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Event related packaging

instruments in packages should remain sterile indefinitely unless an event causes them to become contaminated

tort law

involving an act that brings harm to a person or damage to a property

Noncritical instrument

item that comes in contact with intact skin only

Contaminated waste

items such as gloves and patient napkins that may contain the potentially infectious body fluids of patients

due care

just, proper, and sufficient care, or the absence of negligence

statutory law

law enacted by legislation through US Congress, state legislature, or local legislative bodies

National Institution for Occupational Safety and Health -NIOSH-

leadership to prevent work-related illness and injuries

standard of care

level of knowledge, skill, and care comparable with that of other dentists who are treating similar patients under similar conditions

general supervision

level of supervision in which the dental auxiliary performs delegated functions according to the instructions of the dentist, who is not necessarily physically present

direct supervision

level of supervision in which the dentist is physically present when the dental auxiliary performs delegated functions

licensure

license to practice in a specific state

infraction

minor offense that usually results in only a fine

misdemeanor

offense that may result in imprisonment of 6 months to 1 year

informed consent

permission granted by a patient after he or she is informed about the details of a procedure

malpractice

professional neglegence

expanded functions

specific intraoral functions delegated to an auxiliary that require increased skill and training

board of dentistry

state agency that adopts rules and regulations and implements the specific state's Dental Practice Act

reciprocity

system that allows individuals in one state to obtain a license in another state without retesting

Process indicators

tapes, strips, or tabs with heat-sensitive chemicals that change color when exposed to a certain temperature

HIPAA

the Health Insurance Portability and Accountability Act of 1996; specifies federal regulations ensuring privacy regarding a patient's healthcare information

the potential risk for infection associated with their intended use

the patient care items classified are based on what?

Organization for Safety, Asepsis and Prevention -OSAP-

the premier infection control agency in the United States

implied consent

type of consent in which the patient's action indicates consent for treatment

toxic waste

waste that can have a toxic effect to humans

abandonment

withdrawing a patient from treatment without giving reasonable notice or providing a competent replacement

What does respondeat superior mean

"Let the master answer" The employer is responsible for any harm caused by the actions of the employee while the employee is carrying out the business of the employer

What does res ipsa loquitur mean?

"The act speaks for itself" the evidence is clear. Ex. dentist pulls wrong tooth

What is meant by res gestae?

"things done" statements made spontaneously by anyone at the time of an alleged negligent act are admissible as evidence and may be damaging to the dentist and assistant in a court of law

Implied contract

A contract that established bby actions and not words

Expressed contract

A contract that is established through verbal or written words

Expressed contract

A contract that may be verbal or written

Dental Auxillary

A dental assistant, a dental hygienist, or a dental laboratory technician

Under no conditions can

A dentist refuse to treat a patient with HIV

Respondeat superior

A legal doctrine that holds the employer liable for the acts of the employees

General supervision

A level of supervision in which the dentist has given instructionsbut need not be physically present at the time the expanded functions are being performed by the dental auxiliary

Direct supervision

A level of supervision in which the dentist is physically present when expanded functions are being performed by the dental auxiliary

Felony

A major crime, such as fraud or drug abuse. Conviction can result in imprisonment of 1 year or longer

Mandated reporter

A professional who is required by state law to report known or suspected child abuse

Endospore

A resistant, dormant structure formed inside of some bacteria that can withstand adverse conditions.

Expanded function

A specific intraoral function delegated to an auxiliary that requires increased skill and training

Res Gestae

A statement that is made at the time of an alleged negligent act and is amissable as evidence in a court of law

Reciprocity

A system that allows individuals in one state to obtain a license in another state without retesting

Malpractice

A type of professional negligence

Board of dentistry

An agency that adopts rules and regulations and implements the state dental practice act

Respondeat superior states that

An amployer is responaible for the actions of his or her employees

moist heat/steam

An autoclave instrument sterilization process uses which sterilization agent?

static air

An example of dry heat sterilization

Patient of record

An individual who has been examined and diagnosed by the dentist and has had the treatment planned

flash sterilization

Another name for unwrapped sterilization

Contract law

Binding agreements involve

Contract law

Category of law that involves an agreement for services in exchange for payment

Administrative Law

Category of law that involves regulations established by government agencies

A category of law is

Civil and contract law

FDA; regulatory

Concerned with the regulation of sterilization; recommendations or regulatory?

