The staff of the Ben Archer Health Center in rural New Mexico believes infection control is important, and they are taking every possible step to show their patients and colleagues why.
Jose Hernandez, DMD, and
Frances Rodriguez, CDA
Will the dental industry pay increasing attention to infection control in the future? In our opinion, the answer is "yes," because of two obvious reasons: ethical considerations (it is imperative that we protect ourselves, our staff, our families, and our patients from infectious agents) and regulatory requirements (OSHA requires that specific infection control practices be followed in all U.S. dental practices).
But infection control is also a crucial foundation to a "quality of care standard" that dental professionals can use to attract new patients and keep existing patients happy. The patient`s knowledge of infection control has grown significantly in recent years - and will continue to grow. Stories circulating throughout the media regarding new and increasingly virulent strains of infectious agents can be expected to surface. More patients will take a hard look at their dentist`s infection-control procedures.
Modeling infection-control standards
The Ben Archer Health Center is a not-for-profit, federal- and state-funded health center that provides medical and dental care to four rural communities in and around Hatch, N.M.
In some ways, our situation is unlike that of many privately owned practices. Our clinics are intended to reach people who may be underserved or underprivileged. But we share with all dental practices a commitment to the well-being of our patients. This commitment has resulted in a reputation for delivering a high level of care. Our infection-control practices provide a fitting example of how we set and apply patient care standards that, in many ways, lead the industry.
Barriers: the first line of defense
Good infection control requires a combination of smart processes and effective tools. Barriers are indispensable infection-control tools. In our clinic, a barrier protects any object that might be contaminated by a patient`s saliva or blood. We use barriers on everything from light switches to saliva ejectors, and from patient chairs to our high-speed suction apparatus. These barriers are faithfully changed with each patient. If a patient sits in a chair - even for a few seconds - a dental assistant changes the barrier.
Barriers require us to make simple modifications to procedures. For example, we use a film made by Kodak™ that comes prepackaged with a ClinAsept™ barrier - a plastic envelope encasing the film. To use this type of film, a dental assistant will wear two pairs of gloves. After a film is exposed, the dental assistant removes the barrier from the film, disposes of the barrier, takes off the outer pair of gloves, and disposes of them. The film, and the remaining pair of gloves, has had no contact with the patient`s bodily fluids. The film can be processed without contaminating the darkroom with infectious agents, virtually eliminating the risk of transferring infectious agents to staff or other patients.
Barriers provide both tangible and intangible benefits. On a physiological level, barriers block infectious agents from contaminating surfaces that might be touched by other patients or staff. Cost is never a deciding factor when we evaluate barrier products.
But there are other benefits as well. Barriers are highly visible infection-control tools. Patients see them, and realize that we are actively protecting them.
Questions also provide an opportunity to explain how our clinic sets and meets high standards for infection control. We can point to tools such as our barriers and explain how we use them to protect our patients.
Infection-control procedures
While tools such as barriers are important, Ben Archer does much more. Our clinic complies with OSHA regulations to ensure we meet infection-control guidelines. At each of our facilities, we have designated a dental assistant as an OSHA compliance manager. This dental assistant coordinates all compliance activities, such as state-mandated OSHA training. As regulations are refined, our OSHA compliance manager also makes sure we update our procedures.
We also work with our patients to prevent the spread of infectious agents. For example, if someone arrives for an appointment and appears to have a cold or symptoms of the flu, we ask the patient to reschedule. We explain that even cleaning a cavity releases a higher-than-normal level of bacteria into a patient`s mouth, which could make a sick person even sicker. We tell the patient to take two weeks to get better, then come back. With this approach, our patients understand that we are protecting them. They often thank us for asking them to come back another time!
Recognized for excellence
We at Ben Archer have also received outside recognition for our practice-management standards. We have achieved accreditation by the Joint Commission of Hospital Accreditation Organization (JCAHO).
JCAHO is an independent, not-for-profit organization that identifies standards for health-care providers and conducts evaluations to assess whether providers meet those standards. JCAHO was founded in 1919, and the American Dental Association has been a corporate member since 1979.
Infection control is a key element in the JCAHO accreditation rating system. Ben Archer opted to apply for JCAHO accreditation for three reasons:
(1) As a clinic funded by the government, we are expected to meet not only federal practice standards, but to also seek independent evaluation of our clinics.
(2) The accreditation process validated our practice management. When the commission evaluated our facilities for the first time, we scored in the 90th percentile. The professionals at the Ben Archer clinics knew the JCAHO accreditation substantiated an exceptional standard of care.
(3) JCAHO accreditation is good business. It demonstrates our commitment to quality in the communities we serve. We also believe that as practices become accredited by JCAHO, it helps the dental profession as a whole. After all, it is up to individual practices - whether they are public or private - to set standards for practice management. We create safer work environments for our employees and ourselves, and we help ensure the best possible care for our patients.
For more information about this article, contact the authors at (505) 267-3088. Biographies of the authors appear on page 8.
