What qualifies as an infection control breach? What is the easiest way to prevent them? In this episode of Talking with the Toothchop, India Chance and Michelle Strange return for a conversation about infection control breaches. We talk about what they are, why we can’t ignore them, and how we can do our part to prevent them.
Outline of This Episode
- [7:05] What is an infection control breach?
- [13:11] Have written protocols in place
- [15:56] The most common infection control breach
- [21:30] Why training + preparation is important
What is an infection control breach?
A breach in infection control is when there is a lapse—a failure to break the chain of infection—that impacts patients and employees. You have to recognize that there was a failure and notify those who were affected.
In 2013, the dental board in Oklahoma exposed Dr. W. Scott Harrington for unsafe practices in his dental office. One of his patients contracted HIV from his unhygienic practices and up to 7,000 others were exposed to hepatitis B, hepatitis C, and HIV.
It’s not always egregious or newsworthy breaches. It can be a corner that got cut. It can be something that got dropped on the ground. These protocols aren’t just in place to protect patients, they’re in place to protect staff as well. The bottom line is that the medical field doesn’t mess around with infection control breaches—neither should dentistry.
Have written protocols in place
All of us run into difficult conversations with staff about personal hygiene—even something that seems as silly as wearing nail polish and fake nails. It’s uncomfortable. Plus, research has been done on how nail beds with chipped polish and artificial nails are perfect reservoirs for bacterial loads. It’s why India and Michelle encourage dental practices to have written protocols in place for personal hygiene. It’s less of a headache when you have a policy and it isn’t just “anything goes.”
Common infection control breaches
I think the most common infection control breach I see is with sterile processing. Michelle got a call from a dental office with a big sterilization breach that had to do with a malfunctioning sterilizer. They weren’t doing the necessary prevention protocols.
India sees a lot of little small breaches like someone cutting corners or simply weren't sure they were doing things correctly (and they weren’t…). But she agrees that the large breaches where patients must be notified seem to be with sterilization.
Michelle sees a lot of needlestick injuries. Michelle once witnessed a hygienist get punctured by a tip and was bleeding. Her reaction was “Oh I’ll just wash my hands” and didn't get a medical follow-up. Luckily, she wasn’t working with a patient. Her exposure could’ve been far worse, especially because a lot of dental practices don’t take adequate medical histories.
Many dental offices don’t use the health history section of their digital charting much—if at all. If you do have one of those injuries, you need to have a grab-and-go kit in place. You just grab it and head to get medical attention.
At LevelUp, they’re training infection control coordinators to do that across the board. Regardless of the injury or hazard, they have a grab-and-go packet for medical attention. No one wants to have to dig to reference infection control protocols—have it ready.
Why training + preparation is important
When I do OSHA and infection control training, I talk about what an occupational exposure is as well as what steps to take after exposure. But I don’t want you to have to remember the protocol. The sad truth is that if you know what to do, you’ve dealt with it too many times. You need to do a root cause analysis and find out why it keeps happening. Is it a systemic failure? Was someone just not paying attention? Was someone not wearing PPE?
More training needs to happen upfront before you even touch a patient so dental staff aren’t questioning what to do if something happens. We need to do our part to train our staff with the correct protocols, infection control programs, standard operating procedures, etc. We need to have written policies, and reinforce a culture of compliance.
Dental practice owners need to understand the cost analysis with infection control breaches. Occupational hazards are so expensive to deal with. They don’t know how much more it’s costing them. Safety is good for business. Prevention is less expensive. It will save you time and money. We must shift the perspective in infection control breaches from the standpoint of reacting to one of prevention.
Tune in next week for the rest of our conversation about infection prevention!
Resources & People Mentioned
- Story on Tulsa Dentist