The Safest Dental Visit™ Toolkit: Consultant & Speaker

As a consultant/speaker, you play a pivotal role in providing support and training in dental infection prevention and patient and provider safety for dental health care professionals (DHCP). This toolkit will help strengthen your consulting and speaking practice while helping dental offices ensure that every dental visit is a safe visit. Click on the links at the top of the page to access all the resources!

Download printable pledge to hang in your office.

Infection Prevention and Control Program

Every office needs an infection prevention and control (IPC) program – a system of policies, procedures, and practices that minimize the risk of transmission of microorganisms and disease when properly implemented. Essential elements include guidelines, standards, and regulations; professional standards and best practices; ethics; and standard operating procedures (SOPs).

Policies and procedures should be tailored to the dental setting and reassessed regularly (e.g., annually) or according to state or federal requirements. Development should consider the types of services provided by dental health care personnel (DHCP), the patient population served, extending beyond the Occupational Safety and Health Administration (OSHA) bloodborne pathogens standard to address patient safety.

CDC Guidelines

All dental settings, regardless of the level of care provided, must make infection prevention and control (IPC) a priority and should be equipped to observe Standard Precautions and other IPC recommendations in the CDC Guidelines for Infection Control in Dental Health-Care Settings — 2003.

Below is an overview of the nine key elements of the CDC Guidelines. Detailed information on all of these can be found in the following resources:

• CDC Guidelines for Infection Control in Dental Health-Care Settings — 2003
• CDC Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care 
• From Policy to Practice: OSAP's Guide to the CDC Guidelines (2022 Edition) workbook
• OSHA & CDC Guidelines: OSAP Interact Training System 7th Edition workbook

Additional resources with more information on specific topics are included in each section below.

1. Personnel Health Elements of an Infection-Control Program

A written health program should be developed for dental healthcare workers. Personnel health elements covered in this program (with policies, procedures, and guidelines) include:

• Education and training
• On initial employment; when new tasks require additional training; when changes in recommendations/OSHA mandates requires this; AND, at least annually
• Medical conditions, work-related illness, and associated work restrictions
• Contact dermatitis and latex hypersensitivity
• Immunizations
• Exposure prevention, and postexposure management, including having referral arrangements from the outset (as opposed to in an emergency situation after an incident has occurred)
• Maintenance of records, data management, and confidentiality.

Resources

• CDC Advisory Committee on Immunization Practices (ACIP) Vaccine Recommendations and Guidelines
• CDC Patient Notification Toolkit
• CDC Recommended Vaccines for Healthcare Workers
• OSHA Guide to Compliance with OSHA Standards for Medical & Dental Offices

2. Preventing Transmission of Bloodborne Pathogens

The CDC recommendations include immunization recommendations against Hepatitis B (HBV), testing post-immunization, education on the risks of HBV, counseling, and general recommendations related to standard precautions and OSHA’s Bloodborne Pathogens Standard. In addition, engineering and work controls to reduce the risk of sharps injuries are addressed, and postexposure management and prophylaxis. In accordance with OSHA requirements, all personnel with occupational risk for bloodborne pathogens must be offered Hepatitis B vaccination at no charge prior to performing tasks with potential exposure. If they decline, they must sign a Hepatitis B declination form which must be kept in the personnel records.

Resources

• OSHA Hepatitis B declination statement
• OSHA Model Plans and Programs for the OSHA Bloodborne and Hazard Communication Standards
• OSHA Sample Bloodborne Pathogens Exposure Control Plan

3. Hand Hygiene

Hand hygiene must be performed: Before donning (putting on) and after doffing (taking off) gloves; when changing gloves during a procedure; before and after ungloved skin contact with patients; following ungloved skin contact with potentially contaminated inanimate surfaces. The specific method depends on the type of procedure, presence/absence of visible contamination, and other factors.

