2018 Buyers Guide

According to the OSHA, Bloodborne Pathogens Standard, an exposure incident is: • A cut or puncture with a contaminated item • Puncture of the skin with a contaminated needle or instrument • Splashing of blood and/or saliva onto mucous membranes (eyes, nose or mouth) • Splash or splatter of blood and/or saliva onto non-intact (chapped or abraded) skin

OSHA requires reporting and recording of such incidents. OSHA requirements further stipulate that dental practices must have a written plan for follow-up and possible treatment of employee if an exposure incident occurs and employers are required to keep records of exposures on file. For OSHA violations, it is important to note the employer pays any fine(s), not the employee. The most common citations issued is related to non-compliance with the Blood borne Pathogen Standard, which involves a starting penalty of $12,675 per violation. Failure to Abate, meaning a practice failed to respond in the timeframe OSHA indicated. The most serious violation is the Willful or repeated violation, which is the result of a practice not having a safety program or having a prior citation that has gone without correction. (Source: Dental Products Report, 6 Scary Consequences of Not Following Good Infection Control Practices, 10/25/2017) Despite the fact that it is a requirement, exposure incidence can go unreported so it is unknown exactly how many incidents in total actually take place. Shockingly, healthcare providers have a myriad of excuses not to report incidences. One of the most common excuses is the lack of education and perceived low risk of disease transmission associated with seemingly minor events. Additionally, certain healthcare providers will make judgements based on the perceived health of their patients and many are afraid that speaking out is a reflection on their competency and fear that it may jeopardize their employment. The Dental Assistant is instrumental with ensuring all persons in the practice adhere to proper procedures and protocol in working with patients, handling of instruments and using consumables, especially those that involve needles or instruments with sharp edges/surfaces. The Dental Assistant is typically the primary person responsible for OSHA infection control products as 87% of the time he/she is the one purchasing those supplies or products (Source: American Dental Assistant Association (ADAA)) that include personal protection equipment such as gloves, masks, protective eyewear and protective clothing. Proper infection control procedures are supported by worker training, which is required annually by OSHA, about the risks of exposure and proper use of personal protection equipment (PPE). Oral health professionals and patients rely on expert infection control guidelines and practices including those for patients from the Centers for Disease

Control (CDC), which provides evidence-based rules, recommendations and guidelines. Their summary of infection control procedures provide recommendations around proper hygiene, precautions, safe injection practices, sterilization and disinfection of devices, and more. Those can be referenced here at: https://www.cdc.gov/oralhealth/infectioncontrol/pdf/ safe-care.pdf. This reference document contains an infection prevention checklist that can be used as part of internal audit processes and for assessing the current infection prevention and control procedures for a dental practice. Periodic monitoring via a mock OSHA audit or self-audit done by the clinic team ensures that employees are both doing what they are supposed to be doing and what they’ve been instructed to do. The Dental Assistant serves a vital role for the dental practice in the area of infection control. From an awareness standpoint to procedures and training, diligent activity done periodically will ensure proper procedures are utilized to avoid incidence exposure and protect safety and well-being of both patients and employees involved in practice care.

Summary of Infection Prevention Practices in Dental Settings

Basic Expectations for Safe Care

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