Chapters 6, 8, 19

Which of the following is an example of an OSHA required sharp with engineered injury protection:

A shelf-sheathing needle attached to a dental anesthetic syringe.

2. The _____________ has provided detailed infection control recommendations since the 1970s and currently makes such recommendations through its Councils on Scientific Affairs and Dental Practice.

American Dental Association (ADA)

According to OSHA Bloodborne pathogens Standard, the written exposure control plan must be updated at least:

Annualy

The ____________ is a voluntary organization composed of manufacturers, distributors, researchers, regulators, and users of medical/dental equipment. One component of this organization is devoted to developing sterilization standards including recommended practices on how properly to use sterilizers and technical documents on the equipment.

Association for the Advancement of Medical Instrumentation

When sharps injuries can occur

At chairside, during instrument processing, and other times. Look at chapter 19 learning objectives for examples.

The U.S. Environmental Protection Agency (EPA) is associated with infection control by

Attempting to ensure the safety and effectiveness of disinfectants. The EPA also is involved in regulating medical waste after it leaves the dental office.

Which of the following diseases is caused by bloodborne pathogen: a. Tetanus b. Hepatitis C c. Measles D. Influenza

B. Hepatitis C

According to OSHA, if an exposure incident to potentially infectious materials occurs, the employer is required to document all of the following except the: a. protective barriers used at the time b. Medications given to the source patient c. Route of exposure d. Name of the source patient

B. Medication given to the source of patient

Hepatitis __ are generally transmitted through contact with bodily fluids.

C and D

Which of the following is not an acceptable technique for the handling of sharps? a. recapping the needle using a cap holder b. recapping a needle using scoop technique c. disposing of a needle in a general trash bag d. disposing of a needle in a puncture-resistant container

C. Disposing of a needle in a general trash bag

Which of the following is included in an exposure control plan: a. The documentation of employee infectious disease status b. The documentation of patient infectious disease status c. The evaluation of safety devices d. The evaluation of sterilization procedure.

C. The evaluation of safety devices

Hepatitis D is a :

Coinfection with Hepatitis B

Improving the quality of dental unit water addresses which pathway of cross-contamination in the office:

Community to office

Improving the quality of dental unit water addresses which pathway of cross-contamination in the office?

Community to office

Which of the following infection control procedures is not covered by the bloodborne pathogens standard? a. Wearing a surgical mask at chairside during patient care b. Wearing gloves during instrument processing and operatory cleanup c. Handwashing d. Cleaning and sterilizing reusable hand instruments between patients

D. Cleaning and sterilizing reusable hand instruments between patients

According to OSHA, when developing an exposure control plan, an employer should seek the input of:

Employees who have direct patient contact

According to the bloodborne pathogens standard, who pays for employee training and hepatitis B immunization:

Employer

The accessibility of the exposure control plan for the employees is the responsibility of the:

Employer

When an employee is sent for medical services following an exposure incident, who is responsible for the cost of the treatment:

Employer

Define and give examples of engineering controls and work practice controls in dentistry.

Engineering controls: Has been modified to include as examples "safer medical devices such as sharps with engineered sharps injury protections and needleless systems." a device that removes the potential hazard, e.g., sharps containers; engineered medical devices with sharps injury prevention features such as a protective needle sheath Work practice controls: Actions that alter the manner in which a task is performed, e.g., the one-handed scoop technique for recapping a used needle

Differentiate between engineering and work practice controls in dentistry.

Engineering: Generally act on the hazard itself so the employee may not have to take self-protective action. An example is use of a sharps container. Work practice controls: Alter the manner in which a task is performed reducing the likelihood of exposure such as safe handling techniques for needles.

Which governmental agency controls the safety and effectiveness of surface disinfectants?

Environmental Protection Agency (EPA)

Which governmental agency controls the safety and effectiveness of sterilizers?

