Infection-control training is an ongoing need that allows us to keep up-to-date and assess how continually occurring changes may affect the office.
Keeping up with changes related to our profession is a major task for all in the office and requires ongoing training in one of many available formats. Training here is used in its broadest sense and includes any form of learning. Let`s consider three types of changes: global changes (those that relate to all, most, or large groups of offices), optional changes (those that are adopted by choice in an office), and unique changes (those that may be unique within an individual office).
Global changes related to infection control and disease prevention occur slowly, but at a constant rate. Over the last few years, these types of changes have included:
* The ADA`s 1995 recommendation to dental unit manufacturers and researchers concerning dental-unit water quality
* The continued discovery of bloodborne hepatitis viruses
* Changes in some state dental rules regarding infection control
* Attention to the prevention of tuberculosis in health-care facilities
* CDC`s recommendation to actually test for immunity after health-care workers receive the hepatitis B vaccine
* Emphasis on understanding the reactions one may experience when wearing latex gloves
Training relating to these changes involves understanding the changes and determining how they affect the office. Global changes often are well publicized and fully explained in several formats, including written articles in several types of publications (RDH, for example), continuing-education courses, and special lectures or presentations at state and national meetings.
Optional changes present new choices to dental offices. These occur mainly in the new-product development area. For example, in the last couple of years, we`ve seen:
* The enhanced emergence of powder-free and low-protein latex gloves
* A new liquid sterilant for use at room temperature
* New models of sterilizers
* New designs of instrument cassettes
* New ultrasonic cleaning units
* New ultrasonic detergents
* New enzyme cleaners
* New surface disinfectants
* New disposable products and surface covers
* A variety of chemicals and devices presented to improve the microbial quality of dental-unit water.
These changes in the infection-control armamentarium will continue to occur. They come to our attention in a variety of ways through advertisements, direct mail, recommendations from other offices, and displays at state and national meetings. Related training may involve seeking information that will determine if a new product really can benefit your office. Special training may be needed to better understand the nature of some new product classes (how devices that are supposed to improve the quality of dental-unit water actually work, or how powder-free gloves reduce exposure to latex allergens). This type of training may be available from continuing-education courses and special lectures or presentations at state and national meetings.
These changes occur in your individual office. Examples include changes resulting from:
* The new application of global changes
* New employee-safety programs that may be emphasized in your office
* Actual purchase or trial use of new products or equipment
* Hiring of new office staff or a new associate dentist u
* Use of a different infection-control procedure
* Change from a reusable to a disposable product
* Use of a new spore-testing service or waste-management service
Related training might include how to use a new product, operate and maintain a new piece of equipment, perform a new procedure, orient new staff to office policies and procedures, and enhance office safety with a new program.
The training mentioned above results from ongoing changes that might affect the office infection-control program. Parts of this training are included in a more routine form of infection-control training as part of the Bloodborne Pathogens Standard and some state rules.
The OSHA Bloodborne Pathogens Standard requires the employer to provide dental-office employees with specific training if they may be exposed to body fluids (blood or saliva) during the course of their work activities. This training is to be provided at the time the employee is hired, at no cost to the employee, and during normal working hours.
Annual retraining for all employees also must be provided. The specific areas to be included in this training are listed in the OSHA standard, OSHA publication #3129, and in the March 1998 issue of RDH on page 24. Also, additional training must be provided at other times when any change occurs that may affect an employee?s chances for occupational exposure.
In summary, infection-control training is an ongoing need that allows us to keep up-to-date and assess how continually occurring changes of all types may affect the office and our compliance with OSHA and state regulations.
Chris Miller is director of Infection Control Research and Services and professor of oral biology at Indiana University.