NIH

Conducts and supports medical research

NIOSH; recommendations

Conducts research and deals with preventions of work-related disease and injury; recommendations or regulatory?

Written consent

Consent that involves a written explanation of diagnostic findings, prescribed treatment, and reasonable expectations about treatment results

Implied Contract

Contract that is established by actions, not words

Implied contract

Contract that is established by actions, not words

Duty, derelict, direct causes, and damages are

Coponents of a successful malpractice suit

What are the 2 types of statutory law?

Criminal law and civil law

EPA; regulatory

Deals with issues of concern to the environment or public safety; recommendations or regulatory?

Criminal law

Deals with the violation against the state or government

The actions of a patient

Demonstrate implied consent

What are mandated reporters?

Dental Professionals

Dental Auxiliary

Dental assistants, dental hygienists, and dental laboratory technicians

Dental auxiliary

Dental assistants, dental hygienists, and dental laboratory technicians

Ultrasonic cleaner

Instrument that loosens and removes debris by sound waves traveling through a liquid

Written consent

Involves a written explanation of the diagnostic findings, the the prescribed treatment, and the reasonable expactations regarding the results of treatment

The state dental practice act

Is interpreted by the board of dentistry

What authority does a state board of dentistry have?

Issue a license and revoke, suspend, or deny renewal of a license

CDC; recommendations

Issues recommendations on health and safety; recommendations or regulatory?

Why should broken appointments be noted on a patient's chart?

It helps to protect the practice from legal recourse should a patient claim negligence against the dentist

Semicritical insrtument

Item that comes in contact with oral tissues but does not penetrate soft tissue or bone.

critical instrument

Item used to penetrate soft tissue or bone

Due care

Just, proper, and sufficient care or the absence of negligence

respondeat superior

Latin for "let the master answer" legal doctrine that holds an employer liable for acts of the employee

res gestae

Latin for "things done" Statements made by a person present at the time of an alleged negligent act that are admissible as evidence in a court of law

res ipsa loquitur

Latin phrase for "the thing speaks for itself"

General supervision

Level of supervision in which the dental auxiliary performs delegated functions according to the instructions of the dentist, who is not necessarily physically present

Direct Supervision

Level of supervision in which the dentist is physically present when the dental auxiliary performs delegated functions

Direct supervision

Level of supervision in which the dentist is physically present when the dental auxiliary performs delegated functions

PHAC

Main Federal Agency responsible for public health in Canada

Res ipsa loquitor

Means the act speaks for itself

ADHA

National professional organization for dental hygienists

Can a dentist refuse to treat a patient only because he or she has HIV infection?

No. The only exception would be if the patient has a special condition such as severe periodontal disease and has to be referred to a specialist

hazard communication standard -HCS-

OSHA standard "right to know"

Misdemeanor

Offense that may result in imprisonment of 6 months to 1 year

ADAA

Oldest largest group that represents professional dental assistants

A broken appointment should be recorded

On a patient record

National Institutes of Health (NIH)

One of the world's foremost research centers

National Institutes of Health -NIH-

One of the world's foremost research centers.

three

Patient care items are classified into how many groups?

Use-life

Period of time during which a germicidal solution is effective after it has been prepared for use.

Informed Consent

Permission granted by a patient after he or she is informed about the details of a procedure

Informed consent

Permission granted by a patient after he or she is informed about the details of the procedure

OSHA; regulatory

Pertains to employee safety; recommendations or regulatory?

Contaminated area

Place where contaminated items are brought for precleaning

Clean area

Place where sterilized instruments, fresh disposable supplies, and prepared trays are stored.

