Occupational Safety/Administrative Protocol

the water quality standard for dental treatment water, as established by the CDC, is:

500 CFU/mL

Disposal of regulated waste from a dental practice is governed by EPA rules. What agency oversees the regulated waste while it is still in the dental office?

OSHA

if water or other solutions are spilled on a floor in the office, the spill must be cleaned up as soon as possible to avoid:

.a slip and fall accident.

After the required OSHA training on bloodborne pathogens is provided at the time of employment, update training is to be given at least every:

1 year

OSHA requires infection control training records to be kept on file in a dental practice for:

3 years

OSHA requires that employee training records be maintained for what amount of time?

3 years from the date the training was provided. Rationale:The OSHA BBPS requires that training records be maintained for at least 3 years. The requirement for retaining records for the duration of employment plus 30 years refers to maintenance of hepatitis B vaccination records.

The section of a Safety Data Sheet that contains important information regarding measures that should be taken if an exposure to a chemical or product occurs is section:

4 - First Aid Measures.

In the OSHA and CDC hierarchy of preventing workplace injuries, which of the following is the least effective?

A A.Wearing personal protective equipment B.Minimizing or eliminating hazards C.Engineering controls D.Administrative and work practice controls Rationale:OSHA, NIOSH, and CDC all subscribe to the same hierarchy of controls for preventing occupational injuries. In this hierarchy, wearing PPE is the least effective of these measures. The most effective measure is to eliminate the potential hazard.

Which is classified as regulated waste in the dental office?

A A.endodontic file B.surface barrier C.saliva-soaked gauze D.contaminated patient bib Rationale:An endodontic file is classified as regulated waste. The OSHA Bloodborne Pathogens Standard classifies regulated and nonregulated waste in the dental office. Surface barriers, saliva-stained gauze, and a contaminated patient bib are classified as nonregulated waste according to the OSHA Bloodborne Pathogens Standard.

The CDC Summary of Infection Prevention Practices in Dental Settings recommends that its Infection Prevention Checklist be completed in order to ensure all of the following EXCEPT that the practice:

A A.would be able to pass an OSHA inspection. B.has the appropriate infection policies in place. C.has on hand the appropriate supplies to provide safe care to patients. D.can systematically assess compliance with infection control practices.

If employees in a dental practice are required to wear respirators rather than face masks for respiratory protection, all of the following apply to the respirators EXCEPT:

B A.employees must be trained on when to use, how to don and how to doff. B.respirators are interchangeable with face masks. C.wearing respirators requires a seal-check when donning. D.respirators must be fit tested prior to use.

Which is classified as nonregulated waste in the dental office?

B A.needles B.surface barrier C.blood-stained gauze D.contaminated broken glass

If a dental assistant is injured by etching solution that was splashed into his or her eye, all of the following are true EXCEPT that the:

D A.affected eye must be rinsed immediately at the eye wash station. B.eye protection work may not have been adequate to prevent it. C.injury must be reported to the OSHA officer and documented. D.injury will not cause significant or permanent damage to the eye.

Which members of the dental team must comply with OSHA regulations:

Both employers and employees

If a dental practice is inspected by OSHA, the inspector will ask to see all of the following EXCEPT:

C A.vaccination records for hepatitis B. B.training records. C.employee personnel records. D.written safety plans.

Which agency categorizes patient care items as critical, semicritical, or noncritical based on the potential risk of infection during the use of the items?

CDC

Which agency determines how often sterilizers must be spore tested?

CDC

OSHA's Hazard Communication Standard requires the following types of documentation:

Chemical inventory, SDS, and chemical safety plan

Which of these would OSHA classify as a tripping hazard?

Cords or cables stretched across the floor

If a dental health care worker refuses to wear PPE when required by OSHA, what does OSHA require an employer to do?

Discipline the employee as described in the Hazard Communication Plan.

How should an extracted tooth be disposed of if it contains an amalgam restoration?

Disinfect and dispose of with other amalgam waste. Rationale:EPA regulations state that amalgam waste, including that in extracted teeth, must be disposed of through a recycling process that does not include incineration, since mercury vapor could be released. Since sharps containers are incinerated, it is not appropriate to place teeth with amalgam respirators in them for disposal. Red bag waste is also incinerated, and extracted teeth with amalgam should not be placed in these containers. Bleach should never be used with amalgam since it can cause the amalgam to break down and release mercury. This is especially important with evacuation system cleaners.

Which entities are responsible for regulating how hazardous waste is removed from the dental office for disposal?

EPA - federal and state rules

If a dental practice wants to utilize a less toxic, "natural" disinfectant such as tea tree oil for operatory surfaces, the practice needs to ensure any disinfectant used in the treatment rooms is:

EPA registered and tuberculocidal.

A shield on a model trimmer or a laboratory lathe is an example of what type of safety protocol in a dental practice?

Engineering control Rationale:OSHA defines an engineering control as the placement of a barrier; in this case a shield between the hazard (splatter) and the worker is used to prevent injuries or exposure to chemicals or infectious diseases.

According to OSHA, which document must be in writing and reviewed annually?

Exposure Control Plan

Compressed gasses in a dental office such as oxygen and nitrous oxide can be a____hazard

FIRE

OSHA and the World Health Organization developed a program for standardizing product safety information for chemicals in 2013. This program is called:

Globally Harmonized System (GHS)

What type of gloves must a dental assistant wear when retrieving items from a high-level disinfectant?

Heavy-duty utility gloves.

What type of sign does OSHA require posted on a doorway that leads to the basement of a building?

Not an exit

If a dental assistant notices that the indicators on the packaging from the instruments used on a patient did not change color, what should be done?

Notify the patient that the instruments may not have been sterilized.

When OSHA updated the Hazard Communication Standard to be aligned with the Globally Harmonized Standard (GHS) on chemical safety, it made two significant changes, which were:

MSDSs changed to SDSs, and pictograms were adopted.

Which activity is contraindicated during the use of nitrous oxide in conscious sedation?

Maintain a conversation with the patient

What types of products DO NOT require Safety Data Sheets in a dental practice?

Medications that are dispensed Rationale:Medications such as antibiotics that may be dispensed in a dental practice are controlled by the FDA and do not require an employer to maintain an SDS. The other types of products that do not require SDSs are consumer products, such as dish soap or household cleaning solutions.

the agency that certifies face masks and respirators as effective for use in health care is:

NIOSH

Which entity developed the Bloodborne Pathogens Standard?

Occupational Safety and Health Administration (OSHA)

Which regulatory agency requires the use of surface disinfection?

Occupational Safety and Health Administration (OSHA)

What type of documentation is a dental practice required to maintain regarding the disposal of regulated waste?

Pickup and destruction records

If equipment or surfaces in the operatory are difficult to clean and disinfect, what is an effective way to prevent cross-contamination?

Place impervious barriers on the equipment and surfaces.

When disposing of items after treatment, what should be done with empty anesthetic cartridge?

Place in the sharps container in the operatory. Rationale:EPA rules state that pharmaceutical waste containers cannot be placed in sharps containers for incineration. If a cartridge is empty, it can be discarded in the trash along with gloves, masks, and other patient care items. If the cartridge still has anesthetic remaining, it must be recycled through a licensed pharmaceutical waste company.

Information about cleaning up a spill of a product that contains hazardous chemicals is required to be provided by the manufacturer on the product's:

Safety Data Sheet.

What is used on the nitrous oxide delivery system to check for leaks?

Soap solution

The CDC is not a regulatory agency, yet dental practices are required to follow CDC guidelines because:

Some state dental boards and OSHA require that these guidelines be followed. Rationale:Many state dental boards have adopted CDC guidelines in their dental rules for regulation of infection control in dental practice. In addition, OSHA uses CDC guidelines for enforcement guidelines for infection control. These guidelines are the recognized standards of care for infection control and prevention in dentistry and must be followed

Which would describe the relationship that OSHA standards have with dentistry?

Some, but not all, OSHA rules apply to dentistry.

If a community is under a "boil water" alert, what type of water should be used for patient rinsing and handwashing?

bottled or distilled water

If a dental product is dispensed out of the manufacturer's original container and not used up immediately, such as a high-level disinfectant, what must be done with the container the product is stored in?

The product must be relabeled per OSHA standards.

If a dental assistant is assigned the task of maintaining the sterilization maintenance records, what information should be included?

The sterilizer model, date of cleaning or service, initials of cleaner or service tech

Which of the following best describes the Exposure Control Plan required for the office by the Occupational Safety and Health Administration (OSHA)?

a healthcare facility's written protocol for reducing contact with bloodborne pathogens

To decrease the potential for a dental health care worker to be exposed to nitrous oxide that may be exhausted into the treatment room, patients should be instructed to:

breathe through their nose and avoid talking.

The EPA requires many dental offices to have ___________________ installed to prevent discharge of ________________ into the sewer system.

amalgam separators and mercury Rationale:While some dental practices are exempt from the EPA rule, general, pediatric, and endodontic practices must have amalgam separators installed to prevent the possible discharge of mercury into the wastewater. Some local and state water authorities may require backflow prevention devices for irrigation systems, but that is not specific to dentistry.

