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Infection Prevention and Control Resources for Dental Healthcare

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<strong>Infection</strong> <strong>Prevention</strong> <strong>and</strong> <strong>Control</strong> <strong>Resources</strong> <strong>for</strong> <strong>Dental</strong> <strong>Healthcare</strong> Settings<br />

Recommended Documents <strong>and</strong> <strong>Resources</strong> <strong>for</strong> Planning,<br />

Training <strong>and</strong> Quality Assurance<br />

Updated February 10, 2012<br />

Kathy Eklund<br />

keklund@<strong>for</strong>syth.org<br />

Note to users: This guide is organized by topic <strong>and</strong> by agency. Some of the resources <strong>and</strong> websites are<br />

repeated when applicable to different sections of this h<strong>and</strong>out. It is important to routinely update this<br />

resource to ensure current <strong>and</strong> accurate in<strong>for</strong>mation.<br />

Collect <strong>and</strong> maintain updated file copies of regulatory st<strong>and</strong>ards<br />

including State <strong>and</strong> Federal Law<br />

State or Province <strong>Dental</strong> Law / Practice Act <strong>and</strong> associated Rules & Regulations.<br />

Review the specific dental practice law <strong>for</strong> your state or province. For example: state law may use<br />

the latest CDC Guidelines as the “st<strong>and</strong>ard of care”, or list specific requirements <strong>for</strong> infection control<br />

training, or m<strong>and</strong>ates <strong>for</strong> frequency of sterilizer testing.<br />

State Public Health Law:<br />

Some states have additional m<strong>and</strong>ates not included in <strong>Dental</strong> Practice Act.<br />

North Carolina is one example.<br />

Guidelines <strong>and</strong> <strong>Resources</strong> from the U.S. Centers <strong>for</strong> Disease <strong>Control</strong> <strong>and</strong> <strong>Prevention</strong> ( CDC) www.cdc.gov<br />

U. S. Health <strong>and</strong> Human Services Centers <strong>for</strong> Disease <strong>Control</strong> (CDC) “Guidelines <strong>for</strong> <strong>Infection</strong> <strong>Control</strong> in <strong>Dental</strong><br />

Health-Care Settings – 2003” – Guideline Document: www.cdc.gov/mmwr/PDF/rr/rr5217.pdf or<br />

http://www.cdc.gov/oralhealth/infectioncontrol/guidelines/index.htm<br />

Other CDC <strong>Infection</strong> Oral Health <strong>Infection</strong> <strong>Prevention</strong> <strong>and</strong> <strong>Control</strong> <strong>Resources</strong>:<br />

http://www.cdc.gov/oralhealth/infectioncontrol/index.htm<br />

Federal OSHA St<strong>and</strong>ards<br />

The focus is worker safety. Institutions must in<strong>for</strong>m employees that the st<strong>and</strong>ards exist & how to<br />

access at their institution (if electronic, must be easy to access). It is recommended to keep a set of<br />

hard copies <strong>for</strong> quick access.<br />

The Bloodborne Pathogens St<strong>and</strong>ard (29 CFR 1910.1030) sets rules <strong>for</strong> protective attire, sharps<br />

safety <strong>and</strong> more. To find OSHA documents <strong>and</strong> other materials on-line:<br />

http://www.osha.gov/SLTC/dentistry/index.html<br />

http://www.osha.gov/SLTC/dentistry/control.html<br />

http://www.osha.gov/SLTC/dentistry/st<strong>and</strong>ards.html<br />

• 1910.1030, Bloodborne pathogens [related topic page]<br />

• 1910.1200, Hazard communication [related topic page]<br />

• 1910.132, Personal protective equipment, general requirements [related topic page]<br />

• 1910.133, Eye <strong>and</strong> face protection [related topic page]<br />

• 1910.37, Maintenance, safeguards, <strong>and</strong> operational features <strong>for</strong> exit routes<br />

• 1910.106, Flammable <strong>and</strong> combustible liquids<br />

• 1910.138, H<strong>and</strong> Protection<br />

• 1910.242, H<strong>and</strong> <strong>and</strong> portable powered tools <strong>and</strong> equipment, general [related topic page]<br />

• 1910.141, Sanitation<br />

• 1910.151, Medical services <strong>and</strong> first aid [related topic page]<br />

1


The St<strong>and</strong>ard: This is the link to the full Bloodborne Pathogens St<strong>and</strong>ard<br />

http://www.osha.gov/pls/oshaweb/owadisp.show_documentp_table=STANDARDS&p_id=10051<br />

Recordkeeping - including a model sharps injury log: Go to<br />

http://www.osha.gov/Publications/OSHA3187/osha3187.html<br />

http://osha.gov/recordkeeping/index.html<br />

A model exposure control plan organizes the required in<strong>for</strong>mation in a fill-in-the-blank template:<br />

http://www.osha.gov/OshDoc/Directive_pdf/CPL_2-2_69_APPD.pdf<br />

The full en<strong>for</strong>cement directive document may be seen at:<br />

http://www.osha.gov/pls/oshaweb/owadisp.show_documentp_table=DIRECTIVES&p_id=2570<br />