Reciprocity allows a licensed practitioner to

Practice in another state

A professional can prevent a malpractice suit by

Practicing prevention and communication with the patient

OSAP

Premier resource for safety and infection prevention information in dentistry

What are the best defenses against a malpractice suit?

Prevention and good communication with the patient

Malpractice

Professional negligence

ADA

Professional organization for dentists

HIPAA

Provide consumers with greater access to healthcare insurance, to protect the privacy of protected health information, and to promote greater standardization and to enhance efficiency in the healthcare industry.

What is meant by reciprocity and licensure by credential?

Reciprocity an agreement between 2 or more states that allows a dentist or dental hygienist who is licensed in one state to receive, usually without further examination or requirements, a license to practice in any of the other states in the reciprocity agreement. Licensure by credential allows an individual who is currently licensed in one state to become licensed in another state if certain requirements are met.

Chronic exposure

Repeated exposures, generally to lwer levels, over a long time

Expanded functions

Specific intraoral functions delegated to an auxiliary that require increased skill and function

State dental practice act

Specifies the legal requirements for an individual to practice dentistry in the state

Board of Dentistry

State agency that adopts rules and regulations and implements the specific state's Dental Practice Act

Board of dentistry

State agency that adopts rules and regulations and implements the specific states Dental Practice Act

Chemical vapor sterilization

Sterilization by means of hot formaldehyde vapors under pressure.

Process integrators

Strips placed in packages that change color when exposed to a combination of heat, temperature, and time.

Multi-parameter indicators

Strips placed in packages that change color when exposed to a combination of heat, temperature, and time. Also known as process integrators.

Reciprocity

System that allows individuals in one state to obtain a license in another state without retesting

Single-parameter indicators

Tapes, strips, or tabs with heat-sensitive chemicals that change color when exposed to a particular temperature. Also know as process indicators.

Res gestae is a

Term for a statement that is made at the time of an alleged negligent act and is admissible as evidence in a court of law

Abandonment

Terminating the dentist-patient relationship without reasonable notice to the patient

HIPAA

The Health Insurance Portability and Accountability Act of 1996; specifies federal regulations ensuring privacy regarding a patient's healthcare information

Civill law

The category of law that deals with the relations of individuals or corporations

Direct supervision means that

The dentist must be physically present

Guidelines for Infection Control in Dental Healthcare Settings

The infection-control procedure practiced in dentistry are based on what?

Public Health Agency of Canada (PHAC)

The main federal agency responsible for public health in Canada.

Implied consent

The patient's actions indicating agreement to undergo treatment

Organization for Safety, Asepsis and Prevention (OSAP)

The premier infection control agency in the United States

Canadian Dental Assistants Association (CDAA)

The professional organization for dental assistants in Canada.

American Dental Assistants Association (ADAA)

The professional organization for dental assistants in the United States

American Dental Assistants Association -ADAA-

The professional organization for dental assistants in the United States.

American Dental Hygienists' Association (ADHA)

The professional organization for dental hygienist

American Dental Association -ADA-

The professional organization for dentists

American Dental Association (ADA)

The professional organization for dentists.

cavitation

The ultrasonic cleaner works by sound waves that cause what?

Purpose of HIPAA

To ensure portability of health benefits for employees who change jobs and whose eligibility for benefits may have changed because of a change in health status. To provide tax credits for employers to encourage employee medical savings accounts. To reduce fraud and abuse (principally in medicare and medicaid). To encourage administrative simplification in healthcare, while maintaining patient confidentiality

What is the primary purpose of reporting suspected cases of child abuse?

To protect the child

The purpose of being licensed is

To protect the public from incompetent practitioners

What is the purpose of licensure?

To protect the public from unqualified or incompetent practitioners

Implied Consent

Type of consent in which the patient's action indicates consent for treatment

Implied consent

Type of consent in which the patients actions indicates consent for treatment

Expressed and implied are

Types of contracts

Biologic Monitoring

Verifies sterilization by confirming that all spore-forming microorganisms have been destroyed

Biologic indicators

Vials or strips, also known as spore tests, that contain harmless bacterial spores;used to determine whether sterilization has occured

Infectious waste

Waste that is capable of transmitting an infectious disease

Hazardous waste

Waste that poses a risk to humans or to the environment.

Utility gloves, mask, eyewear, and protective clothing

What PPE is necessary when one is processing instruments?

the NIH

What agency serves as the dental research institute?

instruments do not rust, short cycle time, and availability of a dry instrument after the cycle

What are some advantages of chemical sterilization?

damages some plastic and rubber items, requires a special solution, cannot sterilize liquids, and cannot use closed containers.

What are some disadvantages of chemical sterilization?

forceps, scalpels, bone chisels, scalers, and burs

What are some examples of critical instruments?

plastic-handed brushes, high-volume evacuator tips, rubber dam forceps, x-ray film holders, and amalgam carriers

What are some examples of semicritical instruments?

steam, chemical vapor, and dry heat

What are the commonly used forms of heat sterilization?

physical, chemical, and biological

What are the forms of sterilization monitoring?

critical, semicritical, and noncritical

What are the instrument classifications used to determine the method of sterilization and disinfection?

hand scrubbing, ultrasonic cleaning, with a thermal washer and disinfector

What are the methods of precleaning?

Chemical vapor, steam, and dry heat

What are the most common forms of heat sterilization?

Transport, cleaning, packaging, sterilization, storage, delivery, and quality

What are the seven steps for instrument processing?

Physical, chemical, and biologic

What are the three forms of sterilization monitoring?

Critical, semicritical, and noncritical

What are the three instrument classifications that are used to determine the method of sterilization?

handscrubbing, ultrasonic cleaning, and thermal washer and disinfector

What are the three methods of precleaning instruments?

static air and forced air

What are the two types of dry heat sterilization?

Inadequate instrument cleaning, improper packaging, improper loading, improper timing, and improper temperture

What causes sterilization failures?

improper contact of sterilizing agent, improper temperature, and overloading of the sterilizer

What causes sterilization failures?

recommendations with which the dental office should comply

What do nonregulatory agencies issue?

rules and regulations with which the dental offices must comply.

What do regulatory agencies issue?

exposure to temperature/heat

What does a single-parameter chemical monitoring device indicate?

that the contents will remain sterile unless some event occurs to contaminate the contents

What does event related packaging mean?

The organization for safety, asepsis prevention

What is OSAP?

the instruments will not rust

What is a major advantage of chemical vapor sterilization?

regulate medical and dental devices

What is a primary role of the FDA?

tapes, strips or tabs with heat sensitive chemicals that change color when exposed to a certain temperature. They are placed outside of instruments packages before packaging

What is a process indicator and where is it placed?

strips that are placed in packages that change when exposed to a combination of heat, temperature, and time.

What is a process integrator and where is it placed?

to process contaminated instruments and other patient cares items for reuse

What is on of the most important responsibilities of the dental assistants?

the FDA

What is the agency that regulates the manufacturing and labeling of dental devices?

single-loop

What is the basic rule of the workflow pattern in an instrument processing area?

Processing of instruments should proceed in a single loop, from dirty , to clean, to sterile, to storage, without ever "doubling back".

What is the basic rule of the workflow pattern in an instrument-processing area?

Biologic monitoring

What is the best way to determine whether sterilization has occurred?

using biologic monitoring

What is the best way to determine whether sterilization has occurred?

the CDC

What is the dentist's resource for infection control and safety?

recommendations are based on scientific evidence and are the standard of care for dentistry today. Regulations the dental offices must comply with or penalties will be occur

What is the main difference between a recommendation and a regulation?

