Dental Tribune UK Edition, September 13-19, 2010, Vol. 4 No. 21

15Infection Control TribuneSeptember 13-19, 2010United Kingdom Edition H ealthcare professionals at every level and in eve- ry discipline can never forget the ever-present risk of cross infection. The knowledge and application of preventive protocols is today more impor- tant than ever before, with more sophisticated and even interna- tional social intercourse likely to introduce a widening spectrum of pathogens into the clinical en- vironment. In the context of cross-infec- tion, a pathogen is defined as a transmissible biological agent, which disrupts the wellbeing of its host. Usually in the form of a micro-organism, pathogens can infect a host body via the skin and mucous membranes, inha- lation, ingestion, injection, im- plantation and through the pla- centa to an embryo in utero, and all of these routes are relevant in everyday dental practice. Protecting yourself Although advances in medical science have greatly improved the diagnosis and treatment prognosis of pathogen-inspired infections, the responsibil- ity of practice staff to protect themselves, their colleagues and their patients from possible cross-infection remains undi- minished. The aggressive nature ofmanypathogensdictatesthatall blood, saliva and gingival fluids should be regarded as potentially dangerousreservoirsoftransmis- sible disease, with control pro- cedures scrupulously observed in every case. The most frequent occur- rences of cross-infection are the result of a failure to observe cor- rect procedures in three princi- pal areas – hand hygiene, equip- ment sterilisation, and omitting to wear designated personal pro- tective clothing. Scrupulous attention to de- tail is vital during the cleaning, disinfection and sterilisation of instruments and equipment after each use. To safeguard both the wearer and others within the practice from the dangers of pathogen transfer, personal protective equipment and clothing must be worn without exception when- ever appropriate. In 2009, the Department of Health (DH) published the HTM 01-05 Decontamination Proto- cols, a comprehensive, updated statement of the guidelines for clinical hygiene procedures de- signed to ensure the safety of both clinical staff and the pub- lic from fluid-borne infections, with particular reference to den- tal practices. These guidelines cover: • The use of personal protection equipment • Aerosols and splashes • Surgery cleaning protocols • The use of disposable instru- ments and sundries • Instrument decontamination • Sterilisation • New instruments • Aseptic storage • Equipment repair • Waste disposal • The safe use and disposal of sharps • Training in hygiene procedures • Communication • The monitoring of infection control techniques. Rigid adherence to these guidelines should ensure the safety of staff, patients and prac- tice visitors at all times through- out the practice. Special treatment Standard hygiene procedures must be applied to every patient, but there may be occasions when special measures are needed, for example if a patient presents themselves with a pre-existing transmissible medical condition. A first appointment ques- tionnaire should ascertain any specific risks, which should be monitored thereafter. Admis- sions staff should be aware that patients may not know they are carrying an infection, and some who do know may not be pre- pared to admit it in response to questioning. This lack of certain- ty emphasises the importance of rigorously enforcing all standard hygiene procedures for every pa- tient at all times. It is in the best interests of the practice, as well as the in- dividual, to ensure that all staff A team effortProtection from cross-infection depends on the commitment and co-operation of the en- tire practice team, says Richard Musgrave ‘To safeguard both the wearer and oth- ers within the practice from the dangers of pathogen transfer, personal protective equipment and clothing must be worn without exception whenever appropriate.’ page 16DTàCross infection control within the practice should be a team effort