by Kristy Menage Bernie, RDH, BS, and Charles John Palenik, MS, PhD, MBA
In December 2003, the Centers for Disease Control and Prevention (CDC) issued a set of new infection control recommendations (Guidelines for Infection Control in Dental Health-Care Settings - 2003), which updated those released in 1986 and 1993.
CDC guidelines consolidate recommendations for preventing and controlling infectious diseases and managing personnel health and safety concerns related to infection control within dental settings. The guidelines update several previous CDC recommendations, incorporate relevant infection control measures from other CDC guidelines, and discuss concerns not previously addressed in dentistry.
The CDC ask dental practices to develop a written infection control program to prevent or reduce the risk of disease transmission. Such a program must protect patients from care-associated infections and protect dental health-care practitioners from work-related injuries and illnesses. The program helps practices establish and implement necessary infection control policies and procedures. The process involves proper selection and use of technologies and products. The program should reflect the principles of infection control and occupational health. It should also adhere to all federal, state, and local regulations and guidelines.
The CDC indicate that a knowledgeable infection control coordinator called an ICC (any member of the practice team) should be given the responsibility for coordinating the program. The ICC will have a substantial number of important duties. A collective charge, however, is the overall responsibility for the effectiveness of the program on a day-by-day basis. This includes the monitoring of practice policies, procedures and practices. The practice program must be both effective and efficient.
The role of an ICC
While there are no specific regulations regarding who can be an ICC, this individual will be critical to safe practices for both employees and patients. The registered dental hygienist’s background and education make him or her uniquely qualified to head up the infection control team. A review of elements for the ICC, as well as considerations for effective facilitation of an infection control program will be discussed. Click here to view table...
While the overall responsibility for a comprehensive infection control program falls on the employer, utilization of an ICC will greatly enhance compliance and safety within the practice. Although there are no specific regulations regarding the qualifications of the ICC, the CDC recommend that the ICC be knowledgeable in the area of infection control or be willing to be educated. In addition, the ICC should be responsible for overseeing the facilitation, monitoring and updating of an office infection control program on a day-to-day basis.
The ICC should possess certain characteristics. A list of recommended abilities and skills are listed in table I. The combined responsibilities and characteristics provide a foundation for the ICC. Table 1 also lists duties that give the ICC an outline to follow with respect to various areas of the practice:
Resources for the ICC
While many may feel this position should not be attempted by the inexperienced, the truth is that there are a variety of resources to assist the ICC with developing, implementing, and maintaining a solid infection control program.
First, the ICC should obtain and be familiar with the state dental practice act requirements as they relate to infection control, as well as the state OSHA regulations and the 2003 CDC guidelines. Today, most of these documents can be obtained online. Once the state and OSHA regulations are reviewed, these documents will provide the foundation for the program required in the practice, or the minimum criteria the program should address. To maximize a program, the CDC recommendations will take the practice to the ultimate level while providing invaluable information regarding specific infection control practices, protocols, and sciences.
To develop a program, the best resource available is the Organization for Safety and Asepsis Procedures (OSAP, www.osap.org). They offer the following key resources:
• Interact Training System - complete training system that will provide the basics regarding infection control
• Infection Control In Practice - Ideal for keeping staff up-to-date on changes or new findings.
• TIP - Demonstrate that staff is up-to-date on the latest by having them sign they have read assigned articles/publications.
• ICIP (OK)
• From Policy to Practice: OSAP’s Guide to the Guidelines, an OSAP workbook on the CDC recommendations concerning infection control in dental environments.
• With the U.S. Federal Services, OSAP co-sponsored “Infection Control and Occupational Safety & Health, Fourth Annual Intermediate Course” in January in Atlanta.
• OSAP Annual Symposium, June 2-5, in Denver
Additional resources include continuing education programs offered by professional associations and trade publications, as well as special consultants whose focus is in this area. The ICC need not go it alone, and utilizing resources will go a long way in establishing and maintaining the optimal infection control program.
Infection Control Resources
* State practice act infection control requirements
* OSHA - www.osha.gov/SLTC/dentistry/index.html
* CDC Guidelines for Infection Control in Dental Health-Care Settings, 2003 - www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm
* OSAP - www.osap.org
US Air Force -In Control, The Dental infection Control & Safety Supplement to Dental Items of Significance - www.brooks.af.mil/dis/INCON22/sex1.htm
The RDH as an ICC
The registered dental hygienist would make an ideal ICC. His or her background in science and disease prevention lends itself perfectly to overseeing an infection control program. In addition, the ICC will expand his or her resume by having the opportunity to develop public speaking, managerial, administrative and leadership skills. Those interested in pursuing the role of ICC should schedule a meeting with their employer and outline a business plan that would include duties, responsibilities, additional compensation requirements, and the employer’s role.
Consideration for expanding your clinical practice in this direction is warranted and needed. The RDH/ICC would be an integral part of a successful and healthy practice.
Investigate your current program and see if you might be able to develop and implement the optimal infection control program!
Kristy Menage Bernie, RDH, BS, is director and co-founder of Educational Designs, a consulting company that devises and implements education-based marketing strategies for dental companies. She is an active member of both OSAP and ADHA. She is expanding her study to include the art and science of yoga as it applies to the dental clinician. She welcomes comments and inquiries at (925) 735-3238 or at [email protected].
Charles John Palenik, MS, PhD, MBA, is an assistant director of Infection Control Research and Services at the Indiana University School of Dentistry. Dr. Palenik has authored numerous articles, book chapters, and monographs, and is the co-author of the popular Infection Control and Management of Hazardous Materials for the Dental Team. He serves on the Executive Board of OSAP, dentistry’s resource for infection control and safety. Questions about this article or any infection-control issue may be directed to [email protected].