The Hazard Communications St<strong>and</strong>ard (29 CFR 1910.1200) requires training <strong>for</strong> chemicals <strong>and</strong><br />

other hazards in the dental workplace. The General Duty Clause cites requirements <strong>for</strong> exits,<br />

emergency evacuations, etc. Full text of the St<strong>and</strong>ard available at:<br />

http://www.osha.gov/SLTC/dentistry/st<strong>and</strong>ards.html<br />

Other OSHA online resources <strong>for</strong> dental hazards include:<br />

Nitrous Oxide / anesthetic gases:<br />

http://www.osha.gov/dts/osta/anestheticgases/index.html<br />

http://www.cdc.gov/niosh/nitoxide.html<br />

http://www.cdc.gov/niosh/noxidalr.html<br />

State OSHA Plans: The following states have approved OSHA State Plans:<br />

Alaska, Arizona, Cali<strong>for</strong>nia, Connecticut, Hawaii, Indiana, Iowa, Kentucky, Maryl<strong>and</strong>, Michigan,<br />

Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Puerto Rico,<br />

South Carolina, Tennessee, Utah, Vermont, Virgin Isl<strong>and</strong>s, Virginia, Washington, Wyoming.<br />

Connecticut, New Jersey, New York <strong>and</strong> Virgin Isl<strong>and</strong>s plans cover public sector (state <strong>and</strong> local<br />

government workers) only.<br />

http://www.osha.gov/dcsp/osp/index.html<br />

EPA Regulations.<br />

Hazardous waste management, waste water treatment, etc.<br />

Federal regulations prevail unless your region or state has unique EPA regulations.<br />

Your institution or campus safety manager may be a resource <strong>for</strong> local / state regulations.<br />

Special dental issues include disposal of biohazard waste <strong>and</strong> chemical waste such as mercury /<br />

amalgam <strong>and</strong> radiographic processing wastes. For example, some states require amalgam<br />

separators. Waste disposal <strong>and</strong> EPA regulations may be cited in state <strong>Dental</strong> Practice Law.<br />

www.epa.gov<br />

Collect print copies of “Must Have” Guidelines <strong>and</strong> Forms<br />

U. S. Health <strong>and</strong> Human Services Centers <strong>for</strong> Disease <strong>Control</strong> (CDC)<br />

“Guidelines <strong>for</strong> <strong>Infection</strong> <strong>Control</strong> in <strong>Dental</strong> Health-Care Settings – 2003” –<br />

www.cdc.gov/mmwr/PDF/rr/rr5217.pdf<br />

This document is frequently cited as the “st<strong>and</strong>ard of care”. Provides evidence based guidance <strong>for</strong><br />

many aspects of infection control management. Includes continuing education, references. Use in<br />

conjunction with OSHA St<strong>and</strong>ards to produce a complete <strong>Infection</strong> <strong>Control</strong> <strong>and</strong> Safety Compliance<br />

Policy. Tip: Obtain print copies <strong>for</strong> key institution / clinic personnel (clinic managers, clinic<br />

coordinators, Associate Clinical Deans).<br />

Free individual print copies may also be obtained by calling: 770.488.6054.<br />

U. S. Department of Labor Occupational Safety <strong>and</strong> Health Administration (OSHA)<br />

2


OSHA St<strong>and</strong>ards: “General Duty Clause”, Bloodborne Pathogens, <strong>and</strong> Hazard Communications.<br />

At least one print copy of each st<strong>and</strong>ard should be kept on file.<br />

http://www.osha.gov/SLTC/dentistry/st<strong>and</strong>ards.html<br />

OSHA Compliance Assistance on-line program: “Quickstarts”<br />

This is not a separate set of regulations but OSHA’s version of a “Guide to the St<strong>and</strong>ards”.<br />

This step by step guide has a specific section on <strong>Healthcare</strong> <strong>and</strong> links the user to most of the OSHA<br />

compliance <strong>for</strong>ms.<br />

http://www.osha.gov/dcsp/compliance_assistance/quickstarts/index.html<br />

OSAP – Organization <strong>for</strong> Safety, Asepsis <strong>and</strong> <strong>Prevention</strong><br />

From Policy to Practice: OSAP’s Guide to the Guidelines.<br />

This 170 page workbook contains practical in<strong>for</strong>mation to assist health care professionals in<br />

implementing the CDC Guidelines. The workbook was produced by OSAP through a CDC<br />

cooperative agreement. The workbook may be ordered from the OSAP on-line “store” at<br />

www.osap.org<br />

<strong>Infection</strong> <strong>Control</strong> <strong>and</strong> Safety Guidelines Checklist<br />

OSAP, in its January 2004 issue of <strong>Infection</strong> <strong>Control</strong> in Practice, turned the CDC Guidelines For<br />

<strong>Infection</strong> <strong>Control</strong> in <strong>Dental</strong> Health-Care Settings - 2003 into a checklist.. This checklist is a valuable<br />

resource to help practices follow these important CDC infection control guidelines.<br />

Click HERE to download the checklist.<br />

http://www.osap.org/displaycommon.cfman=1&subarticlenbr=370<br />

Use Low Cost or Free Media <strong>and</strong> Training Programs<br />

Slide Presentation on <strong>Infection</strong> <strong>Control</strong> <strong>for</strong> <strong>Dental</strong> Offices, produced by the CDC.<br />

Slide presentation on infection control <strong>for</strong> dental offices<br />

www.cdc.gov/oralhealth/infectioncontrol/guidelines/ppt.htm<br />

Free slide presentation in powerpoint <strong>for</strong>mat produced by the Centers <strong>for</strong> Disease <strong>Control</strong>. This<br />

program provides an overview of basic principles contained in the CDC Guidelines <strong>for</strong> <strong>Infection</strong><br />

<strong>Control</strong> in <strong>Dental</strong> Health-Care Settings—2003. It can be downloaded as a PowerPoint presentation<br />

or viewed on the Web site. Good visuals <strong>and</strong> charts.<br />

From Policy to Practice: OSAP’s Interactive Guide to the CDC Guidelines.<br />

The Organization <strong>for</strong> Safety, Asepsis <strong>and</strong> <strong>Prevention</strong> (OSAP) has an on-line interactive educational tool<br />

designed to provide education <strong>and</strong> training in basic infection control principles <strong>and</strong> the CDC Guidelines <strong>for</strong><br />

<strong>Infection</strong> <strong>Control</strong> in <strong>Dental</strong> Health-Care Settings. This is an excellent tool <strong>for</strong> entry level training <strong>and</strong> as<br />

refresher training. There is no charge to access <strong>and</strong> view the complete course. For those who wish to be<br />

tested on the material <strong>and</strong> earn 10 CE credits, processing fees apply. Free, self paced, modular, interactive<br />

http://osaplms.ts.karta.com/<br />

The OSAP/Interact Training System<br />

The OSAP Interact Training System is a comprehensive infection control <strong>and</strong> safety education <strong>and</strong> training<br />

program. The system can be used in educational settings as well as institutional <strong>and</strong> private practice dental<br />

settings. The system consists of individual interactive workbooks <strong>for</strong> personnel <strong>and</strong> DVD presentations that<br />

coordinate with the workbooks. The system is designed to integrate CDC guidelines, OSHA regulations <strong>and</strong><br />

basic infection control principles with site-specific infection control <strong>and</strong> safety policies <strong>and</strong> procedures.<br />

Updated March 2008. http://www.osap.org/displaycommon.cfman=1&subarticlenbr=39<br />

3


If Saliva Were Red: A Visual Lesson on <strong>Infection</strong> <strong>Control</strong><br />

This classic is an 8 minute video training system. Features two segments – one illustrating dental<br />

procedures without most of the recommended barriers <strong>and</strong> practices; then another segment with<br />

recommendations in use. Red dyes are incorporated to illustrate the otherwise invisible cross<br />

contamination potential of saliva <strong>and</strong> other oral fluids. The program is not narrated, allowing great<br />

flexibility in use. The program includes a trainer’s guide <strong>and</strong> is available to order from OSAP at the<br />

on-line “store”.<br />

If Saliva Were Red<br />

www.osap.org<br />

CDC H<strong>and</strong> Hygiene Course.<br />

Free, online interactive course in Powerpoint <strong>for</strong>mat with short video action clip demonstrating h<strong>and</strong><br />

hygiene techniques using soap <strong>and</strong> water <strong>and</strong> alcohol h<strong>and</strong> rub. Access course at:<br />

www.cdc.gov/h<strong>and</strong>hygiene/training/interactiveEducation/<br />

OSHA’s Needlestick <strong>Prevention</strong> powerpoint slide program:<br />

“Safer Needle Devices: Protecting Health Care Workers” Includes illustrations of safety needle<br />

devices. Available free at<br />

www.osha.gov/dcsp/ote/library/bloodborne/revised_bbp_st<strong>and</strong>ard.ppt<br />

OSHA media presentations.<br />

Topics include an overview of bloodborne pathogens st<strong>and</strong>ard, ergonomics, introduction to ionizing<br />

radiation, etc. Most are available as powerpoint slide programs.<br />

www.osha.gov/SLTC/multimedia.html<br />

Post Exposure Protocols <strong>and</strong> Sharps Safety<br />

CDC <strong>and</strong> U.S. Public Health Service Guidelines <strong>for</strong> Management of Occupational Exposures<br />

<strong>and</strong> Post exposure prophylaxis:<br />

http://www.cdc.gov/ncidod/dhqp/gl_occupational.html<br />

http://www.cdc.gov/mmwr/PDF/rr/rr5409.pdf<br />

Centers <strong>for</strong> Disease <strong>Control</strong> <strong>and</strong> <strong>Prevention</strong> (CDC), Morbidity <strong>and</strong> Mortality Weekly Report<br />

(MMWR) 50(RR11);1-42 (2001, This provides the current CDC recommendations <strong>for</strong> post exposure<br />

management that should be used by the designated health care provider.<br />

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm<br />

CDC Sharps Injury <strong>Prevention</strong> <strong>and</strong> Safety Device Evaluation <strong>Resources</strong><br />

Centers <strong>for</strong> Disease <strong>Control</strong> <strong>and</strong> <strong>Prevention</strong> (CDC) has developed two sample <strong>for</strong>ms (with instructions <strong>for</strong><br />

use) to assist dental personnel in screening <strong>and</strong> evaluating devices <strong>for</strong> clinical acceptability. These <strong>for</strong>ms<br />

have been pilot tested with focus groups of different types of dental staff members, including end users <strong>and</strong><br />

purchasers. To increase the safety of both dental personnel <strong>and</strong> their patients, we are making these <strong>for</strong>ms<br />

available <strong>for</strong> general use. Although these <strong>for</strong>ms are specific <strong>for</strong> anesthetic syringes, they can be modified <strong>for</strong><br />

use with other types of dental devices. http://www.cdc.gov/oralhealth/infectioncontrol/<strong>for</strong>ms.htm<br />

OSHA web sites specific <strong>for</strong> exposure prevention <strong>and</strong> post exposure requirements:<br />

http://www.osha.gov/SLTC/bloodbornepathogens/index.html<br />

http://www.osha.gov/SLTC/bloodbornepathogens/postexposure.html<br />

OSHA Recordkeeping Requirements: OSHA has specific injury recordkeeping requirements<br />

http://osha.gov/recordkeeping/index.html<br />

American <strong>Dental</strong> Association (ADA) resources <strong>for</strong> post exposure management<br />

Documents provides guidance to dental employers about their responsibilities under the OSHA<br />

st<strong>and</strong>ard <strong>for</strong> providing post-exposure evaluation <strong>and</strong> follow-up <strong>for</strong> employees exposed to bloodborne<br />

pathogens.<br />

http://www.ada.org/prof/resources/topics/osha/intro.asp<br />

4


PEPline: National Clinicians Post Exposure Prophylaxis Hotline 1.888.448.4911<br />

Available 24/7. Experts can provide timely advice <strong>and</strong> reassurance regarding actual levels of risk<br />

based on exposure factors. Does not take the place of an established procedure <strong>for</strong> referral of<br />

exposed, injuried persons.<br />

http://www.ucsf.edu/hivcntr/Hotlines/PEPline.html<br />

Injection Safety Topics: References oriented toward medical / hospital providers.<br />

Helpful <strong>for</strong> educational institutions with oral surgery or hospital based components.<br />

http://www.cdc.gov/ncidod/dhqp/injectionsafety.html<br />

Needle Safety Act <strong>and</strong> Evaluation of Safer Devices.<br />

Includes background in<strong>for</strong>mation, sample evaluation <strong>for</strong>ms <strong>and</strong> recommendations.<br />

http://www.cdc.gov/oralhealth/infectioncontrol/<strong>for</strong>ms.htm<br />

Commercial examples of safety devices:<br />

Sultan Chemists. This is an eight minute flash tutorial on a safer needle device to help prevent<br />

needlestick injuries <strong>for</strong> dentists. Caution: Use of video alone does not meet the intent of the Needle<br />

Safety Act. Clinicians <strong>and</strong> staff should conduct h<strong>and</strong>s – on evaluations of needle safety devices.<br />

The One Shot Syringe Tutorial.<br />

<strong>Resources</strong> <strong>for</strong> Immunization Recommendations<br />

CDC Immunization <strong>Resources</strong> <strong>for</strong> <strong>Healthcare</strong> Personnel<br />

http://www.cdc.gov/vaccines/hcp.htm#healthcare <strong>and</strong> http://www.cdc.gov/vaccines/<br />

This site on the CDC website provides valuable in<strong>for</strong>mation <strong>and</strong> educational <strong>and</strong> training resources <strong>for</strong><br />

healthcare personnel <strong>and</strong> immunizations <strong>for</strong> vaccine preventable diseases.<br />

<strong>Resources</strong>(publications, Vaccine In<strong>for</strong>mation Statements, etc.)<br />

Immunizations <strong>for</strong> <strong>Healthcare</strong> Personnel<br />

Immunization Schedules<br />

Guidelines / Recommendations <strong>and</strong> Vaccine Administration<br />

Vaccines <strong>and</strong> VPDs<br />

Vaccine Shortages <strong>and</strong> Delays<br />

Vaccine Storage <strong>and</strong> H<strong>and</strong>ling<br />

CDC Immunization Recommendations <strong>for</strong> <strong>Healthcare</strong> Personnel:<br />

Visit this website <strong>for</strong> general in<strong>for</strong>mation about immunizations <strong>for</strong> healthcare workers:<br />

http://www.cdc.gov/vaccines/spec-grps/hcw.htm<br />

Centers <strong>for</strong> Disease <strong>Control</strong> (CDC) “Guidelines <strong>for</strong> <strong>Infection</strong> <strong>Control</strong> in <strong>Dental</strong> Health-Care Settings –<br />

2003” Review pages 8, 9, Recommendation #1. A. 1. <strong>and</strong> Appendix B<br />

www.cdc.gov/mmwr/PDF/rr/rr5217.pdf<br />

Resource Summary Table of Immunization Recommendations <strong>for</strong> HCP<br />

A summary of immunization guidelines is also available at:<br />

http://www.immunize.org/catg.d/p2017.pdf<br />

CDC Influenza http://www.cdc.gov/flu/<br />

Influenza In<strong>for</strong>mation <strong>for</strong> <strong>Healthcare</strong> Professionals<br />

http://www.cdc.gov/flu/professionals/index.htm<br />

5


<strong>Infection</strong> <strong>Control</strong> Guidance <strong>for</strong> <strong>Healthcare</strong> Settings<br />

http://www.cdc.gov/flu/professionals/infectioncontrol/<br />

http://www.cdc.gov/oralhealth/infectioncontrol/factsheets/2009_h1n1.htm<br />

CDC Guideline: <strong>Prevention</strong> Strategies <strong>for</strong> Seasonal Influenza in <strong>Healthcare</strong><br />

Settings<br />

http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.ht<br />

m<br />

Hazard / Chemical <strong>Control</strong> Program <strong>Resources</strong><br />