A dosimeter is a device used to measure:

an absorbed dose of radiation.

To effectively protect employees from eye injuries in dentistry, eye protection must meet certain safety standards according to OSHA. All of the following must be met EXCEPT:

antifogging ability. Rationale:Although some protective eyewear or safety glasses have antifog coatings, it is not a safety feature and is not required by OSHA. Impact resistance from flying debris, the ability to filter certain light wavelengths, and proper fit on the face are the criteria that OSHA enforces.

Hazard Communication training in a dental practice must be provided:

at the beginning of employment, annually, and when changes occur.

A hazardous chemical that is classified as flammable on an SDS or product label should be stored:

away from heat sources and flames.

If a high-level disinfectant is tested for concentration, and the solution is not at the optimal level for use, it should be:

changed immediately if the concentration is not optimal

OSHA rules are enforceable through __________ and ___________.

complaints and inspections Rationale:OSHA enforces its safety standards by responding to complaints from employees of unsafe work conditions and inspecting workplaces either as a response to a complete or as part of a special emphasis program

Hepatitis B vaccination records and exposure incident reports are classified by OSHA as:

confidential medical records.

Hazardous chemical exposures can have immediate effects on those that may not be apparent for months or years. These effects are called:

cumulative Rationale:One of the greatest dangers of exposure to hazardous chemicals is that the damage is not immediately apparent. If a chemical burns the skin, it is an acute or immediate injury. Repeated exposure to chemicals such as spraying disinfectants may not be apparent until permanent damage has occurred to the lungs. The OSHA HazCom Standard was instituted to prevent both types of injuries from occurring.

The OSHA Bloodborne Pathogens Standard does not classify saliva as a potentially infectious material EXCEPT in:

dentistry

If a dental assistant punctures a hand with a contaminated instrument while cleaning the instruments, the dental team is required by OSHA to record the injury and:

determine whether a safety device might have prevented the injury

Glutaraldehyde disinfection solutions require special handling for their disposal. This may include all of the following EXCEPT

diluting the solution before pouring down the drain.

OSHA requires employers to provide safety training that must be:

documented. Rationale:OSHA requires that all safety training must be documented with the date of the training format, the employees who attended the training, and the name and credentials of the person who presented the training as well as the topics covered in the training. OSHA does not specify a length for the training but does specify that it must be provided during normal work hours.

One of the most important characteristics of face masks used in dentistry is:

fluid resistance. Rationale:According to NIOSH, fluid resistance is the most critical property of a face mask, since bacteria, viruses, and other contaminants may be passed through the mask on blood or saliva particles in dentistry. The face mask must provide splash and splatter protection for the user. If a face mask becomes wet or damp, it must be changed immediately.

Placing barriers on equipment in a dental treatment room to prevent contamination is an example of a(n):

engineering control.

Although OSHA does not require dental practices to use sharps safety devices, such as self-sheathing syringes, all practices are required to:

evaluate whether the devices would enhance sharps safety in the practice. Rationale:OSHA requires that employers annually evaluate commercially available sharps safety devices that may reduce the number of sharps injuries in a facility. The evaluation must include management and nonmanagement employees. Most practices are exempt from keeping a sharps injury log. Practices are not required to purchase or document the purchase of safer sharps devices.

Which Occupational Safety and Health Administration (OSHA) document required for the office contains a plan for postexposure evaluation and follow-up?

exposure control plan

The OSHA Bloodborne Pathogens Standard requires employers to develop and maintain a(n):

exposure or infection control plan.

If a dental practice uses a hand-held digital x-ray unit, the appropriate location for a dosimeter or film badge would be in/on the:

finger or hand. Rationale:The manufacturers of portable x-ray units recommend that if dosimeters are worn, they are best placed on the fingers or hands, in the form of a ring dosimeter. This would be the most common body part to be exposed to the scatter radiation produced by the hand-held unit. OSHA does not require the use of dosimeters at the federal level, but some state OSHA plans require employees to wear them.

OSHA requires employers to provide a(n) ________________ for employees who may need treatment for minor injuries at work.

first aid kit

Which disinfectant produces fumes that are toxic to lung tissue?

glutaraldehyde

A dentist employer must have documentation that employees have either received the hepatitis B vaccine or that they:

have a health or religious reason for declining the vaccine.

If a dental assistant refuses to be vaccinated for hepatitis B, his or her employer should:

have the assistant sign a declination form

OSHA requires safety training for employees because it believes that training:

increases the level of awareness of potential hazards.

The CDC recommends that an individual in a dental practice be designated as the:

infection control coordinator.

In a dental practice, hazardous chemical exposures can occur from all of the following EXCEPT:

injection.

