by Mary Govoni, CDA, RDA, RDH, MBA
As I spend time lecturing to dental teams and consulting with teams individually, I'm continually surprised by their lack of understanding and misuse of infection control products and equipment.
Although products and equipment may appear to be working effectively, there are potential hazards to patients from improper use and maintenance of products and equipment. Dental teams should constantly ask if they are doing the best they can do to protect patients from exposure to pathogenic microorganisms during treatment. Not “doing the right thing” may not only harm patients, it may also expose the dental practice to liability for the consequences.
Many of the common errors I've observed in dental practices relate to the lack of understanding about the products or equipment being used. This is not the fault of the product manufacturers; they do an excellent job of providing clear and concise instructions for use. Dental teams need to read and follow the instructions.
For example, did you know that many of the dental unit water line products that are designed as continuous-use products (you add them each time you fill the water bottle) recommend that a “shock treatment” be performed when starting to use the product, and at periodic intervals?
Products such as BluTab from ProEdge Dental Products, ICX from A-dec, Citrisil from Sterisil, MicroCLEAR from Rowpar, and VistaTab from Vista Research Group are continuous-use antimicrobial agents for dental unit water lines. Each of these products has specific recommendations regarding the protocol for shock treatments for the water lines. Some also have recommendations regarding the source water — whether it should be tap water or distilled water.
These recommendations are specific to each product and can impact the effectiveness of the product. In addition, these products have recommendations regarding monitoring the quality of the water from the dental units. Check your product recommendations.
If you use a class B or prevacuum sterilizer, are you aware manufacturers recommend that an air removal and air leak test be run at the beginning of each day to verify the proper functioning of the unit?
This is commonly known as a Bowie-Dick test, which must be run with the autoclave empty. The prevacuum sterilizers commonly sold in the U.S. are from A-dec, Tuttnauer, and Sirona. Some models have the air removal and leak test built in, while others require a separate indicator to be run through a cycle each day.
Whatever type of autoclave you use in your practice or facility, read the manufacturer's recommendations on loading the sterilizer. Improper loading can prevent your instruments from being sterilized and can put patients at risk.
Other products, such as surface disinfectants, have critical information in their instructions regarding the use of the products. Variables such as contact times, dilution (if the product does not come premixed), whether the product is a cleaner/disinfectant, or whether it requires the use of a separate cleaner prior to applying can determine if a product is effective.
Some products can be misused in a way that may be harmful to equipment. For example, some dental teams attempt to make instrument handling safer by using disinfecting solutions in their ultrasonic instrument cleaners. According the manufacturers' instructions, only ultrasonic cleaning solutions should be used in these devices since the pH of the product is specifically designed to be compatible with the metal in the unit. Using other types of solutions can cause the metal to break down or the unit to malfunction.
It's easy to get caught up in the busyness of our day's work while trying to provide the best care we can. Take a few minutes to learn if you are using infection control products and equipment effectively.
Mary Govoni, CDA, RDA, RDH, MBA, is the owner of Mary Govoni & Associates, a consulting company based in Michigan. She is a member of the Organization for Safety, Asepsis and Prevention. She can be contacted at [email protected] or www.marygovoni.com.
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