Knowing the protocol is only the beginning. In The Clean Bite, Sherrie Busby explores how explaining the why, addressing staff concerns, and creating clear procedures can help dental teams make infection control part of everyday practice.
Welcome back to The Clean Bite. September is National Dental Infection Control Month, and I’d like to bring your attention to a few things as this annual deep dive into infection control comes to a close.
The
In September, we focus more on the day-to-day workflow of providing the
If you are following along with social media, you will find dozens of leading dental professionals sharing:
If you’ve not been watching, Google or type “Dental Infection Control Month” into YouTube to find those infection control leaders and learn more.
Today I’d like to focus on the workflow.
This is where the best laid systems fall apart because we either don’t remember our training or don’t really understand the why behind the guidelines. As human beings, our habits are our own, and if you are like my husband, “his way” is the only right way to do something and do it right.
These beliefs are a tough nut to crack, and just telling someone “This is how we do it here” most often won’t cut it.
So, to make needed and often necessary changes, we need to focus on 3 things:
Why something matters
What’s in it for “me”
How do I fit this into my existing workflow
Let me explain
If you ask a group of dental assistants and hygienists which way the pouches go into the autoclave, paper up or paper down, you will get all different answers depending on their personal beliefs. The real answer? It depends on what type of autoclave you are using. Example in one style, it’s paper up, but another style recommends paper down or pouches standing on their sides, paper to plastic.
We don’t know what we don’t know!
How do I know these differences? Because I Googled the user guides for each! When do you think an office team member last looked up or read the user guide for their equipment? I venture to say NEVER!
This is where our own habits come back into play. As leaders, we need to find out for ourselves and then share with the team why which way the pouches go into the autoclave matters.
Manufacturers spend a lot of money and resources making sure that their machines function in a way that produces the expected outcome (eg, ensuring complete sterilization of dental instruments) before they even put the first one on the market. They communicate these directions in their instructions for use (IFUs). That expected outcome of completely sterilized instruments is why they go to the trouble and recommend that we follow their instructions.If you read either of the documents I linked to, you will see what happens if the directions are not followed correctly, along with several cautionary notes.
So, if you don’t know the full why of something, I suggest a little homework to prepare you to talk to your team member or the full team.
Next is what’s in it for me?
Going back to our personal habits, we really need to focus on how the person, or the entire team, will benefit. As a professional infection control leader, I can tell you from personal experience that unless something benefits me, I most likely either will not pay attention or, worse yet, come to the meeting without an open mind. When our minds are closed to other ways or possibilities, we tend not to implement anything new.
So, focusing on “what’s in it for me” is vital to the implementation process.
One of the hardest “habits” to break is not using utility gloves when breaking down the operatory and when handling reusable sharps during reprocessing in the sterilization lab. Most often, the utility gloves available are for a quarterback that no “normal-sized hand” person can ever think to fit. When the glove doesn’t fit, it is almost impossible to grasp the instruments to inspect, dry, and package, not to mention have you ever tried to peel the tape off a peel-view pouch? Take it from me, it ain’t gonna happen!
So, what is the solution?
First:
Take the time to sit down with the “offender” and have an open and nonjudgmental conversation. The goal is to uncover the real reason they are not wearing utility gloves. Make sure you show genuine concern for your team members’ health and welfare during the conversation. Let them know you are bringing this up to keep them safe during the crazy busy day.
More often than not, the offender doesn’t know why not wearing FDA-approved utility gloves is an OSHA violation. I would advise reviewing your office’s sharps injury logs to see how often and where such injuries occurred over the past couple of years. Do a little research and ask fellow offices if they would share where theirs occur. But keep in mind that most sharps injuries are not reported.If your team member is like me, then they washed the wound, slapped a band-aid on, and went back to work.
If you or your team members feel uncomfortable with this type of conversation, bring it up at your next team meeting and ask for an open, honest discussion about the challenges. These types of discussions will help to identify the problem, and together you will come up with a viable solution that everyone can follow.
Need more information to get the conversation started? Do a Google search as I did here.
“While there is no single metric for the absolute volume of physical sharp objects allocated to a sterile processing lab, standard industry tracking focuses on where sharps injuries and handling risks occur.
Epidemiological data from dental specialty environments show that approximately 44% to 47.1%of all dental sharps incidents happen during post-treatment instrument processing, cleaning, and sorting.”
Because nearly all multi-use instruments in dentistry (such as dental burs, scalers, and explorers) must be scrubbed, sorted, and sterilized, the processing area represents a significant hub for sharps exposure (Figure 1).
Second:
Purchase an assortment of utility glove sizes to take that part of the resistance away. Our friends at
Working into the daily workflow is easy after that.
I may get pushback on this one, but order each team member their own pair of utility gloves to keep in the operatory and the lab.I did this for my team, and then there was no “yucky” multiperson hands going into those hot gloves. OR keep a personal set in the op and then use exam gloves underneath the utility gloves. This makes it way easier to get them on anyway.
Another option is to have 2 individual sets and install a curtain rod above the sink in the lab or inside a lower cabinet, and use a named or color-coded clamp hook to hold them together.
Then, the next thing about working it into the daily workflow is that it covers every important follow-up!
Start an individual conversation, or reopen the topic in a team meeting, and ask the team how working with utility gloves (or other objectives) in the workflow is going. When we have an open and honest discussion about any workflow, it helps to have everyone on the same page, and we tend to help hold one another accountable and, when needed, offer assistance or advice.
Put the whole thing in writing.
Creating a Standard Operating Procedure (SOP) for whatever it is you are trying to implement is vital to your success.SOPs not only spell it out for the team but also serve as your office bible for additional training or holding someone accountable.
Not sure how to create an effective SOP?Do a Google search “how to create an SOP,” or reach out to me, and I’ll be glad to help. Sherrie.busby@yahoo.com
I want to leave you with these thoughts…
Let’s make a plan to include an infection control conversation at every team meeting, follow up in a timely manner, and create the safest visit possible for the patients under our care.
Until next time, my friends—
Stay informed. Stay clean. Stay safe.
🦷✨ — Sherrie, The Clean Bite