The ADA

What is the national professional organizations for dentists known as?

inability to wrap items

What is the primary disadvantage of "flash" sterilization?

requires a 10 hour contact time

What is the primary disadvantage of liquid chemical sterilization?

employees

What is the primary focus of OSHA in dentistry?

to protect the safety and health of american workers

What is the primary role of OSHA in dentistry?

public health

What is the primary role of the CDC in dentistry?

safety and effectiveness of disinfectants

What is the primary role of the EPA in dentistry?

enviornment

What is the primary role of the EPA?

regulate medical and dental devices

What is the primary role of the FDA in dentistry?

to promote general health

What is the primary role of the NIDCR?

conducts and supports medical research

What is the primary role of the NIH?

They will cause holes in the packaging

What is the reason that pins, staples, and paper clips are not used on instrument packaging?

Pubic health in Canada

What is the responsibility of the PHAC?

250 degrees

What is the typical sterilization temperature at 30 minutes?

lightweight aluminum foil

What is used to test the efficiency of the ultrasonic cleaner?

the NIOSH

What nonregulatory agency focuses on the health and safety of American workers?

They must be FDA approved

What prevents kitchen dishwashers from being used to preclean instruments?

OSHA

What regulatory agency ensures the safety and health of American workers?

stored, sterilized instrument packets.

What should not be located in the packaging area of the instrument processing area?

heat

What sterilizes in autoclave, the heat or the pressure?

275 degrees

What temperature should the dry heat sterilization not exceed for handpieces?

steam and chemical vapor

What type of heat sterilization is appropriate for high speed handpieces?

sterile gloves

What type of personal protective equipment is necessary when one is processing instruments?

steam and chemical vapor

What types of heat sterilization are appropriate for high-speed handpieces?

only when instrument processing cannot be completed

When should holding solution be used as part of the instrument processing procedure?

when instruments cannot be immediately cleaned after a procedure is performed

When would you used a holding solution?

outside the package

Where do you place a process indicator?

central location

Where should the sterilization area be?

hand scrubbing

Which method of precleaning instruments is least desirable?

they are not FDA approved

Why is it that kitchen dishwashers are not used to preclean dental instruments?

maintain sterility

Why should instruments be packaged for sterilization?

it could penetrate the packaging

Why should you never use pins, staples, or paper clips on instrument packages?

to prevent the drying of blood and debris

Why would you use a holding solution?

Abandonment

Withdrawing a patient from treatment without giving reasonable notice or providing a competent replacement

expressed contract

a contract that is established through verbal or written words

chemical inventory

a list of every patient used in the office that contains chemicals

felony

a major crime, such as fraud or drug abuse. Conviction can result in imprisonment of 1 year or longer

What is the difference between an act of omission and an act of commission?

an act of omission is not doing something that should have been done. Commission is doing something that should not have been done

biologic monitoring

another term for spore testing

child abuse

any act that endangers or impairs a child's physical or emotional health or development

civil law

category of law that deals with relations of individuals, corporations, or other organizations

contract law

category of law that involves an agreement for services in exchange for a payment (contract)

administrative law

category of law that involves regulations established by government agencies

criminal law

category of law that involves violations against the state or government

Toxic chemicals

chemicals that can have a fatal or toxic effect to humans

written consent

consent that involves a written explanation of diagnostic findings, prescribed treatment, and reasonable expectations about treatment results

implied contract

contract that is established by actions, not words

dental auxiliary

dental assistants, dental hygienists, and dental laboratory technicians

mandated reporters

designated professional who are required by law to report known or suspected child abuse

State Dental Practice Act

document of law that specifies legal requirements for practicing dentistry in a particular state

spousal abuse

domestic violence intentionally inflicted by a family member or members

Safety data sheet

form that provides printed information regarding the hazards of materials that contain chemicals

water should be flushed through it

how should High speed handpieces be processed before sterilization?

elder abuse

includes physical or sexual abuse, financial exploitation, emotional confinement, passive neglect, or willful deprivation of an elderly person

patient of record

individual who has been examined and diagnosed by the dentist and has had treatment planned

Autoclave

Instrument for sterilization by means of moist heat under pressure

What is the difference between direct supervision and general supervision?