Food and Drug Administration (FDA)

A hepatitis B carrier is:

HBsAg-positive

Which type of bloodborne can be easily killed outside of the body: a. Hep A b. HIV c. Hep C d. HBV

HIV

The dental assistant should ____ ______ teeth that do not contain amalgam following an extraction before used for educational purposes:

Heat sterilize

An unvaccinated dental health care worker is at greatest risk of exposure to which microorganism during dental treatment procedures:

Hep B

Sharps injuries are primarily associated with occupational transmission in which of the following diseases

Hep B, Hep C, and HIV

Sharp instruments are primarily associated with occupational transmission in which of the following diseases:

Hep B, Hep C, and human immunodeficiency virus (HIV)

List the three bloodborne pathogens associated with sharps injuries.

Hepatitis B (HPV) Hepatitis C (HCV) Human Immunodeficiency (HIV)

The vaccine for hepatitis B protects against:

Hepatitis B and D

Which hepatitis virus is transmitted through contaminated food and water?

Hepatitis E

Which body system is destroyed by HIV disease?

Immune

When a used needle is removed form a syringe during treatment, it should be placed:

In a sharps container in the treatment room.

Which of the following is not a mode of spread of HIV disease? a. Percutaneous b. Inhalation c. Sexual activities d. From infected mother to child at birth

Inhalation

How does HIV cause AIDS?

It destroys the body's defenses against diseases.

How does HIV cause Aids?

It destroys the body's defenses against diseases.

The major source of disease agents in the dental office are the:

Mouths of the patients

________ is a division of the U.S. Department of Labor, and its charge is to protect the workers of America from physical, chemical, or infectious hazards in the workplace.

OSHA

Which governmental agency requires employers to protect their employees from exposure to blood and saliva at work:

Occupational Safety and Health Administration

Which governmental agency requires employers to protect their employees from exposure to blood and saliva at work?

Occupational Safety and Health Administration (OSHA)

Discuss the proper handling of extracted teeth in regards to proper infection control

One should dispose of extracted teeth as regulated medical waste unless they are returned to the patient. One should not dispose of teeth containing amalgam in regulated medical waste intended for incineration (wasting something, such as burning). One should clean and place extracted teeth in a leak-proof container labeled with a biohazard symbol and containing an appropriate disinfectant for transport to educational institutions or to a dental laboratory. One should heat-sterilize teeth that do not contain amalgam before they are used for educational purposes.

Which of the following is the infection control education organization in dentistry?

Organization for Safety and Asepsis Procedures (OSAP)

According to the following pathways for cross-contamination _______ is the most difficult to control:

Patient to dental team

State the most serious type of occupational exposure to bloodborne pathogens.

Percutaneous (through the skin)

How should a used anesthetic needle be handled before placing it in a sharps container:

Recap it and remove from the syringe

Summarize the components of the OSHA bloodborne pathogen standard

Requires that the employer has the responsibility to protect employees from exposure to blood and other potentially infectious materials in the workplace and to give proper care if such exposure does occur. The standard applies to employers in any type of facility in which employees have a potential for exposure to body fluids including dental and medical offices; dental, clinical, and research laboratories; hospitals; funeral homes; emergency medical services; nursing homes; and others. The bloodborne pathogens standard is the most important infection control law in dentistry for protection of health care workers.

After an exposure incident, the employer must provide the evaluation physician with a description of the:

Source patient treatment plan

Bloodborne transmission of certain viruses, such as human immunodeficiency virus (HIV), can occur through cuts, punctures, and:

Spatter of blood onto mucous membranes.

The concept that human blood; body fluids secretions, excretions regardless of whether they contain blood; nonintact skin; and mucous membranes are treated as if known to be infectious is known now as:

Standard Percautions

What is the infection control protocol when working with an HIV-positive patient:

Standard Precautions

when performing oral surgery, one should perform ________ hand asepsis before donning ______ surgical gloves:

Surgical sterile

Sharps containers should be replaced when:

The contents reach the fill line on the indicator

According to Occupational Safety and Health Administration (OSHA) a bloodborne pathogen training program should include a general explanation of:

The epidemiology and modes of disease transmission

Occupational acquired Hep B in health care workers is most commonly contracted:

Through sharp injuries

Occupationally acquired hepatitis B in health care workers is most commonly contracted:

Through sharps injury

The best way for one to avoid contracting a bloodborne disease in the office is:

To handle sharps carefully

State the goal of infection control

To reduce the dose of microorganisms that may be shared between individuals or between individuals and contaminated surfaces

The CDC does not have the authority to make laws, but many of the local, state, and federal agencies:

Use CDC recommendations to formulate the laws.