Resources

• CDC Guideline for Hand Hygiene in Health-Care Settings
• CDC Interactive Training Guide

4. Personal Protective Equipment (PPE)

PPE protects skin, and mucous membranes of the eyes, nose, and mouth, from exposure to blood or other potentially infectious material (OPIM) via direct/indirect contact, splashes, spatter (splatter), and bacterial aerosols. PPE is required during patient care, instrument processing, and operatory clean-up. Appropriate gloves, surgical facemasks, protective eyewear, and protective clothing are also mandated by OSHA when there is an occupational risk of exposure to bloodborne pathogens. During influenza epidemics and for specific diseases (e.g., TB), NIOSH respirators should be used instead of surgical facemasks as part of transmission-based/isolation precautions.

Resources

• CDC Facemasks Do's and Don'ts
• CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007)
• CDC Sequence for Donning and Removing Personal Protective Equipment (Poster)
• NIOSH TB Respiratory Protection Program In Health Care Facilities - Administrator's Guide
• ADS If Saliva Were Red
• OSHA Bloodborne Pathogens and Needlestick Prevention
• OSHA Hospital Respiratory Protection Program Toolkit
• OSHA Respiratory Protection

5. Contact Dermatitis and Latex Hypersensitivity

Latex hypersensitivity reactions and irritant and allergic contact dermatitis can be associated with frequent hand hygiene and glove use. Using products containing emollients and hand lotion helps to prevent irritation (not allergic reactions). Latex Type I hypersensitivity occurs rapidly can include itching, runny nose, asthma, difficulty breathing, and is potentially life-threatening. Non-latex gloves must be available for personnel and patients, and emergency treatment kits containing latex-free products must always be available.

Resources

• CDC Guideline for Hand Hygiene in Health-Care Settings

6. Sterilization and Disinfection of Patient-Care Items (Instrument Processing)

Instrument Processing is required for all reusable instruments and devices. Appropriate PPE must be worn (see above). A designated central processing area is recommended. The stages involved include 1) Transportation; 2) Sorting (critical, semi-critical, and noncritical instruments per Spaulding’s classification; 3) Cleaning (optional pre-soak) – preferably automated cleaning, which is more effective and safer; 4) Preparation and Packaging; 5) Sterilization; and, 6) Storage. Only semi-critical instruments may be sterilized unwrapped, and provided they will be used immediately. Semi-critical heat-sensitive reusable instruments (except handpieces) may be processed after the cleaning stage by using FDA-cleared, high-level sterilant/disinfectants in accordance with the instructions for use. Handpieces must be cleaned and heat-sterilized; the manufacturer’s instructions must be followed. Sterilization monitoring consists of mechanical, chemical, and biological (spore test) indicators – these are to be used in accordance with the CDC recommendations.

Resources

• CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
• FDA 510(k) Premarket Notifications
• FDA Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling

7. Environmental Infection Control

Environmental surfaces consist of housekeeping surfaces and clinical contact surfaces. The requirements for clinical contact surfaces are more stringent as there is a greater risk of contact with these by personnel, patients, and instruments/devices. Requirements for clinical contact surfaces include the use of an EPA-registered intermediate-level or low-level disinfectant – an intermediate-level is required if the surface is visibly contaminated with blood. The surfaces must be cleaned prior to disinfection – if the disinfectant contains a cleaning agent (i.e., is a cleaner/disinfectant), then the same product may be used for cleaning and disinfecting. If not, a separate cleaner must be used, then the disinfectant. Appropriate PPE must be worn during cleaning and disinfecting of surfaces. Clinical contact surfaces can be treated with barrier protection replaced for each patient and are especially useful for difficult-to-clean surfaces.

Resources

• EPA Selected EPA-Registered Disinfectants
• Kurita H, Kurashina K, Honda T. Nosocomial transmission of methicillin-resistant Staphylococcus aureus via the surfaces of the dental operatory. Br Dent J. 2006; 201:297-300.