According to OSHA, the person who presents safety training to employees must be:

knowledgeable on the topic.

OSHA is a federal agency that has jurisdiction in all states. In some states, however, a state OSHA division has been established, and it can develop its own safety standards. These state standards can be all of the following EXCEPT:

less stringent than the federal standards.

If a dental health care worker experiences a puncture on the finger from an instrument that has been cleaned in the ultrasonic, but not yet sterilized, the exposure risk for HIV would be classified as a ___________ risk of infection.

low Rationale:OSHA and CDC state that the highest risks of HIV infection from puncture injuries occur when an instrument or needle has wet blood. In this case, the instrument should be free of visible blood after cleaning, but it is not a sterile instrument. Therefore, a low level of infection risk does still exist. The employee must always consult a medical provider to determine if follow-up testing and treatment are advised.

OSHA requires that employees have access to all of the following safety documents EXCEPT:

medical records.

If a dental practice places amalgam restorations, OSHA requires the practice to have a:

mercury spill kit.

Engineering and work practice controls are designed to ___________________ workplace safety hazards.

minimize

Regarding multidose medication vials, the CDC guidelines state that the vials should:

not be used on more than one patient if used in the treatment room

A possible effect of prolonged exposure to spraying disinfecting solutions that has been identified among dental health care workers is:

occupational asthma.

When a dental practice is required to use the OSHA injury and illness record forms, a copy of the summary of workplace illness and injuries is required to be posted in the office:

once a year.

During a widespread outbreak of an infectious disease, such as influenza, the CDC recommends that patients with respiratory symptoms should:

only be seen if emergency treatment is necessary.

OSHA regulates safety standards for employees. The CDC recommends safety guidelines for:

patients and health care workers.

OSHA and CDC define a parenteral injury as a(n):

piercing of mucous membranes or skin. Rationale:OSHA and CDC define a parenteral injury as piercing mucous membranes or the skin barrier through such events as needle sticks, human bites, cuts, and abrasions.

When a contaminated needle is removed from a syringe, it should be:

placed in the sharps container.

OSHA defines engineering controls as:

placing a barrier between the hazard and the worker. Rationale:OSHA states that engineering controls, such as those required in the BBPS and the HazCom Standard, place a barrier between a worker and a potential hazard. For example, using a needle recapping device protects the hands of the dental health care worker when recapping contaminated needles

The purpose of the OSHA GHS pictograms is to:

provide a visible warning about chemicals.

OSHA states that Safety Data Sheets (SDSs) must be _______________ to or by all employees in the workplace:

readily accessible

If the area where a dental practice is located was under a boil water alert, which has been canceled, the dental practice must do all of the following to resume treating patients EXCEPT:

reprocessing all the dental instruments.

In addition to the installation of a scavenging system to capture and exhaust nitrous oxide to the outside, a properly fitting ____________ protects the dental team from exposure to nitrous oxide.

scavenging mask Rationale:Scavenging masks are available in multiple sizes, depending on the patient. Using the proper size mask for each patient prevents nitrous oxide from escaping into the room air under the edges of the mask. A respirator will not protect a dental health care worker from nitrous oxide exposure.

If a dental health care worker experiences an exposure incident, OSHA requires that an employer provide postexposure testing and medical follow-up. If an employee refuses testing and postexposure treatment, the employee must:

sign a declination statement stating that they refuse testing and treatment.

Laser technology in dentistry poses some risks to the eyes of dental health care workers, and OSHA requires that dental health care workers wear protective eyewear that is:

specific to the type of laser being used.

If a practice uses nitrous oxide sedation for patients, the exhaust ventilation must be vented to ____________ and not into the room ventilation system to prevent exposure to the dental team members.

the evacuation system

What is the term for the type of waste material that cannot be disposed in the regular trash??

toxic waste Rationale:Toxic waste is poisonous and contains substances such as arsenic, barium, mercury, lead, and so forth. Contaminated waste includes nonregulated waste such as patient bibs and saliva-soaked gauze. Regulated waste includes sharps, blood-soaked or blood-caked items, human tissue, and pathology samples. Medical waste includes any solid waste that is generated in the diagnosis or treatment. Only a small percentage of medical waste is infectious and has to be regulated.

According to OSHA, employers must require all employees to be vaccinated for:

vaccinations cannot be required

Dental practices must have written protocols for emergencies, which would include all of the following EXCEPT a(n):

water leak from a broken pipe.

The EPA rules state that amalgam separators must be inspected _____________, and that the manual for the unit be stored _________________

weekly and near the amalgam separator

A one-handed scoop technique for recapping a contaminated needle is classified by OSHA as a(n):

work practice control.