The Hazard Communications St<strong>and</strong>ard (29 CFR 1910.1200) requires training <strong>for</strong> chemicals <strong>and</strong> other<br />

hazards in the dental workplace. The General Duty Clause cites requirements <strong>for</strong> exits, emergency<br />

evacuations, etc. Full text of the St<strong>and</strong>ard available at:<br />

http://www.osha.gov/SLTC/dentistry/st<strong>and</strong>ards.html<br />

Identify <strong>and</strong> inventory the chemical <strong>and</strong> physical hazards (compressed gases, dental materials <strong>and</strong> devices,<br />

radiation, mercury, etc. found in your facility.<br />

http://www.osha.gov/SLTC/dentistry/recognition.html<br />

Nitrous Oxide <strong>and</strong> other gases:<br />

http://www.osha.gov/dts/osta/anestheticgases/index.html<br />

National Institute <strong>for</strong> Occupational Safety <strong>and</strong> Health (NIOSH), DHHS Publication No. 96-107,<br />

Hazard <strong>Control</strong> HC3 (1996), 6 pages. This document presents NIOSH research that shows controls<br />

including system maintenance, ventilation, <strong>and</strong> operations. Includes step-by-step approach to<br />

controlling N 2 O exposure.<br />

http://www.cdc.gov/niosh/nitoxide.html<br />

National Institute <strong>for</strong> Occupational Safety <strong>and</strong> Health (NIOSH), DHHS Publication No. 94-100<br />

(1996, August 5), 8 pages. This alert presents control measures <strong>for</strong> preventing or greatly reducing<br />

exposure to N 2 O during the administration of anesthetic gas.<br />

http://www.cdc.gov/niosh/noxidalr.html<br />

NIOSH – National Institute <strong>for</strong> Occupational Safety <strong>and</strong> Health<br />

(Nitrous Oxide, Lab materials, Latex, etc.)<br />

www.cdc.gov/OralHealth/infectioncontrol/<br />

Beryllium Hazards in <strong>Dental</strong> Laboratories<br />

OSHA (2002, May), 42 KB PDF, 9 pages. Hazard In<strong>for</strong>mation Bulletin (HIB) in<strong>for</strong>ms employers <strong>and</strong><br />

employees about risk of dental laboratory technicians developing chronic beryllium disease (CBD).<br />

http://www.osha.gov/dts/hib/hib_data/hib20020419.pdf<br />

More Centers <strong>for</strong> Disease <strong>Control</strong> <strong>Infection</strong> <strong>Control</strong> Guidelines/ Documents:<br />

CDC's Oral Health <strong>Resources</strong> site <strong>for</strong> infection control in dentistry:<br />

http://www.cdc.gov/oralhealth/infectioncontrol/index.htm<br />

Frequently Asked Questions in <strong>Infection</strong> <strong>Control</strong>.<br />

Guidelines <strong>for</strong> Protecting Patients <strong>and</strong> Health Care Workers (by date)<br />

http://www.cdc.gov/ncidod/dhqp/guidelines.html<br />

6


Guidelines <strong>for</strong> Protecting Patients (by date)<br />

CDC Guideline: <strong>Prevention</strong> Strategies <strong>for</strong> Seasonal Influenza in <strong>Healthcare</strong> Settings<br />

http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm<br />

Guideline <strong>for</strong> Disinfection <strong>and</strong> Sterilization in <strong>Healthcare</strong> Facilities, 2008<br />

PDF (1.80 MB / 158 pages<br />

Guideline <strong>for</strong> Isolation Precautions 2007<br />

Management of Multidrug-Resistant Organism 2006 PDF (233 KB, 74 page)<br />

Preventing <strong>Healthcare</strong>-Associated Pneumonia, 2003<br />

Environmental <strong>Infection</strong> <strong>Control</strong> in <strong>Healthcare</strong> Facilities, 2003<br />

H<strong>and</strong> Hygiene in <strong>Healthcare</strong> Settings, 2002<br />

<strong>Prevention</strong> of Intravascular Device-Related <strong>Infection</strong>s, 2002<br />

<strong>Prevention</strong> of Surgical Site <strong>Infection</strong>s, 1999<br />

<strong>Prevention</strong> of Catheter Associated Urinary Tract <strong>Infection</strong>s, 1981<br />

CDC Guidelines <strong>for</strong> Protecting <strong>Healthcare</strong> Workers (by date)<br />

Management of Occupational Exposures to Hepatitis B, Hepatitis C, <strong>and</strong> HIV <strong>and</strong> Recommendations <strong>for</strong><br />

Postexposure Prophylaxis - 2001<br />

<strong>Infection</strong> <strong>Control</strong> in <strong>Healthcare</strong> Personnel - 1998<br />

See more <strong>Healthcare</strong> Worker Occupational Health Guidelines<br />

http://www.cdc.gov/ncidod/dhqp/wrkr_occHealth.html<br />

CDC Seasonal Influenza <strong>and</strong> 2009 H1N1 Influenza: <strong>Resources</strong> <strong>for</strong> Clinicians<br />

http://www.cdc.gov/flu/about/season/index.htm<br />

http://www.cdc.gov/flu/professionals/index.htm<br />

http://www.cdc.gov/h1n1flu/clinicians/<br />

http://www.cdc.gov/flu/professionals/infectioncontrol/<br />

CDC H1N1 Influenza A : http://www.cdc.gov/h1n1flu/<br />

<strong>Infection</strong> <strong>Control</strong> In a <strong>Healthcare</strong> Setting<br />

o http://www.cdc.gov/flu/professionals/infectioncontrol/index.htm<br />

o Q&A: Updating Guidance on <strong>Infection</strong> <strong>Control</strong> Measures <strong>for</strong> Influenza in <strong>Healthcare</strong> Settings<br />

o Q&A: Respiratory Protection For Preventing 2009 H1N1 Influenza Among <strong>Healthcare</strong><br />

Personnel<br />

Tuberculosis (TB)<br />

CDC Guidelines <strong>for</strong> Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings,<br />

2005. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.htm (last cited October 2, 2010)<br />

Publication <strong>for</strong> Dentistry:<br />

Tuberculosis <strong>Infection</strong> <strong>Control</strong> <strong>for</strong> Dentistry (September 2009)<br />

Clevel<strong>and</strong> JL, Robison VA, Panlilio AL. Tuberculosis epidemiology, diagnosis <strong>and</strong> infection control<br />

recommendations <strong>for</strong> dental settings: An update on the Centers <strong>for</strong> Disease <strong>Control</strong> <strong>and</strong> <strong>Prevention</strong><br />

guidelines. J Am Dent Assoc 2009;140:1092–1099.<br />

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General Facemasks <strong>and</strong> Respiratory Protection In<strong>for</strong>mation<br />

Facemask <strong>and</strong> Respirator Use <strong>for</strong> Home Community <strong>and</strong> Occupational Settings<br />

CDC :<br />

www.cdc.gov/Features/MasksRespirators/<br />

www.cdc.gov/niosh/npptl/topics/respirators/disp_part/RespSource3.html#e<br />

FDA:<br />

www.fda.gov/MedicalDevices/Products<strong>and</strong>MedicalProcedures/GeneralHospitalDevices<strong>and</strong>Supplies/<br />

PersonalProtectiveEquipment/ucm055977.htm<br />

OSHA Respiratory Protection eTool:<br />

https://www.osha.gov/SLTC/etools/respiratory/index.html<br />

CDC National MRSA Education Initiative: Preventing MRSA Skin <strong>Infection</strong>s<br />

http://www.cdc.gov/mrsa/ http://www.cdc.gov/mrsa/index.html<br />

In<strong>for</strong>mation <strong>for</strong> <strong>Healthcare</strong> Professionals<br />

http://www.cdc.gov/mrsa/prevent/healthcare/precautions.html<br />

CDC Patient Safety<br />

http://www.cdc.gov/ncidod/dhqp/patientsafety.html<br />

A documented case of patient to patient transmission of Hepatitis B in a dental office<br />

makes compelling reading. Excellent resource <strong>for</strong> assignment, discussion, case analysis, ethical<br />

considerations. From the Journal of Infectious Diseases.<br />

http://www.cdc.gov/oralhealth/infectioncontrol/hepB.htm<br />

United States Air<strong>for</strong>ce <strong>Dental</strong> Evaluation <strong>and</strong> Consultation Service<br />

This is an excellent resource <strong>for</strong> infection control <strong>and</strong> other dental product <strong>and</strong> device in<strong>for</strong>mation in an<br />

objective <strong>and</strong> non-commercial <strong>for</strong>mat. The service provides in<strong>for</strong>mation, resources <strong>and</strong> product evaluation<br />

<strong>for</strong> all branches of the US armed <strong>for</strong>ces, US Public Health Service <strong>and</strong> other US government agencies<br />

providing dental care. Access to the website is free <strong>and</strong> open to the public.<br />

http://air<strong>for</strong>cemedicine.afms.mil/decs<br />

Organization <strong>for</strong> Safety Asepsis <strong>and</strong> <strong>Prevention</strong> (OSAP) <strong>Resources</strong>:<br />

OSAP is a unique group of dental practitioners, allied healthcare workers, industry representatives, <strong>and</strong> other<br />

interested persons with a collective mission to promote infection control <strong>and</strong> related science-based health<br />

<strong>and</strong> safety policies <strong>and</strong> practices. OSAP supports this mission through collaborations with many agencies<br />

<strong>and</strong> professional groups. The organization has an international member base.<br />

Website:<br />

Publications:<br />

www.osap.org<br />

http://www.osap.org/storeindex.cfm<br />

Meetings <strong>and</strong> Training Events:<br />

CDC <strong>and</strong> OSAP co-sponsored Annual <strong>Infection</strong> <strong>Control</strong> Boot Camp; Mid January; Atlanta, GA<br />

Full week course, target audience clinic managers, military, public health <strong>and</strong> institutional dental<br />

personnel, educators, dental school clinical staff. Covers all aspects of infection control & safety.<br />

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Annual OSAP Symposium. Held mid June. Varying locations. See www.osap.org <strong>for</strong> details.<br />

Presentations provide both beginners <strong>and</strong> experts with valuable in<strong>for</strong>mation, resources, training<br />

Exclusive Member Benefits:<br />

http://www.osap.org/displaycommon.cfman=1&subarticlenbr=199<br />

APIC – Association <strong>for</strong> Professionals in <strong>Infection</strong> <strong>Control</strong> & Epidemiology.<br />

<strong>Infection</strong> <strong>Control</strong> Organization with broad scope of interest in the medical community.<br />

Membership, Annual Session <strong>and</strong> American Journal of <strong>Infection</strong> <strong>Control</strong> – highly recommended resources <strong>for</strong><br />

everyone, <strong>and</strong> especially institutions <strong>and</strong> programs with hospital based clinical rotations, oral surgery<br />

graduate programs, etc. www.apic.org<br />

Portable <strong>and</strong> Mobile <strong>Dental</strong> Programs – <strong>Infection</strong> <strong>Control</strong> <strong>Resources</strong><br />