8. Dental Unit Waterlines, Biofilm, and Water Quality

Water from dental unit waterline (DUWL) water must meet the standards for drinking water (<500 CFU/mL of heterotrophic water bacteria) for routine dental treatment output water. For routine, nonsurgical care, DUWL should be treated and maintained using a product intended for this use. Antiretraction valves/devices in the dental unit must also be maintained in accordance with the unit’s manufacturer’s recommendations. During a boil-water advisory, water from the DUWL and public water supply may not be used for patient care, rinsing, or hand hygiene.

Resources

• Dental Unit Water Quality: Organization for Safety, Asepsis and Prevention White Paper and Recommendations– 2018
• Ricci ML, Fontana S, Pinci F et al. Pneumonia associated with a dental unit waterline. The Lancet. 2012;18;379:684.

9. Special Considerations

The CDC Guidelines also contain information and recommendations on other issues under “Special Considerations.” Each of these topics is listed below.

• Dental Handpieces and Other Devices Attached to Air and Waterlines
• Dental Radiology
• Aseptic Technique for Parenteral Medications
• Single-Use (Disposable) Devices
• Preprocedural Mouth Rinses
• Oral Surgical Procedures
• Handling of Biopsy Specimens
• Handling of Extracted Teeth
• Dental Laboratory
• Laser/Electrosurgery Plumes/Surgical Smoke
• Mycobacterium tuberculosis
• Creutzfeldt-Jakob Disease (CJD) and Other Prion Diseases
• Program Evaluation

Resources

• CDC Guidelines for Infection Control in Dental Health-Care Settings — 2003
• From Policy to Practice: OSAP's Guide to the CDC Guidelines (2022 Edition) workbook

Additional Resources

• CDC Guidelines for Infection Control in Dental Health-Care Settings — 2003
• From Policy to Practice: OSAP's Guide to the CDC Guidelines (2022 Edition) workbook
• ADS Agency Resources
• ADS Frequently Asked Questions (FAQs)
• ADS Toolkits & Topics

CDC Interim Guidance

Find the most up-to-date information about infection prevention and control practices on CDC’s COVID-19 page, including CDC’s Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, which is applicable to all U.S. settings where healthcare is delivered, including dental settings.

Developed for dental clinicians, front office staff, and other personnel, the OSAP/CareQuest Institute Best Practices for Infection Control in Dental Clinics During the COVID-19 Pandemic document is a compilation of current regulations, guidance, and practice tips, and has two sections, a practical checklist, and a companion resources/tools section. 

ADS developed resources to supplement CDC guidance with additional considerations for practical implementation to protect the health, safety, and well-being of students, teachers, staff, and dental healthcare personnel (DHCP) who participate in school sealant programs (SSPs). For more information visit Portable & Mobile Dentistry. 

As a consultant/speaker, we encourage you to share these COVID-19 resources with your clients/audiences. 

Resources

• ADS/CareQuest Institute Best Practices for Infection Control in Dental Clinics During COVID-19 Pandemic
• ADS/CareQuest Institute Dental Patient Care in the Era of COVID-19
• ADS/CareQuest Institute Dental Patient Care in the Era of COVID-19 (Spanish version)
• ADS Coronavirus Disease (COVID-19) Toolkit
• ADS Portable & Mobile

OSHA Standards & Requirements

The Occupational Health and Safety Administration (OSHA) establishes standards, guidelines and promotes health and safety in the workplace in the United States and its territories. It applies to private-sector employees and employees.

OSHA covers full-time, part-time, temporary, contract, and per diem employees. Employers must be familiar with all applicable standards. The full text for these can be found at www.osha.gov. Employers and employees must comply with the guidelines and standards.

OSHA Standards, Requirements, and the Dental Office

OSHA standards and requirements that are normally applicable to dental settings include but are not limited to:

• General requirements (includes PPE, walking-working surfaces)
• Bloodborne Pathogens Standard
• Hazard Communication Standard (revised)
• Ionizing Radiation
• Formaldehyde
• Exit Routes
• Electrical

Additional OSHA standards may apply to some offices. In states and territories with OSHA-approved state plans, there may be regulations in addition to those required by Federal OSHA and listed above. The complete text of regulations is available in Title 29 of the Code of Federal Regulations (29 CFR).

OSHA-Required Training

OSHA mandates training for all employees falling under OSHA. Training on the applicable standards must be provided during work hours and at no cost to the worker. See Training Requirements in OSHA Standards. 

Bloodborne Pathogens Standard: Employers must ensure that all workers with occupational exposure in the office participate in a training program. Training on bloodborne pathogens must be provided to employees with occupational exposure to bloodborne pathogens:

• At the time of initial hire
• Annually, within one year of the employee’s previous training.
• When changes such as modification of tasks or procedures, or institution of new equipment, tasks, or procedures affect the worker's occupational exposure – this additional training may be limited to addressing the new exposures created.
• Within 90 days after the effective date of the standard and for workers who have received training on bloodborne pathogens in the year preceding the effective date of the standard, only training with respect to the provisions of the standard which were not included need be provided.

Hazard Communication Standard: Training must be provided on this standard and additional training provided when introducing new hazards into the office that are covered by the Hazard Communication Standard.

Exposure Control Plan

OSHA requires that employers in private dental settings (and applicable public dental settings) must have a written exposure control plan. Your exposure control plan must be accessible for all employees, and on request, employees must be able to receive a copy of this. Employers must review its location during training.  

The exposure control plan's overall goal is to identify potential occupational exposure to bloodborne pathogens and describe the methods that are and will be used in the dental setting (i.e., the specific dental office) to prevent exposure.

Content Requirements
The following must be included in your exposure control plan:

• Determination of employee exposure (a list of who and which jobs have occupational exposure, and during which tasks and procedures)
• Safe work practices and methods of implementation and control (e.g., PPE, engineering and work practice controls, universal precautions)
• Hepatitis B vaccination
• Communication of hazards to employees and training
• Post-exposure evaluation and follow-up
• Recordkeeping (training records on BBP Standard, medical records, declination of Hep B vaccination, OSHA recordkeeping, sharps injury log)
• A list and description of procedures for evaluating exposure circumstances.

Executing an Exposure Control Plan
Each office must have an exposure control plan. Sample plans are available on the OSHA website (Sample Bloodborne Pathogens Exposure Control Plan). The exposure control plan has sections where all of the content requirements are addressed in a practical and logical manner. After completing the exposure control plan, this must be reviewed and updated annually. Employers must review its content and location during training.  

Authorized OSHA Outreach Training Program Trainer Designation

To become an OSHA Outreach Training Program trainer, an individual must meet the prerequisites and complete the applicable industry trainer course through an Authorizing Training Organization (ATO). See the specific industry program procedures for detailed information. Trainer course prerequisites include components for both industry-specific safety and health experience and training in OSHA standards for that industry. These are separate components. Industry experience cannot be used to fulfill or replace the training prerequisite component. OSHA does not waive the training prerequisite component.

Note: The OSHA Outreach Training Program is not a certification program and must not be advertised as such.

Resources

Occupational Safety and Health Administration (OSHA)

• Coronavirus Disease (COVID-19)
• Fact Sheets
• Frequently cited OSHA Standards
• Guide to Compliance with OSHA Standards for Medical & Dental Offices
• Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers
• Hepatitis B Declination Statement
• How to Plan for Workplace Emergencies and Evacuations
• Injury and Illness Recordkeeping and Reporting Requirements
• Inspections (Establishment Search)
• Job Safety and Health: It’s the Law poster
• Model Plans and Programs for the OSHA Bloodborne and Hazard Communication Standards
• Occupational Noise Exposure
• Outreach Training Program (OSHA 10-Hour & 30-Hour Cards)
• Personal Protective Equipment
• Hospital Respiratory Protection Program Toolkit
• Respiratory Protection
• Safety and Health Topics - Dentistry
• Sample Bloodborne Pathogens Exposure Control Plan
• State Plans
• Training Requirements and Resources
• Workers’ Rights