Direct supervision generally means that the dentist has delegated a specific procedure to be performed for a patient of record by a legally qualified auxiliary and the dentist must examine the treatment before and after auxiliary treatment. General supervision is indirect supervision which generally means the dentist has authorized and delegated specific procedures that may be performed by the auxiliary for a patient of record. Exposing radiographs and recementing a temporary crown that has become dislodged are examples of functions that are often delegated under general supervision

What is meant by abandonment?

Discontinuation of care after treatment has begun, but before it has been completed

no

Do multi-parameter indicators ensure that an item is sterile?

no

Do process indicators and integrators ensure that an item is sterile?

State dental practice act

Document of law that specifies legal requirements for practicing dentistry in a particular state

What are the 4 D's necessary for a successful malpractice suit?

Duty- dentist patient relationship must exist Derelict- (Lacking a sense of duty, negligent). Negligence occurred because standard of care was not met Direct Cause- Negligent act was the direct cause of the injury Damages- Pain and suffering, loss of income, and medical bills are included in damages

What is the difference between an expressed contract and an implied contract?

Expressed contracts are established through the written word or by a verbal agreement. Commonly used when the required treatment is extensive or will take long time to complete (e.g., orthodontics, full mouth reconstruction). Implied contracts are established by actions not words. If patient comes to the dentist it can be implied the patient wants treatment

Centers for Disease Control and Prevention -CDC-

Federal agency that is non-regulatory and that issues recommendations on health and safety

Centers for Disease Control and Prevention (CDC)

Federal agency that is nonregulatory and that issues recommendations on health and safety

National Institute for Occupational Safety and Health (NIOSH)

Federal agency that is nonregulatory whose mission is to improve oral, dental, and craniofacial health through research, research training, and the dissemination of health information

Environmental Protection Agency -EPA-

Federal agency that is responsible for protecting and restoring the environment and public health through environmental laws.

Food and Drug Administration -FDA-

Federal regulatory agency that regulates food, drugs, medical devices, animal feed and drugs, cosmetics, and radiation-emitting products

Occupational Safety and Health Administration (OSHA)

Federal regulatory agency whose mission is to ensure the safety and health of america's workers by setting and enforcing standards.

Food and Drug Administration (FDA)

Federal regulatory agency whose responsibility is to protect and restore the environment and public health through environmental laws.

Occupational Safety and Health Administration -OSHA-

Federal regulatory agency with the mission to ensure the safety and health of America's workers by setting and enforcing standards.

Licensure

Gives a person the legal right to practice in a specific state

A dentist has performed abandonment when

He or she discontinues treatment after it has begun

A patient is receiving due care when

He or she recieves proper, sufficient care

Acute exposure

High levels of exposure over a short period.

lubricant

How can instrument rusting be prevented?

use of lubrication

How can rusting of instruments be prevented?

sound waves

How does an ultrasonic cleaner work?

by sound waves

How does the ultrasonic cleaner work?

seven

How many steps are there for instrument processing?

everyday or when the solution becomes cloudy

How often do you change the ultrasonic cleaning solution?

in closed or covered cabinets

How should clean supplies and instruments be stored?

with sterile water

How should instruments processed in a liquid chemical sterilant be rinsed?

spore test, biologic monitoring

How would you detect when sterilization failure occurs?

They should be placed in a holding solution

If instruments cannot be processed immediately, what should be done with them?

They should be placed in a holding solution.

If instruments cannot be processed immediately, what should be done with them?

What is the difference between implied consent and written consent?

Implied consent is applied when the patient enters the office and agrees to treatment or at least does not object to it. Written consent is the preferred means of obtaining and documenting the patient's consent to and understanding of the procedure

NIDCR

Improves oral, dental, and craniofacial health

Patient of record

Individual who has been examined and diagnosed by the dentist and has had a treatment planned

Patient of Record

Individual who has been examined and diagnosed by the dentist and has had treatment planned

Regulated waste

Infectious waste that requires special handling, neutralization, and disposal

Dry heat sterilizer

Instrument for sterilization by means of heated air.


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