All of the following are components of the OSHA Required Training program except: a. An explanation of the modes of transmission of bloodborne pathogens b. A general explanation of the epidemiology and symptoms of bloodborne pathogens c. An explanation of engineering work controls d. Information on post-exposure and follow-up

c. An explanation of engineering work controls

The Centers for Disease Control and Prevention guidelines for infection control in dentistry:

cover more topics than the bloodborne pathogens standard

A dental assistant has completed the series of injections of hepatitis B vaccination. The next step is to:

get blood test for HBV antibodies.

The FDA regulates the ________ and _______ of medical devices (such as sterilizers, biological and chemical indicators, ultrasonic cleaners and cleaning solutions, liquid sterilants [e.g., glutaraldehydes], gloves, masks, surgical gowns, protective eyewear, handpieces, dental instruments, dental chairs, and dental unit lights) and of antimicrobial handwashing agents and mouth rinses.

manufacturing and labeling

Blood-borne pathogens enter the __ during some dental procedures.

mouth

Not doing a good job cleaning or sterilizing reusable hand instruments contributes to which pathway of cross-contamination in the office:

patient to patient

Not doing a good job cleaning or sterilizing reusable hand instruments contributes to which pathway of cross-contamination in the office?

patient to patient

Patients who are infected with HIV or AIDS are:

protected from discrimination by the Americans with Disabilities Act.

The goal of dental infection control is to:

reduce the dose of microorganisms that may be shared between individuals

A percutaneous transmission spreads through which route?

skin

The risk of getting AIDS as a dental assistant is:

very low

List the minimum content required from OSHA on the required training

1. An accessible copy of the regulatory text of the bloodborne pathogen standard and an explanation of its contents 2. A general explanation of the epidemiology and symptoms of bloodborne diseases 3. An explanation of the modes of transmission of bloodborne pathogens 4. An explanation of the employer's exposure control plan and the means by which the employee can obtain a copy of the written plan 5. An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials 6. An explanation of the use and limitations of methods that will prevent or reduce exposure including appropriate engineering controls, work practices, and personal protective equipment 7. Information on the types, proper use, location, removal, handling, decontamination, and disposal of personal protective equipment 8. An explanation of the basis for selection of personal protective equipment; information on the hepatitis B vaccine including information on its efficacy, safety, method of administration, the benefits of being vaccinated, and that the vaccine and vaccination will be offered free of charge 9. Information on the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials 10. An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available 11. Information on the postexposure evaluation and follow-up that the employer is required to provide for the employee after an exposure incident 12. An explanation of the signs and labels or color coding required by the standard 13.. An opportunity for interactive questions and answers with the person conducting the training session

State examples of sharps safety

1. Be extra careful when giving a second esthetic injection to the same patient. 2. Use round-tipped scalpel blades instead of pointed-tipped blades. 3. Consider using instruments rather than fingers to retract tissue when giving injections or suturing. 4. Organize sharp instruments in trays/cassettes so that their tips are not pointing up. 5. Make sure handpieces in their holders have the bur pointing away from the operator. 6. Use instrument cassettes thick enough to avoid sharps from protruding out of the cassette. 7. Place sharp instruments back in a stable fashion when returning them to trays, cassettes, or bracket table

List the pathways for cross-contamination in the dental setting

1. Patient to dental team 2. Dental team to patient 3. Patient to patient 4. Dental office to community including the dental team's families 5. Community to patient 6. Dental team to family

What does a health care professional do in a post exposure medical evaluation and follow up?

1. Receives the following from the employer: • Copy of standard • Incident report • Employee's job description • Past written opinions on employee's vaccination status and any past exposure incidents 2. Arranges for testing of source individual (with consent) or receives test results from employer-arranged testing or receives other information about source individual's hepatitis B virus and human immunodeficiency virus status or that consent for testing was not given 3. Evaluates exposed employee for testing with consent and arranges for testing when indicated† 4. Informs exposed employee of: • Source individual's test results, stressing confidentiality • Results of the evaluation • Any condition that requires further evaluation or treatment 5. Gives written opinion to employer that employee was informed of results and of any further evaluation or treatment needed.