National Institute for Occupational Safety and Health (NIOSH)

• Health Hazard Evaluation Program

Association for Dental Safety (ADS), formerly known as the Organization for Safety, Asepsis and Prevention (OSAP)

• Agency Resources
• Frequently Asked Questions (FAQs)
• Toolkits & Topics
• OSHA & CDC Guidelines: OSAP Interact Training System 7th Edition workbook

Infection Control Coordinator

Roles & Responsibilities | Charts & Checklists | Education & Training | Certification | Membership & Networking | Additional Resources

Every office needs at least one assigned Infection Control Coordinator (ICC). As a consultant and/or speaker, you can help educate dental practices and the ICC on their role and responsibilities and collaboratively work together to train other members of the team, and to encourage the safest dental visit and compliance. Training the ICC and providing resources gives them an opportunity to then train their own team members on specific areas of infection control and safety. 

An ICC has training in infection prevention and control (IPC) and should be responsible for developing written infection prevention policies and procedures based on evidence-based guidelines, regulations, or standards. The ICC may have responsibilities within a larger job position (safety director, employing dentist, dental assistant, office manager, etc.). At a minimum, the ICC should have a basic understanding of microbiology, modes of transmission, infection prevention and safety procedures, related governmental regulations and recommendations, and products and equipment available to maintain patient and provider safety.

 Specific roles include but are not limited to the following:

• Lead in policy development, implementation, and monitoring and review and update written policies, standard operating procedures (SOPs), and other documents
• Use credible sources (e.g., CDC, OSHA, EPA), assess expected outcomes
• Maintain relevant regulatory and guidance documents and make sure these are available to all personnel (e.g., Bloodborne Pathogens Standard; PPE (general requirements))
• Maintain current related permits, licenses, and other documents (e.g., training, sterilization, medical and other records and logs)
• Generate/update/maintain logs of (other) safety-related records (e.g., manifests from medical waste haulers, radiographic equipment certifications)
• Act as a resource on infection control/prevention for the team or organization
• Provide infection control (and OSHA-mandated) training and education
• Monitor compliance by observation, sterilization logs, checklists, other methods
• Confirm employee immunizations are current, supplies/equipment ordering systems are in place.

Roles & Responsibilities

Infection Control in Practice (ICIP)

• February 2015 - The Case for Designating a Dental Safety Coordinator
• April 2015- Defining the Role of the Infection Control Coordinator Part 1
• June 2015- Defining the Role of the Infection Control Coordinator Part 2
• August 2015- Defining the Role of the Infection Control Coordinator Part 3
• October 2015- Tools and Resources for the Infection Control Coordinator
• December 2015- Tools and Resources for Evaluating an Infection Control Program
• January 2004 - Incorporating CDC Guidelines Into Your Practice

PowerPoints 

• The Role of the Infection Control Coordinator (Kathy J. Eklund, RDH, MHP, 2020 OSAP Dental Infection Control Boot Camp™)

Articles

• Role of the Infection Prevention Coordinator (Kathy J. Eklund, RDH, MHP, February 2020)
• The Role of the Infection-Control Coordinator (Leslie Canham, CDA, RDA, January 2010)
• Why Your Practice Needs an Infection Control Coordinator (Leslie E. Grant, DDS, MSPA, June 2017)
• Roles of the Infection Control Coordinator (Marie T. Fluent, DDS, June 2017)

Additional Resources

• 7-Week Planning Guide to Take Ownership of the Infection Control Coordinator (ICC) Role
• 12-Month Planning Guide to Establish a High-Quality Infection Prevention and Control (IPC) and Safety Program
• Infection Control Coordinator - Sample Job Description

Charts & Checklists

• ADS/CareQuest Institute Best Practices for Infection Control in Dental Clinics During COVID-19 Pandemic
• ADS Checklist: Dental Unit Waterlines
• ADS Checklist: Incorporating CDC Guidelines into Your Dental Practice
• ADS Checklist: Infection Control Coordinators: Roles, Resources, and Responsibilities 
• ADS Checklist: Instrument Cleaning
• ADS Checklist: Instrument Packaging
• ADS Checklist: Operatory Reprocessing
• ADS Checklist: Sterilization Audit
• ADS Checklist: Sterilization Loading
• ADS Checklist: Sterilization Log
• ADS Checklist: Sterilization and Monitoring
• Sterilization and Dispensary Flow Chart
• Screening and Evaluating Safer Dental Devices (sample forms)

Education & Training

In-Person Course & Conference

• ADS Dental Infection Control Boot Camp™-  foundational level course in dental IPC and patient safety. The course takes place once a year in January.
• ADS Annual Conference - conference covers topics relevant to dental IPC, occupational health, and patient safety, including evolving guidance, compliance, and emerging IPC and safety issues. The conference takes place once a year in May/June.

Dental Infection Prevention and Control Certificate™ 

Dental Infection Prevention and Control Certificate™ - as a consultant/speaker you should complete this comprehensive, online, baseline educational program. You can also encourage your clients and audiences to complete it as well, as it is intended for all dental team members, including dentists, dental hygienists, dental assistants, dental laboratory technicians, ICCs, and practice managers who want to learn more about dental IPC. The certificate was developed by the ADS and the DALE Foundation. 

Online Courses & Webinars

• ADS Online Courses & Webinars - view online courses and webinars in ADS's Infection Prevention and Safety CE Center
• Infection Control in Practice (ICIP) - a bi-monthly publication that features real-life scenarios with checklists on how to prevent negative outcomes. ICIP is developed to be used for team discussion and activities.

Visit CE Center

• ADS-DALE Foundation Online Courses - ADS has developed several online courses with the DALE Foundation. These courses are available for purchase on the DALE Foundation website.
• CDC Foundations: Building the Safest Dental Visit - provides an overview of the basic expectations for safe care—the principles of infection prevention and control that form the basis for CDC recommendations for dental healthcare settings. Learners who complete the training are eligible for 3 CE Credits provided by ADS.
• CDC Hand Hygiene Interactive Training - intended for healthcare providers and reviews key concepts of hand hygiene and Standard Precautions.

InfoBites

The weekly InfoBites help take some of the effort out of staying up-to-date. It provides relevant short summaries of the latest news related to patient safety and infection control worldwide.

Workbooks & Textbook

• From Policy to Practice: OSAP's Guide to the CDC Guidelines (2022 Edition) workbook - helps dental team members understand and implement the CDC guidelines into practice.
• OSHA & CDC Guidelines: OSAP Interact Training System 7th Edition workbook - helps dental team members understand the health and safety considerations established by government guidelines and regulations.
• Infection Control & Management of Hazardous Materials for the Dental Team, 7th Edition textbook - covers everything from basic concepts in microbiology to protocols for clinical asepsis.

PowerPoint Slides

• CDC Training: Basic Expectations for Safe Care - covers the basic principles of infection prevention and control that form the basis for CDC recommendations for dental health care settings. 
• ADS Infection Prevention & Control Guide for School Sealant Programs During the Coronavirus Disease 2019 (COVID-19) - a PowerPoint slide set and presenter script to complement the Infection Prevention & Control Guide for School Sealant Programs During the Coronavirus Disease 2019 (COVID-19).

Videos

• If Saliva Were Red - training video that demonstrates the potential for cross-contamination and how to prevent it. It includes a ‘How to Tell the Story: A Trainer's Guide’ with talking points, a checklist, and FAQs
• Handwashing Gangnam Style
• I Wash My Hands For You- Music Video- Gerber Hospital
• WHO Hand Hygiene Video

Certification

Certified in Dental Infection Prevention and Control^® (CDIPC^®) - is a professional certification that is intended for all dental team members who implement federal infection prevention and control standards and guidelines in dental settings; educators and supervisors of those dental team members; corporate educators; and consultants providing information on implementing federal infection prevention and control guidelines in dental settings. 

For more information for yourself or clients/audiences, visit dentalinfectioncontrol.org for more information. 

Membership & Networking

Encourage your clients/audiences to become ADS members!

• ADS Membership
• Individual Memberships
• Basic – $75/yr. (not eligible for discounts on ADS-related events or store items)
• Premium – $120/yr.
• Student – FREE (Click here to learn more!)
• Group Memberships
• Professional Practice I – up to 10 team members – $200/yr.
• Professional Practice II – 11 - 300 team members–$1,500/yr.

Additional Resources

Agency for Healthcare Research and Quality (AHRQ)

• TeamSTEPPS® 3.0

Centers for Disease Control and Prevention (CDC)

• Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus 
• Advisory Committee on Immunization Practices (ACIP) Vaccine Recommendations and Guidelines
• Cover Your Cough Poster
• DentalCheck Mobile App
• Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care (guide and checklist)
• Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007)
• Guidelines for Infection Control in Dental Health-Care Settings—2003
• Hand Hygiene in Healthcare Settings
• Immunization/Vaccine Schedules
• Infection Prevention Checklist for Dental Settings
• Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care
• TB Respiratory Protection Program In Health Care Facilities - Administrator's Guide

Food and Drug Administration (FDA)

• 510(k) Premarket Notifications
• Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling

Environmental Protection Agency (EPA)

• List N: Disinfectants for Coronavirus (COVID-19)
• Selected EPA-Registered Disinfectants

Occupational Safety and Health Administration (OSHA)

• Bloodborne Pathogens and Needlestick Prevention
• Guide to Compliance with OSHA Standards for Medical & Dental Offices
• Hazard Communication Standard
• Health and Safety Topics: Dentistry
• Hepatitis B Declination Statement
• Model Plans and Programs for the OSHA Bloodborne and Hazard Communication Standards
• Hospital Respiratory Protection Program Toolkit
• Respiratory Protection
• Sample Bloodborne Pathogens Exposure Control Plan

Association for Dental Safety (ADS), formerly known as the Organization for Safety, Asepsis and Prevention (OSAP)

• Agency Resources
• Ask ADS
• ADS/CareQuest Institute Best Practices for Infection Control in Dental Clinics During COVID-19 Pandemic
• ADS/CareQuest Institute Dental Patient Care in the Era of COVID-19
• ADS/CareQuest Institute Dental Patient Care in the Era of COVID-19 (Spanish version)
• ADS Infection Prevention & Control for School Sealant Programs (SSPs) During COVID-19
• Frequently Asked Questions (FAQs)
• InfoBites
• Toolkits & Topics

Recommended Vaccines

Dental health care personnel (DHCP) are at risk for exposure to serious and sometimes deadly diseases. If you work directly with patients or handle material that could spread infection, you should get appropriate vaccines to reduce the chance that you will get or spread vaccine-preventable diseases. Protect yourself, your patients, and your family members. Make sure you are up-to-date with recommended vaccines.

DHCP refers to all paid and unpaid personnel in the dental healthcare setting who might be occupationally exposed to infectious materials, including body substances and contaminated supplies, equipment, environmental surfaces, water, or air. DHCP includes dentists, dental hygienists, dental assistants, dental laboratory technicians (in-office and commercial), students and trainees, contractual personnel, and other persons not directly involved in patient care but potentially exposed to infectious agents (e.g., administrative, clerical, housekeeping, maintenance, or volunteer personnel).

Resources

• CDC ACIP Vaccine Recommendations and Guidelines
• CDC General Best Practice Guidelines for Immunization

Culture of Safety

In dentistry and healthcare in general, a “Culture of Safety” involves a commitment to the safety of patients and personnel by everyone in the organization (office/institution), including management. The Safest Dental Visit™ requires that a Culture of Safety be present and includes a commitment to the relevant CDC guidelines and all applicable OSHA standards and requirements.

Implementing and working in a positive culture of safety means:

• Individual accountability and commitment for safety is promoted
• Protocols and activities promoting safety are suggested, planned, and implemented
• Mechanisms are in place to determine if safety guidelines and policies are followed
• All employees and personnel are empowered to make suggestions/voice safety concerns - Download Infection Control in Practice "Who is Managing Your Safety Culture"
• All employees and personnel are involved in the decision making
• A protocol is in place to address suggestions/concerns related to improving safety
• All personnel, including management, receive initial training, OSHA-mandated training, and updates when mandated and when changes are made
• Reporting systems are in place for safe behaviors, injuries, near misses, and hazards
• To show the differences when safe behaviors are in place
• To investigate, make corrections, prevent a recurrence, ‘provide follow-up care
• A post-exposure management program that follows the guidelines of the U.S. Public Health Service is in place (and is required by OSHA)
• Management is involved, supports related activities
• Resources are committed to safety (e.g., money for safety devices such as needless injection systems, sharps devices, cassettes)
• Systems are in place to acknowledge safety practices (e.g., recognition, award points)
• Adverse events related to patient care are reported, investigated, and remediated
• Dental care is patient-centered. The Institute of Medicine (IOM) defines patient-centered care as “Providing care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.” Safety is a value of patient-centered care.
• Patients are informed of the risks, benefits, and alternatives to the proposed treatment.

Staff meetings are an opportunity to review results, obtain suggestions and make recommendations. These can occur at least monthly or more frequently. Additional meetings are required to report breaches, take corrective action and provide (re)training.

• Checklist to help prepare for a safe dental visit (does not address COVID-19 interim guidance)
• ADS/CareQuest Institute Best Practices for Infection Control in Dental Clinics During COVID-19 Pandemic
  

Measuring a culture of safety

Surveys are available that measure whether personnel believes their work environment has a positive culture of safety, where they are empowered (vs. fearing reprisal).

Mechanisms to determine adherence to safety guidelines and policies

1. Observations and reviewing records and logs help to determine adherence. Examples of observations that measure adherence include:

• Are surfaces uncluttered?
• Are floor areas clear and free of cables and other obstacles
• Compliance with hand hygiene – is it being performed and supplies being used at the rate you would expect?
• Compliance with PPE – is everything wearing appropriate PPE when you do spot checks and are they wearing it properly? Is it being appropriately disposed of?
• Are work practices geared to safety routinely followed?
• Are the fire extinguishers accessible and working?
• Are hazardous materials isolated and accessible only to authorized personnel?
• Is waste being disposed of properly?

2. Checklists can be used to determine compliance with safety and infection control.

3. Review adherence to your written safety and prevention plans and policies required by OSHA. This can help identify any gaps or improvements that may need to be made, including in the policies themselves and practices that help adherence.

What to do when injuries/near misses/hazards occur?

Fully investigating these without placing blame fosters a continued positive culture while finding out why the event occurred, after which corrective action can be implemented and then reassessed days/weeks and months later. If necessary, further action can be taken to improve safety.

Resources

• National Occupational Research Agenda (NORA) Stops Sticks Campaign
• Agency for Healthcare Research and Quality. Medical Office Survey on Patient Safety Culture
• Agency for Healthcare Research and Quality. Hospital Survey on Patient Safety Culture
• Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS® 3.0
• Gawande A. The Checklist Manifesto
• ADS Frequently Asked Questions (FAQs)
• ADS Toolkits & Topics
• Siegel JD, Rhinehart E, Jackson M, and Chiarello L. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am J Infect Control 2007; 35 (No. 10 Suppl. 2), p S94.
• U.S. Department of Veterans Affairs. Root Cause Analysis.

Media Kit

Coming soon!