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10 things your office should know about Infection Control with Julie Varney (15 min Interview)

06.13.2019, 10:03 PM
10 things your office should know about Infection Control with Julie Varney (15 min Interview)

10 Things Every Assistant Should know about Infection Control:

  • PPEs – 4 items – mask; gloves; goggles; gown
  • Utility Gloves
  • Transport bins – to transport our items from the operatory to the sterilization area in a closed puncture proof, leak-proof container. With a biohazard sticker.
  • Disinfectants – 2 step or 1 step. One step or two-step and are you doing, if you’re using a two-step, are you doing the true two steps.
  • Loading Autoclave – Paper down. Plastic up.
  • Dating Indicators on pouches – Loading the autoclave indicators, on pouches, there’s external and internal. Then on the wrap, they’re on paper and tape, the tape changes to stripe but we also need to put an indicator inside our cassettes.
  • Seven, was the date your items by load date and autoclave if you have more than one.
  • Eight was you need to weekly spore test your autoclave or whatever sterilizer you use.
  • Then always read your IFUs, your infection, we’re talking about infection control, your instructions for use on any type of product. Always read. Read. Read. Read.
  • Ten was your annual training. Because things change, just like one of the changes last year was all handpieces that are air driven must be autoclaved, the last tip must be autoclaved between each patient.

Tiger: Julie, I really appreciate you sending a text message, “Hey Tiger what did you do in section control with all the zen people?” This is a big subject, a lot of people talk about and you then came up with such a cool title Ten Things That Every Dental Assistant Should Know About in Infection Control.

Tiger: I know that our assistants are busy but a lot of them will be able to watch this later. So let’s just dive into this. Just I can’t even add my two cents into this. This is a new subject for me I’m taking notes.

Julie Varney: You can’t? You don’t know anything about section control

Tiger: Literally I’m going to take notes.

Julie Varney: You’re going to take notes. All right. So first things first, we start with your PPE. [1] Everybody knows about the PPEs but what they sometimes fail to use are everything of them. Right, so sometimes they might not wear goggles, so we should always be wearing our masks, our gloves, our goggles or our face shield and we should always be wearing a gown with our arms covered. So we should not have our arms uncovered.

Julie Varney: If you don’t want to wear it to the office you could always take your lab coat on and off before you leave the laboratory. But those are the four things that protect us and protect the patient from us. So we definitely should be wearing those. There are other times we should wear them through processing instruments and breaking down and cleaning up a room. So those are our four main PPE items.

Julie Varney: Our next thing is [2] utility gloves. So utility gloves are very underutilized in a practice which is according to OSHA is a no-no. We should be using them. So utility gloves should be worn when breaking down and cleaning up a room disinfecting it, when you’re transporting your instruments from the operatory to the sterilization area and also they should be worn while you’re processing your instruments in the sterilization area.

Julie Varney: They need to be leak puncture proof and they need to cover your arms. They do have disposable ones by Halyard I think it is. But you should have a pair kind of everywhere. Where you’re going to be using them.

Julie Varney: So our next thing that people do not do that should be doing is when you transport your items and your instruments from the operatory to the sterilization area, they need to go in a [3] leak-proof, closed, puncture-proof container. So if you use a cassette system, the cassettes have holes in them so that doesn’t classify as a puncture proof leak-proof container.

Julie Varney: It has to have a lid or a locking lid. Because the need to transport them so that nothing happens. So if you bump into somebody they’re not going to get poked or cut. So we need to make sure that when we transport, you have a bin that keeps those instruments safe from harming others and you’re wearing your utility gloves.

Tiger: You have to have utility gloves when you grab the tub with instruments to bring them into sterile.

Julie Varney: Yeah. Absolutely, and this is the safest practice for the assistant or the hygienist or whoever’s turning over the rooms. Because we don’t want to risk any type of injury that’s going to get them hurt on the job and that’s more paperwork so let’s just do things the right way the first way.

Tiger: Wow. Okay.

Julie Varney: Next is, [4] disinfectant. There are lots and lots of products out there which people don’t realize is that there’s a one-step or a two-step process. So you need to read the instructions for use on your containers. Because some of the disinfectants that we use to wipe down our rooms are technically a two-step process. But they’re being used as a one step.

Julie Varney: So a two-step means, if you’re using a Cavi-wipe has to be used once to clean and then it has to be used again to disinfect. So if you’re using a product that is a two-step you have to use it twice and you have to use more of it.

Tiger: So, meaning we wipe up the surface first and then we take another one and we have to wipe up the surface again?

Julie Varney: Yeah. Because with a two-step process, you have to pre-clean and disinfect. So if you read the back, whether it’s Birex or Cavi wipes, any type of disinfectant that’s EPA regulated so we can’t use Lysol FYI. Lysol is not EPA regulated or hospital grade. They tell you the instructions for you. Whether you have to pre-clean and then disinfect or if there’s one step. So often one by Scican is a one-step process so it saves you time and it saves you money because you’re not using as much of the product and it’s also healthier for you.

Tiger: Do you know what other products are one step? That’s probably something I should know.

Julie Varney: Yeah, well I believe Cavi wipes has now a one-step process. There are a couple of other products that have converted over to being one step instead of pre-cleaning and disinfecting, they now do both. You just have to read the directions and their set time and all that stuff.

Tiger: Like a one or three minutes?

Julie Varney: Or on Birex is ten minutes. I think it’s ten minutes. Birex. We shouldn’t be spraying because then you breathe that all in and we need to make sure that when you’re using these products you have all your PPEs on because it’s very important that you don’t breathe in all those aerosols or all those chemical smells. That’s not good for your health either, so we want to make sure we have our PPEs on.

Tiger: So you’re saying if they’re alcohol based don’t be smelling?

Julie Varney: Well, some of them are alcohol based but you need to make sure you have your mask on and your goggles on.

Tiger: Well I’ve experienced that. In a couple of the offices. I went in and smelled all the alcohol base so we won’t talk about it.

Julie Varney: Lysol is not utilized. You cannot use Lysol it has to be EPA regulated at a high level.

Tiger: What did step one or step two or it’s just the nature of the product, one product would be two- step and one product would be one step?

Julie Varney: It’s just the nature I mean, it’s just what the product is made. It’s not they’re better than any other product. You have to read it, the instructions for you if you’re using Birex that’s a two-step product you’re going to want to make sure that you’re doing those two steps so it’s very ineffective. You might not be killing everything if you only do it once. When it’s a [crosstalk 00:07:43] process.

Tiger: Makes sense.

Julie Varney: Check your labels, always read your labels on how to use things.

Julie Varney: So next is … I’m going to go over [5] loading the autoclave. This is a big topic. Like paper or plastic. Up or down. So one: always read your manufacturers whether you have a Statim or a Midmark or I think it’s called a Tuttnauer the big huge gigantic one. Read how they tell you how to load the autoclave. That is important.

Julie Varney: Midmark, I do know, are plastic up and I think the theory behind this, and this is just my theory is because when you put the plastic down and the instruments are maybe a little bit wet, the water’s going to pool on the plastic the air can’t flow and dry the plastic as much as when it’s paper down. The paper gets wet but the air dries the paper. So and the instruments don’t sit as much in the plastic so it’s always plastic up, paper down for Midmark when loading.

Tiger: Paper down. Plastic up. Got it.

Julie Varney: I want to make sure that you’re not over packing the autoclave because you have to have certain airflow to let everything, one:
get sterilized and two: get dry.
If everything is compressed it’s not going to get the airflow that it needs. So you can either stack them or you can lay them all spread out but you need to make sure that they’re not compressed and on top of each other.

Tiger: That it?

Julie Varney: Okay and that’s when things melt. So a lot of people complain that “All my X-Ray rings melted.” Yeah, that’s because you probably packed the autoclave and they had no room to breathe or let the heat escape so the heat got trapped and it caused the rings to melt.

Tiger: Got it.

Julie Varney: Also, on your pouches which people sometimes don’t have a tendency to watch. There are indicators that are external and internal. The pouches must have an external and internal indicator so that you can tell that it was properly sterilized.

Tiger: Or they have these little dots or something?

Julie Varney: Yeah. In the corners, the ones you can kind of peel back and you can feel. But then there are also ones in the corners in the pouches that you can’t touch that are in between the plastic. So there’s usually, whatever brand you’re using, most of them, I believe, I’ve never seen one without, have an internal and external.

Tiger: Got it.

Julie Varney: When you’re using cassettes because they’re wrapped in a blue paper with tape, you need to use an internal indicator strip and put it inside the cassette. Because the paper and the tape only have external.

Tiger: Okay. Wow. This is a lot of information.

Julie Varney: These are the most things I see are done wrong.

Tiger: Okay. I’m ready for the next one.

Julie Varney: The next one. We need to be weekly checking for [6] testing our autoclave for Spor Testing. It’s not okay to not do this. Because

Tiger: What is it called?

Julie Varney: … if it’s killing everything it needs to kill and if it’s properly functioning.

Tiger: Spore checking?

Julie Varney: Spore testing yup.

Tiger: Spore testing.

Julie Varney: Yeah you could automate that on your system. But it’s very important that you do it if you have more than one autoclave or sterilizer, that you are numbering them because the next thing is all your items that come out of these sterilizers need to be dated. Cycle dated. If you have more than one autoclave, which autoclave they came out of.

Julie Varney: Because, if something fails, we have to have a record of instruments that maybe were processed before or after. Because all of the instruments that come out need to be date stamped, cycle stamped and they’re only good, they say the recommended, for six months.

Julie Varney: So if they sit in the drawer for two years, it’s highly unlikely they’re still sterile. You might want to redo them.

Tiger: Wow. Okay. Got it.

Julie Varney: All right. My number nine was always read your instructions for you. Always on everything. If you don’t know about the product. Read it.

Tiger: Read instructions? Did you say number nine?

Julie Varney: Number nine. Read your instructions.

Tiger: Number seven?

Julie Varney: Number seven? Number seven was the date of the item.

Julie Varney: Wait, you missed it? Wait no, eight was, monitor your autoclave.

Tiger: Yup.

Julie Varney: Seven was, date your items. I mixed them up. I read it wrong. We’ll recap them all at the end.

Tiger: Yup. We will. We will. Okay.

Julie Varney: And then. [9] Number ten is annual training. You should be getting training once a year in your OSHA and your infection control standards. Do the full office. Three, four hours going through all your processes, checking everything, your eyewash stations, your fire extinguishers, your emergency evacuation plans, your emergency plans. These things should be trained and checked once a year.

Tiger: Okay. So, how do people go about them? So let you say I’m in the office, I know I haven’t done these in a while, what do I do? Call somebody? Because I don’t want to call somebody and somebody reports me that I haven’t done that in a while, so what’s the right way to do it?

Julie Varney: Usually you only get reported if someone complains but there are tons of people to reach out to but you can do in office training that is three or four hours. Some people have CEs they can give. Sometimes, myself, I’m going to tomorrow. I have a four-hour infection control training and OSHA, it’ll be fun. But it should be customized to your office. It also should provide CE because 90 percent of the licenses out there need CEs. I know if you’re a lead assistant you need two CE a year infect control.

Julie Varney: But also if you don’t know there’s https://www.osap.org/, you can reach out to for $150 dollars a year, you can get a membership to OSAP that has all this information about infection control on it. Right at your fingertips, download form, figure it out, they have it all right there for you.

Julie Varney: They promote the safest dental visit. When you send the file off an email, I will give you a code Tiger so that they can get 50 percent off their yearly membership to this organization.

Tiger: Fantastic.

Julie Varney: I know. But there’s no reason why any dental assistant out there should not know the proper way. Because there’s so much information out there and so much free information out there that they should know the proper ways.

Tiger: Right. So, do people really need to pay for OSHA inspections? Is it somebody that has to be certified who does the training or it can be anybody?

Julie Varney: Well, there’s credentialing. I mean people have credentials in this stuff. I don’t think there’s a certification in OSHA but there’s a lot of experts out there and I would definitely do your research before you hire somebody to come in. Because if they tell you wrong and then you’re doing it wrong, there’s a lot of fines behind this stuff.

Julie Varney: So really, if you hire somebody to come into the office, there’s Dr. Kathleen Schrubbe, she’s right there in Illinois. She does a lot of infection control in OSHA, and stuff like that. Linda Harvey, she does all the HIPAA, she’s very good at that stuff so there’s a lot of experts out there and you want to go with that just not winging it.

Julie Varney: I know HIPAA but I’m not an expert in it, I could do a yearly training to update you on it but if you’re just starting off the bat, I will funnel you to Linda because she’s an expert in the HIPAA.

Tiger: You got it. All right. So let’s do a recap.

Julie Varney: All right. So, number one was your PPEs.

10 Things Every Assistant Should know about Infection Control:

  • PPEs – 4 items – mask; gloves; goggles; gown
  • Utility Gloves
  • Transport bins – to transport our items from the operatory to the sterilization area in a closed puncture proof, leak-proof container. With a biohazard sticker.
  • Disinfectants – 2 step or 1 step. One step or two-step and are you doing, if you’re using a two-step, are you doing the true two steps.
  • Loading Autoclave – Paper down. Plastic up.
  • Dating Indicators on pouches – Loading the autoclave indicators, on pouches, there’s external and internal. Then on the wrap, they’re on paper and tape, the tape changes to stripe but we also need to put an indicator inside our cassettes.
  • Seven, was the date your items by load date and autoclave if you have more than one.
  • Eight was you need to weekly spore test your autoclave or whatever sterilizer you use.
  • Then always read your IFUs, your infection, we’re talking about infection control, your instructions for use on any type of product. Always read. Read. Read. Read.
  • Ten was your annual training. Because things change, just like one of the changes last year was all handpieces that are air driven must be autoclaved, the last tip must be autoclaved between each patient.

Julie Varney: Once a week yeah. Then always read your IFUs, your infection, we’re talking about infection control, your instructions for use on any type of product. Always read. Read. Read. Read. Okay. Then ten was your annual training. Because things change, just like one of the changes last year was all handpieces that are air driven must be autoclaved, the last tip must be autoclaved between each patient. So your hygiene close feeds that people technically did not do that, they would wipe them down with a Cavi wipe or some type of disinfectant. They now have to be removed and autoclaved between each patient. Just like your high speeds.

Tiger: So what’s the instrument?

Julie Varney: Your air driven motors. Your high-speed handpieces, your low-speed handpieces. The high speed always had to be autoclaved but the low speed now also is regulated to be autoclaved between each patient.

Tiger: We’ll put that as the bonus section.

Julie Varney: Yeah. Put that in the bonus section. But if any assistant has any questions you can feel free to reach out to me. Like I said, join OSAP there’s a ton of resources out there. There are checklists, there’s protocol on that website. For $150 bucks a year, your whole office can know how to do everything.

Tiger: Right. As a closing note, I’m still trying to wrap my head around how much dental assistants should know.

Julie Varney: They should know as much as they could possibly know right?

Tiger: Right? Just between this stuff here that we covered. My notes here, you can see how many notes I took.

Julie Varney: You took a lot of notes.

Tiger: And order supplies, and turn over the rooms, and assist the doctors

Julie Varney: On fire that little

Tiger: And then we probably didn’t even scratch the surface of really going into the OSHA and all that stuff.

Julie Varney: No, these are just ten common things that I see that are done wrong or done maybe half -done at times. That shouldn’t be. It’s really important that we stick to a good solid infection control plan because it only protects not ourselves, but our patients and we don’t want to be on the news for improper stuff and we don’t want to be closed down or end up in jail. Or hurt someone. That’s the biggest thing. Who wants to hurt somebody and they end up with some infectious disease.

Tiger: Exactly. Awesome these are really cool. Ten actionable steps that any office can use. I love that, it’s tightly packed and that in the notes I’ll make a note on how people can reach out to you.

Julie Varney: Yeah. Absolutely. Like I said we’ll send them a code to get the credit for CEzoom for watching the webinar. I’ll send you a code for the OSAP for them to get 50 percent off of the membership if anyone wants to sign up.

Tiger: That’s awesome.

Julie Varney: Get all the resources and we hope to see you at that, the annual conference which we will be talking about infection control on there. So they’ll learn more about that and the whole process.

Julie Varney: Like I said it’s just scraping the surface but if you don’t know when you need to ask and if the older generation of assistants hasn’t had any training we need to get some training too because we teach the younger generation the wrong way and it’s not okay.

CODE: darocks50 to use with OSPA.org

 

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