Keeping surfaces safe

by Noel Kelsch, RDHAP
[email protected]

When my children were younger, our home was known as the TP house. Whenever someone had the urge to toilet paper a home, our pine tree-covered yard and sprawling front lawn was the perfect spot. One morning I rose to find my entire front lawn a sea of white; it was covered with 10,000 forks poked into the lawn spelling out "we love you." Our pine trees looked as if it had snowed, and my husband's precious truck sat in the driveway covered in papier mache!

I knew at that moment it was no longer funny. I ran to the truck and started to assess the damage. I pulled layers of newspaper dipped in flour paste off the car. The teens had been thoughtful and wrapped the car in a protective layer of plastic. Though my husband's truck was encased in flour and newspaper, the paint and body had not been touched. The protective barrier was keeping it safe.

Clinical contact surfaces can be treated in the same manner, according to the Centers for Disease Control. Clinical contact surfaces are surfaces that are touched during treatment of patients. These can be contaminated by gloved or ungloved hands, instruments, devices, or other items. They may be contaminated with blood, saliva, or other potentially infectious material and then come in contact with instruments, devices, hands, or gloves, causing cross contamination. Some examples of these surfaces include light handles, switches, dental radiographs, equipment, computers, drawer handles, faucet handles, countertops, pens, doorknobs, headrests, and hoses.

The use of these barriers prevents cross contamination, limits the exposure of DHCP to chemicals, and saves a tremendous amount of time cleaning and disinfecting between patients. Your gloved hand will not be touching chemicals on the surfaces that have been disinfected. Patients will not be exposed to chemicals or the taste of that chemical.

Barrier protectors come in many forms. They include clear wrap, wrap with adhesive to keep it in place, bags, sheets, tubing, and other materials that are impervious to moisture. They come in many different sizes and are able to cover just about everything. It is important that they are not permeable to liquid, they fit the item you are protecting, stay in place, and are easy to place and remove.

Using barriers is a simple process:

1. The barriers can become contaminated so they should be removed and discarded between patients while the dental health-care professional (DHCP) is gloved.
2. These are single-use items and can only be used for a single patient.
3. Large bags can be removed by turning them inside out as you remove them. This limits the chances of touching surfaces with the contaminated material.
4. Carefully remove the barrier so that you do not contaminate the surface you are protecting. After removing the barrier, examine the surface to make sure it did not inadvertently become soiled.
5. The surface should be cleaned and disinfected only if contamination is evident.
6. Otherwise, after removing gloves and performing hand hygiene, DHCP should place clean barriers before the next patient.
7. It is not necessary to clean and disinfect if the area is not contaminated.
8. At the end of the day, clean and disinfect all clinical contact surfaces in the operatory.

I've been waiting many years to pay back some of those teens who decorated my house. One of these days Jay Fear, the leader of the pack, may remember me when he opens his door to see a winter wonderland and his car encased in papier mache. Using barrier protection, I promise I will keep his car safe. Keeping patients and staff safe is our first mission in dentistry. Barrier protection is the protective layer that helps to keep everyone safe.

Some barrier tips

• The large chair cover: You can recycle this item by using it as your trash container for cleaning up the room after each patient. After you have turned it inside out, put all the other barrier protection items, disposables such as 2x2's, cotton rolls, etc. in it. Because all the contamination is on the inside, this makes a great tool for room cleanup without getting the trash can out.
• Extra long chair covers that have an extra two feet of plastic at the bottom make great dental unit covers and can cover the foot peddle at the same time.
• Prepare barrier protection kits ahead of time, and include a cover for hoses, chair, etc., on each tray to save time and aid in efficiency of setup.
• Fold back the edge of adhesive products in one area so there is an area where the adhesive does not touch itself. This can help with easy removal after use.

Noel Brandon Kelsch, RDHAP, is a syndicated columnist, writer, speaker, and cartoonist. She serves on the editorial review committee for the Organization for Safety, Asepsis and Prevention newletter and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all and helps facilitate the Simi Valley Free Dental Clinic. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamine and drug use. She is a past president of the California Dental Hygienists' Association.