Training staff

09 May 2011
Volume 27 · Issue 5

Richard Musgrave shows effective infection control is a team effort.

Preventing the spread of harmful pathogens is important if your practice is going to maintain the high standards of health and safety needed to protect patients and staff. To this end, you need to train all members of the dental team in the correct procedures of surgery hygiene.

All members of the practice should be made aware of the types of diseases that could be contracted. This training needs to involve detailed information on: MRSA, Hepatitis C, Tuberculosis , C diff, variant CJD.

The safety of surgery staff should be of paramount importance and the most effective training will stress that all staff should be immunised, with records kept of every vaccine.

Once aware of these harmful diseases, you and your staff can begin to eradicate them from all surfaces and equipment in the surgery. This involves using effective products in removing bacteria and through using the most efficient methods to sterilise your clinical environment.

This is where further extensive training is required. Instrument decontamination is important as dental tools are often sharp and in direct contact with the patient. This process should be done as soon as possible and before sterilisation, so all pathogens are exposed to the steam of the autoclave. Machines that are involved in this decontamination process, like the autoclave, can be difficult to operate and the most successful training will include information on the different types of cleaning machines, and teach all staff members how to use them efficiently.

Zones

Bacteria spread themselves across floors and all other surfaces in the practice. It is essential to perform rigorous cleaning procedures between each patient. For example, the use of 'zoning' is the preliminary step in successful surface disinfection and the most effective way of ensuring decontamination is performed as efficiently as possible. It focuses on those specific areas most frequently contaminated, such as:

  • dental chair and spittoon
  • controls and switches
  • work surfaces
  • floor

Zoning involves dividing contaminated areas from clean and allocating places for 'dirty' and 'clean' instruments. It is important appropriate training in procedures, such as zoning, are provided for all members of the dental team and documented as evidence. However, although dental nurses should have responsibility for maintaining treatment areas, the floors and public areas can be cleaned by hired cleaners.

Hand hygiene is perhaps the most important of all. The HTM 01-05 regulations state all staff should be trained in hand hygiene as part of the staff induction and annually thereafter. Surgical gloves play an important role in maintaining hand hygiene and stop transmission of most viruses. Such gloves should be powder-free, to reduce the chances of an allergic reaction, and should have a low residual chemical content. If any staff members or patients are allergic to latex, suitable replacements are easily found.

Tiny perforations in surgical gloves mean they are not 100 per cent effective in preventing infections from penetrating the skin. Therefore, clean hands are also important. Hand decontamination should be done before and after each patient as well as before and after using the lavatory and eating food. Training your staff in the most effective methods of hand disinfection is made more effective if the trainers provide clear flow diagrams to simplify techniques. In addition, the best companies will also advise you to enlist the use of an emollient hand cream to moisturise your hands, as it will maintain the integrity of the skin that gets damaged through excessive cleaning.

It is important you uphold the guidelines set out in HTM 01-05 to protect your patients and staff from potentially lethal bacteria and viruses.