What does an employee do in a post exposure medical evaluation and follow up?

1. Reports to the health care professional for evaluation 2. Gives or withholds consent for testing 3. Receives own and source individual's test results from health care professional 4. Is told by health care professional of any conditions resulting from exposure that require further evaluation or treatment

What does an employer do in a post exposure medical evaluation and follow up?

1. Sends exposed employee to health care professional for testing (with consent) 2. Sends source individual to health care professional or arranges for other testing (with consent). If hepatitis B virus and HIV status are known already or consent is not given, informs the health care professional 3. Gives the following to the health care professional: • Copy of OSHA standard • Incident report • Employee's job description as related to the exposure incident • Past written opinions on employee's hepatitis B vaccination status and any past exposure incidents • Results of source individual's blood testing, if available 4. Ensures that test results of source individual are given to the health care professional and that health care professional informs employee of these results, stressing confidentiality 5. Receives written opinion from health care professional 6. Maintains written opinion in confidential employee medical records file

Life expectancy after contracting the human immunodeficiency virus (HIV) is

25 years

State the record-keeping requirements for employee medical records

30 years past the last date of employment.

Which percentage of hepatitis B (HBV) cases are asymptomatic?

33%

Most persons who develop HIV disease become HIV-positive within __________ after exposure.

6-12 weeks

About how many persons in the world have been infected with HIV?

78 million

About what percent of persons infected with hepatitis C virus become chronic carriers of the disease?

80%

All of the following types of viral hepatitis are bloodborne except hepatitisa. Ab. Bc. Cd. D

A

List safe dental anesthetic injection practices

Use single-dose vials for parenteral medications whenever possible. • Do not use needles or syringes for more than one patient. This includes manufactured prefilled syringes and other devices such as insulin pens. • Medication containers (single- and multidose vials, ampules, and bags) are entered with a new needle and new syringe, even when obtaining doses for the same patient. • Do not use single-dose (single-use) medication vials, ampules, and bags or bottles of intravenous solution for more than one patient. • Do not combine the leftover contents of single-use vials for later use. The following apply if multidose vials are used: • Dedicate multidose vials to a single patient whenever possible. • If multidose vials will be used for more than one patient, they should be restricted to a centralized medication area and should not enter the immediate patient treatment area (e.g., dental operatory) to prevent inadvertent contamination of the vial with spray and spatter or direct or indirect contact with potentially contaminated surfaces or equipment. (If a multidose vial enters the immediate patient treatment area, it should be dedicated for single-patient use and discarded immediately after use.) • Date multidose vials when first opened and discard within 28 days unless the manufacturer specifies a shorter or longer date for that opened vial. • Do not use fluid infusion or administration sets (e.g., IV bags, tubings, and connections) for more than one patient.

Sharps safety procedures indicate what type of gloves should be work during operatory cleanup and instrument processing:

Utility gloves

Sharps safety procedures indicate what type of gloves should be worn during operatory clean up and instrument processing.

Utility gloves

Define virulence, dose, and body resistance:

Virulence: pathogenic properties of the invading microorganism Dose: The number of microorganisms that invade the body Body Resistance: body defense mechanism of the host

Where should sharps containers be placed in the office?

Wherever disposable sharps are used or may be found

Where should sharps container be placed in the office:

Wherever disposable sharps are used or may be found.

A plan referring to factors that influence overall attitudes and behavior in the office regarding sharps safety is:

a culture of safety

Define the term sharps

a term for devices with sharp points or edges that can puncture or cut skin or other tissue.

Which is a correct statement about hepatitis B? a. Only about one-third of those infected have recognizable symptoms. b. Most dental assistants who have been working for more than 5 years get hepatitis B. c. Most persons who get hepatitis B die. d. Hepatitis B is usually spread through drinking contaminated water.

a. Only about one-third of those infected have recognizable symptoms.