-6984 • DENTA PURE 800-972-3543

49. CHEMICAL TREATMENT • DENTACIDE 210-308-5635 • IGN 500 909-394-1770 • MINT-A-KLEEN 866-246-2548 • SHOCK TUBE 877-755-PURE • STERILEX 800-511-1659 • VISTACLEAN 419-281-3927 • BLU TABLET LOCAL DEALERS

50. WATER PURIFIERS • CROSSTAT 913-312-5860 • VISTACLEAR 419-281-3927 • PURELINE 877-755-PURE • DENTALEZ 866-DTE-INFO