OSAP http://www.osap.org/page=ChartsChecklists<br />

The Organization <strong>for</strong> Safety <strong>and</strong> Asepsis Procedures (OSAP) <strong>for</strong>med a national advisory group to develop a<br />

practical community site assessment <strong>and</strong> corresponding infection control <strong>and</strong> safety checklists. These<br />

checklists offer infection control guidance <strong>for</strong> oral health surveys, screenings, preventive care <strong>and</strong> treatment<br />

regardless of setting. This guidance is based on general principles of infection control <strong>and</strong> is determined by<br />

the provider's level of anticipated contact with the patient's oral mucous membranes (MM), blood or saliva<br />

contaminated with blood.<br />

Guide <strong>for</strong> Safety <strong>and</strong> <strong>Infection</strong> <strong>Control</strong> <strong>for</strong> Oral <strong>Healthcare</strong> Missions. OSAP 2004.<br />

http://www.osap.org<br />

Guide Book <strong>and</strong> CD 52-page, spiral-bound text book with 12 ready-to-edit <strong>for</strong>ms on an<br />

accompanying CD-ROM. This is a practical guide to providing safe dental care in nontraditional<br />

settings. It is designed <strong>for</strong> healthcare providers who participate in humanitarian missions that<br />

provide dental care to individuals in nontraditional settings. These settings often lack the necessary<br />

resources or modern amenities that are found in dental practices in the United States. The Guide<br />

contains a compilation of suggestions provided by person who have actually experienced <strong>and</strong><br />

participated in humanitarian mission. Free Download available at http://www.osap.org/<br />

National Maternal <strong>and</strong> Child Oral Health Resource Center<br />

Seal America: The <strong>Prevention</strong> Invention* http://www.mchoralhealth.org/Seal/index.html<br />

is an online manual designed to assist health professionals initiate <strong>and</strong> implement a school-based dental<br />

sealant program.<br />

Ohio Safety Net Distance Learning <strong>for</strong> School-Based <strong>Dental</strong> Sealant Programs<br />

A five-part, distance-learning course provided to further underst<strong>and</strong>ing of the history, operations, <strong>and</strong><br />

underlying principles of Ohio’s school-based dental sealant programs. Available at:<br />

http://ohiodentalclinics.com/curricula/sealant/index.html infection control section is module 2<br />

http://ohiodentalclinics.com/curricula/sealant/mod2_0.html<br />

Mobile Portable <strong>Dental</strong> Manual http://www.mobile-portabledentalmanual.com/ http://www.mobileportabledentalmanual.com/<br />

This is an online manual <strong>for</strong> planning <strong>and</strong> implementing portable <strong>and</strong> mobile dental service programs.<br />

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The Safety Net <strong>Dental</strong> Clinic Manual http://www.dentalclinicmanual.com/<br />

http://www.dentalclinicmanual.com/chapt4/8_0.html<br />

This resource from the National Maternal <strong>and</strong> Child Oral Health Resource Center . The Safety Net <strong>Dental</strong><br />

Clinic Manual is designed to help safety net dental clinic staff with all aspects of clinic<br />

development <strong>and</strong> ongoing operations.<br />

<strong>Resources</strong> <strong>for</strong> HIV In<strong>for</strong>mation<br />

AETC National Resource Center Update<br />

The AIDS Education <strong>and</strong> Training Centers is a federally funded agency of the U.S. Health Research<br />

Services Agency (HRSA ). The AETCs conduct targeted, multi-disciplinary education <strong>and</strong> training<br />

programs <strong>for</strong> healthcare providers treating persons with HIV/AIDS. This web site provides a central<br />

repository <strong>for</strong> AETC program <strong>and</strong> contact in<strong>for</strong>mation <strong>and</strong> <strong>for</strong> training materials developed within the AETC<br />

network.<br />

http://www.aidsetc.org<br />

The Northeast AIDS Education <strong>and</strong> Training Centers goal is: To increase the number of health care providers<br />

effectively trained to counsel, diagnose, treat <strong>and</strong> manage the care of individuals with HIV infection <strong>and</strong> to assist in the<br />

prevention of high risk behavior which may lead to infection The regional web site is www.neaetc.org<br />

AIDSInfo is a website of the U.S. National Institutes of Health offering HIV in<strong>for</strong>mation <strong>and</strong> resources<br />

on prevention, treatment <strong>and</strong> research<br />

http://www.aidsinfo.nih.gov<br />

HIVDENT is a not-<strong>for</strong>-profit coalition of concerned health care professionals committed to assuring access to<br />

high quality oral health care services <strong>for</strong> adults, adolescents, <strong>and</strong> children living with HIV disease. HIVDENT<br />

disseminates state-of-the-art treatment in<strong>for</strong>mation <strong>and</strong> shares expertise in advocacy, development, training,<br />

integration, <strong>and</strong> evaluation of oral health services <strong>for</strong> the HIV-infected population.<br />

The primary mechanism by which HIVDENT initially intends to accomplish its mission is via this web site.<br />

Inside, not only will you find several sections on the oral manifestations of HIV disease <strong>and</strong> a large picture<br />

gallery, but in<strong>for</strong>mation on infection control, post-exposure protocols, pediatric/adolescent care, medications,<br />

funding <strong>and</strong> other resources.<br />

Through an easily accessible e-mail system, health care professionals <strong>and</strong> consumers alike are able to<br />

communicate directly with the Faculty, some of the <strong>for</strong>emost international experts in these fields.<br />

www.hivdent.org<br />

World Health Organization (WHO)<br />

http://www.who.int/topics/patient_safety/en/<br />

This is the World Health Organization website area that contains many infection control topics,<br />

resources <strong>and</strong> guidelines. Topics include h<strong>and</strong> hygiene, injection safety, safe surgery <strong>and</strong> others.<br />

“Adverse events may result from problems in practice, products, procedures or systems. Patient<br />

safety improvements dem<strong>and</strong> a complex system-wide ef<strong>for</strong>t, involving a wide range of actions in<br />

per<strong>for</strong>mance improvement, environmental safety <strong>and</strong> risk management, including infection control,<br />

safe use of medicines, equipment safety, safe clinical practice <strong>and</strong> safe environment of care.”<br />

10


Author<br />

<strong>Infection</strong> <strong>Prevention</strong> <strong>and</strong> <strong>Control</strong>- Resource Textbooks<br />

Title<br />

Miller & Palenik<br />

<strong>Infection</strong> <strong>Control</strong> <strong>and</strong> Management of Hazardous<br />

Materials <strong>for</strong> the <strong>Dental</strong> Team, 4 th Ed. 2009<br />

Molinari &Harte Cottone’s Practical <strong>Infection</strong> <strong>Control</strong> in Dentistry 2009<br />

Greenwood, Slack, et.al Medical Microbiology, 17th Ed. 2007<br />

Peutherer & Barer<br />

A guide to microbial infections, pathogenesis<br />

Immunity, etc.<br />

Wilson <strong>Infection</strong> <strong>Control</strong> in Clinical Practice, 3 rd Ed. 2006<br />

Mayhall Hospital Epidemiology <strong>and</strong> <strong>Infection</strong> <strong>Control</strong> 2004<br />

Lawrence & May <strong>Infection</strong> <strong>Control</strong> in the Community 2003<br />

Gruendemann & Mangum <strong>Infection</strong> <strong>Prevention</strong> in Surgical Settings 2001<br />

Gorbach, Bartlett, & Blacklow Infectious Diseases 2003<br />

Education <strong>and</strong> Training<br />

<strong>Dental</strong> <strong>Infection</strong> <strong>Control</strong> Educators' <strong>and</strong> Trainers' Toolkit<br />

Available on CD-ROM, OSAP's <strong>Dental</strong> <strong>Infection</strong> <strong>Control</strong> Educators' <strong>and</strong> Trainers' Toolkit is a coaching<br />

workbook designed to assist with the development, planning <strong>and</strong> promotion of successful, high-impact<br />

infection control <strong>and</strong> safety programs <strong>and</strong> presentations. The resources describe the psychology of adult<br />

learning, offers suggestions on delivery techniques, provides sample lesson plans, introduces games that<br />

promote learning <strong>and</strong> much more This is an excellent resource <strong>for</strong> educators, consultants <strong>and</strong> infection<br />

control managers.<br />

GloGerm – A Training Tool <strong>for</strong> H<strong>and</strong> Hygiene<br />

Website <strong>for</strong> in<strong>for</strong>mation on ordering <strong>and</strong> using Glo Germ <strong>for</strong> infection control education:<br />

http://www.glogerm.com/using.html<br />

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Massachusetts Board of Registration in Dentistry<br />

http://www.mass.gov/pageID=eohhs2subtopic&L=5&L0=Home&L1=Provider&L2=Certification%2C+Licensu<br />

re%2C+<strong>and</strong>+Registration&L3=Occupational+<strong>and</strong>+Professional&L4=Dentistry&sid=Eeohhs2<br />

On August 20, 2010 the Massachusetts Board of Registration in Dentistry promulgated new regulations. The<br />

regulations include the following requirements:<br />

234 CMR 5.05 (1) <strong>Infection</strong> <strong>Control</strong> Practices. All persons licensed by the Board <strong>and</strong> all practices providing<br />

dental services are required to operate in compliance with the current Recommended <strong>Infection</strong> <strong>Control</strong> In<br />

<strong>Dental</strong> Health-Care Settings-2003, Centers <strong>for</strong> Disease <strong>Control</strong> <strong>and</strong> <strong>Prevention</strong> (CDC), U.S. Department of<br />

Health <strong>and</strong> Human Services, Atlanta, Georgia, as may be amended <strong>and</strong> republished.<br />

234 CMR 5.05 (2) Occupational Health <strong>and</strong> Safety Practices. All persons licensed by the Board <strong>and</strong> all<br />

practices providing dental services are required to operate in compliance with the Occupational Safety <strong>and</strong><br />

Health Administration St<strong>and</strong>ards at 29 CFR OSHA St<strong>and</strong>ards.<br />

234 CMR 8.03: Required Biennial Continuing Education A licensee seeking to renew his/her license must<br />

complete continuing education as a condition precedent to the biennial renewal of his/her license in the<br />

following areas:<br />

(a) <strong>Infection</strong> <strong>Control</strong> in the dental health-care setting<br />

<strong>Resources</strong>:<br />

U. S. Health <strong>and</strong> Human Services Centers <strong>for</strong> Disease <strong>Control</strong> (CDC)<br />

“Guidelines <strong>for</strong> <strong>Infection</strong> <strong>Control</strong> in <strong>Dental</strong> