CHAPTER 6

Infection Control: Clinical Procedures

KNOWLEDGE EXERCISES

1. Assuring that materials and tissues are free from contamination with organisms by

keeping them off, removing them, or killing them

2. Selecting and maintaining procedures that prevent the transmission of infectious agents

and eliminate cross contamination

3. To protect yourself and your patient from infection

4.

￭ Reduce microorganisms

￭ Break the chain of cross contamination

￭ Use standard precautions for every patient

5.

￭ Dental chair

￭ Light

￭ Clinician’s stool

￭ Floor

￭ Sink

￭ Supplies

￭ Waste systems

6.

￭ Cleaning step—manual cleaning or either ultrasonic or washer/thermal disinfector for

elimination of microorganisms

￭ Packaging step—to prevent recontamination during storage

7.

￭ Washer/thermal disinfector

￭ Ultrasonic processing

￭ Manual scrubbing

8.

￭ Wearing heavy-duty gloves, eyeware, and mask

￭ Scrubbing one carefully positioned instrument at a time, using brush strokes away from

the body

￭ Care not to splash self and surrounding area

9.

￭ Moist heat/pressure—15–30 minutes

￭ Dry heat—2 hours (120 minutes)

￭ Chemical vapor—20 minutes

10. Dry-heat sterilization

11.

￭ External chemical indicator

￭ Internal chemical indicator

￭ Biologic marker

12. Colored marks on packaging or on tape that change color after exposure to a specific type

of sterilization method; does not indicate sterilization, but rather that processing has

happened.

13. Geobacillus stearothermophilus (formerly Bacillus stearothermophilus)

14. At least weekly

15. The prevacuum type (see Table 6-1)

16.

￭ Can’t be used for some kinds of materials

￭ The moisture can corrode carbon steel instruments unless precautions are taken.

￭ Oils and powders may be heat impervious.

17. Helps attain a higher pressure

18.

￭ Space between objects is essential to ensure access for the steam.

￭ Materials must be thoroughly cleaned and air-dried; adherent material can provide a

barrier to the steam.

￭ Air discharge occurs in a downward direction; load must be arranged for free passage of

steam toward bottom of autoclave.

19. 160°C or 320°F

20.

￭ Long, slow, uneven penetration

￭ Very high temperature needed to penetrate to the center of instruments

21. are altered by chemicals or heat; don’t permit penetration of vapors

22. adequate ventilation

23. Geobacillus stearothermophilus (formerly Bacillus stearothermophilus)

24. See Table6-2; regularly 1 time per week and, basically, after any change in sterilizing

procedure

25.

￭ Keep a written record of dates.

￭ Keep a calendar of upcoming test dates.

￭ Test the same day each week.

26. Wrapped and sealed packages

27.

￭ Surfaces in the treatment room

￭ Immersion disinfectants/sterilizers

￭ Handwashing

28.

￭ High level—inactivates spores as well as everything else

￭ Intermediate level—does not inactivate spores

￭ Low level—only inactivates vegetative bacteria and lipid-type viruses

29. From Box 6-2:

￭ Broad spectrum

￭ Fast acting

￭ Not affected by physical factors

￭ Nontoxic

￭ Doesn’t harm surfaces

￭ Has residual (long-lasting) effect

￭ Easy to use

￭ Odorless

￭ Economical

30. The organisms it is effective against—tuberculosis, bacteria, virus, and fungus

31.

￭ Shelf life, use life, re-use life

￭ Directions for mixing

￭ Storage conditions

￭ Directions for use

￭ Directions for disposal

￭ Warnings

32.

￭ Infectious waste: Capable of causing disease

￭ Contaminated waste: Contact with blood or body secretions

￭ Hazardous waste: Poses a risk to humans or environment

￭ Toxic waste: Poison

￭ Regulated waste: Materials covered under OSHA laws

33. special puncture-resistant, leak-proof container

34.

STEP # DESCRIPTION OF STEP

4 Spray surfaces and allow to air dry

1 Put on PPE, including heavy duty household gloves

3 Scrub surfaces with gauze sponges or paper towels

2 Spray all surfaces liberally and completely

35. 2 minutes, 20–30 seconds

36.

￭ Oral hygiene measures—tooth brushing and oral rinsing

￭ Surface antiseptic applied to tissues prior to injection and dental hygiene instrumentation

37.

￭ Comprehensive health history; referral for medical evaluation

￭ Provide protective eyewear

￭ Monitor communicable conditions and avoid elective procedures.

￭ Care in treatment of removal oral prostheses

38. Splashed into eye or mucosa

39.

￭ Wash the wound with soap and water

￭ Report to designated person

￭ Complete incident report

￭ Follow the institution or clinics posted procedures or protocols.

40. Spatter of contaminated material during patient care

41.

￭ Standard precaution procedures

￭ Sources for various infection control materials

￭ Emergency exposure management procedures

42. Refer to Appendix IV in the textbook (CDC 2003 Guidelines for Infection Control in

Dental Health-Care Settings) as you answer the following questions.

