Standard Precautions

What types of PPE are used in dentistry?

-Glove: protect hands -Gowns: protect skin and clothing -Masks: protects mouth/nose -Goggles: protect eyes -Face shields: protect face, mouth, nose, and eyes

What are 4 universal preventative practices to reduce exposures?

1. Careful handling sharps 2. Use of rubber dams to minimize blood splatters 3. Hand washing 4. Use of PPE

What are three ways to limit "touch contamination?

1. Don't touch your face with contaminated gloves 2. Don't adjust PPE with contaminated gloves 3. Don't touch environmental surfaces except as necessary during patient care

What are two reasons to change gloves?

1. During use if torn or when heavily soiled (even during use on the same patient) 2. After use on each patient

What is the sequence for taking off PPE?

1. Gloves 2. Goggles 3. Gown 4. Mask 5. Hand hygiene

What is the sequence for putting on PPE?

1. Gown 2. Mask 3. Goggles/face shield 4. Hand hygiene 5. Gloves

What are examples of standard precautions?

1. Hand hygiene. 2. Use of PPE (i.e. gloves, masks, eyewear) 3. Respiratory hygiene/cough etiquette 4. Sharps safety (engineering and work practice controls) 5. Safe injection practices (i.e. aseptic technique for parenteral medications) 6. Sterile instruments and devices 7. Clean and disinfected environmental surfaces

What are the 3 types of gown materials?

1. Natural or man-made 2. Reusable or disposable 3. Resistant to fluid penetration 4. Clean or sterile

Why are alcohol-based hand rubs decent? (3)

1. They are less damaging to skin than soap and water, resulting in less dryness and irritation. 2. They require less time than hand washing with soap and water. 3. Bottles/dispensers can be placed at the point of care so they are more accessible.

What factors influence PPE selection? (3)

1. Type of exposure anticipated -splash/spray vs touch -patient category of isolation precautions) 2. Durability and appropriateness for the task 3. Fit

When is hand washing required? (3)

1. Visibly dirty 2. After touching contaminated objects with bare hands 3. Before and after patient treatment (before glove placement and after glove removal)

What are the steps of hand washing?

1. Wet your hands with clean, running water, turn off the tap, and apply soap. 2. Lather your hands by rubbing them together with the soap. Be sure to lather the back of your hands, between your fingers, and under your nails. 3. Scrub your hands for at least 20 seconds. 4. Rinse your hands well under clean, running water. 5. Dry your hands using a clean towel or air dry them.

When alcohol-based hand rub is acceptable OR soap and water?

1. after barehanded touching of objects likely to be contaminated by blood, saliva, or respiratory secretions 2. before and after treating a patient 3. before putting on gloves 4. immediately after removing gloves

Name the surfaces of the hands to wash when practicing hand hygiene.

1. back of hands 2. between fingers 3. palms of hands 4. under nails

Protective Elements of Standard Precautions (5)

1. handwashing 2. use of gloves, masks, eye protection and gowns 3. patient care equipment 4. environmental surfaces 5. injury prevention

What kinds of gloves does the UAB dental school use?

1. nitrile (as opposed to vinyl, latex, etc.) 2. non-sterile (as opposed to sterile gloves) 3. one pair (as opposed to double gloving) 4. Single use (vs. reusable)

How long do you wash your hands when they are visibly soiled?

15-20 seconds with soap and water

What year was universal precautions implemented?

1987

The NIH has estimated ______% of all hospital patients develop an infection. What is this type of infection called?

5-10; nosocomial infection

_______ improves clarity of vision of goggles.

Antifog

What is the rule when using refillable soap dispensers?

Do NOT "top off" a partially empty dispenser. It must be washed and dried before refilling.

___________ leave the operatory wearing gloves!

Do not

T/F: Personal glasses are substitutes for goggles.

False

T/F: using a bar soap is equivalent to using soap from dispenser.

False, do not use bar soap

T/F: Nosocomial infections are rare.

False. According to the CDC, there are 99,000 deaths from nonsocial infections.

In the research article, did the last pair of gloves in the box have more bacteria than the first pair?

Gloves from a fresh box and those from boxes that had been in dental operatories until they were nearly empty were relatively bacteria free.

What is the single most critical measure for reducing the risk of transmitting organisms to patients?

Hand washing

How did standard precautions expand on universal precautions?

It includes organisms spread by blood and also: -Body fluids, secretions, and excretions except sweat, whether or not they contain blood -Non-intact (broken) skin -Mucous membranes

Why are Universal Precautions important?

It is impossible to know who may be carrying a blood borne virus.

Where does PPE help us in the chain of infection?

Prevents entry point

Define surgical antiseptics.

Rubbing hands with an alcohol-based hand rub before operations by surgical personnel

Define alcohol-based hand rub.

Rubbing hands with an alcohol-containing preparation

What are standard precautions?

Standard precautions are the minimum infecton prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered. These practices are designated to both protect DHCP and prevent DHCP from spreading infections among patients.

What are universal precautions?

Treating all patient sample as if they are both hazardous and infectious, and capable or transmitting something you don't want, is the basis for the philosophy of safety known as using Universal Precaution. Focuses on the prevention of transmitting blood borne pathogens.

T/F: Alcohol-based hand rubs are reasonable alternatives.

True (need to have at least 60% alcohol)

Define antiseptic hand washing.

Washing hands with water and soap or other detergents containing an antiseptic agent

When is soap and water hand hygiene technique absolutely preferred?

When hands are visibly soiled

When sterilizing/cleaning, always move from ________ to ____________.

clean; dirty

How to cough/sneeze to prevent pathogen spread?

cough/sneeze into the crease of your elbow

When to use masks and gloves?

during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions

When to use gowns?

during procedures and patient care activities when contact of clothing or exposed skin with blood/body fluids, secretions, or excretions is anticipated

Face shields should cover _______, extend below ______ and wrap around ______.

forehead; chin; side of face

Use ______ to prevent hand dryness as part of hand hygiene.

hand lotion

All blood and body fluids that might be contaminated with blood should be treated as _______.

infectious (universal precautions)

Make sure that hand lotions are __________________ so that they do not cause glove failure.

made of compatible ingredients (i.e. not mineral oils or petroleum based)

You should ___________ wash or reuse disposable gloves.

never *This makes more prone to tearing/leaking

Masks should fully cover _______ and ______, fit _______, and prevent ________.

nose; mouth; snuggly; fluid penetration

Perform hand hygiene immediately after ________ and between _______.

removing PPE; patient contacts

Is hand hygiene considered a universal precaution or standard precaution?

required for standard precaution

What is the PPE definition specific to dentistry?

specialized clothing or equipment worn by a dental health care professional for protection against infectious material

In 1996, CDC replaced the Universal Precautions with _______.

standard precautions

How can you tell which side is the outwardly facing side of a mask?

the straps will be connected on the outside surface; or wording will be on the outside

When you change gloves, make sure you ________ the old, soiled gloves.

throw away (i.e. do not leave on the tray)

Gowns should fully cover the ______, fit _______, and have long sleeves that fit snuggly at the ______.

torso; comfortably; wrist

when you wash your hands, make sure you _______ when you are applying soap.

turn off the tap

Define hand washing.

washing hands with plain soap and water

The only time you can wear gloves outside of the operatory is ...?

when returning dirty instruments to sterilization. After dropping off, be sure to promptly throw away even before walking back to operatory.

When to use gloves?

when touching blood, body fluids, secretions, excretions, contaminated items, mucous membranes, and broken skin