CDC 1.

Recommended for implementation based on strong science-based evidence

CDC 2.

Item #8 in Section VI F provides recommendations and item #9 provides recommendations for if

the repeat spore test is positive.

CDC 3.

Intermediate level–level.

COMPETENCY EXERCISES

Click here to access the Evaluation Rubric for Competency Exercises template, which can be

used to grade all competency exercises including Everyday Ethics and Factors To Teach The

Patient.

1. Key Considerations:

￭ The relationship between all aspects of infection control and how all factors interlink to

prevent transmission of disease

2. Key Considerations:

￭ Comparison and appropriate use of terminology

3. Key Considerations:

￭ The concepts of planning ahead and organization prior to patient care

4. Key Considerations:

￭ Integrates pertinent factors related to the educational institution/specific clinical situation

WORD SEARCH

1. ANTIMICROBIAL2. ANTISEPTIC3. BIOBURDEN4. BIOFILM5. CONTAMINATION6. DISINFECTANT7. REGULATED

8. SANITATION9. SPORICIDE10. STERILIZATION11. ENVIRONMENTAL12. CRITICAL13. SEMICRITICAL14. SPORETESTING15. UNITWATERLINES16. HIGH17. AUTOCLAVE18. DISPOSABLE19. OSHA20. ASEPSIS

A PRIMER AND TEMPLATE FOR THE USE OF EVALUATION RUBRICS

Competence is the ability to apply knowledge and skills in a relevant way to solve problems, answer questions, or make decisions.

Objectively evaluating a learner’s ability to recall factual information is relatively easy. Evaluation of student responses to exercises/learning activities that are intended to assess competence is often significantly more difficult. Competence is a complex interaction of skills that begins with an understanding of basic facts (KNOWLEDGE) and incorporates the ANALYSIS of all relevant factors in a specific situation, and SYNTHESIS of information in order to answer questions or solve problems. Competence also includes being able to SUPPORT or clearly explain the rationale for decisions and as well as effectively COMMUNICATE the plan for action.

An academic grading rubric provides objective criteria useful for evaluating student work that has been submitted to demonstrate competence. The assignment of points for each of the criteria stated in the rubric will aid the faculty member in providing an objective grade or score. When the evaluation rubric is provided along with instructions for the assignment, students receive a guide to faculty expectations. When the finished assignment is graded, focused feedback will help the student understand errors or omissions that result in a lower score or grade for the assignment.

The example evaluation rubric below, which is also included as Appendix E in the workbook, can be used as a template for grading all of the competency exercises, including those related to Factors To Teach The Patient and Everyday Ethics, in each chapter of the Student Workbook. The point range as well as the list of criteria in this sample rubric can be revised as needed by the evaluator. The revised rubric can then be downloaded or printed to provide a guide for evaluation of student work.

EVALUATION RUBRIC FOR COMPETENCY EXERCISESCATEGORIES EXCELLENT

3 pointsACCEPTABLE

2 pointsUNSATISFACTORY

0–1 pointsKNOWLEDGEFamiliarity with and understanding of concepts and information.

Points _________

Student includes relevant and accurate information from the main chapter.ANDStudent includes relevant information from related chapters in the textbook (based on what is reasonable to expect at the student’s current level in the dental hygiene curriculum).

Student includes relevant and accurate information from the main chapter.

Significant relevant information from the main chapter is missingOR Misunderstanding of one or more basic concepts is evident.

ANALYSIS Breaking down a complex topic into its component parts.

Points _________

All components of the question, case scenario, or patient assessment data are considered in the student’s answer.

Only minor details or components of the question, case scenario, or patient assessment data have not been addressed in the student’s answer.

At least one major component has not been addressed.

SYNTHESIS Combining ideas to form a complex,

Connection or comparisons made between factors, concepts

Connection or comparisons between factors, concepts, and

Important or obvious connections are missing from the students answer.

cohesive whole using logical reasoning and deduction.

Points _________

and facts/knowledge from the textbook chapter is very clear.

facts/knowledge from the chapter textbook is apparent, but not completely explained.

.

SUPPORTProviding rationale for statements

Points _________

Student provides clear explanations that support conclusions, statements, or connections made. Examples: Linking basic

information and intended actions or conclusions drawn

Explaining personal perspective

Defining controversy that requires further investigation

Explanations are provided that support conclusions, statements, or connections, but could be more completely or clearly explained.

Little evidence is provided to support conclusions, statements or connections

COMMUNICATIONConveying information

Points _________

Meets professional writing standards for: Grammar Spelling Appropriate use of

either a formal or “patient-friendly” writing style (based on the focus of the exercise).

Meets professional writing standards for: Grammar Spelling Appropriate use of

either a formal or “patient-friendly” writing style (based on the focus of the exercise).

Errors in spelling or grammar.ORWriting style is too casual/conversational for professional writing.ORInappropriate professional jargon is used for a patient discussion.

Total points ______________ / 15 possible pointsFACULTY FEEDBACK: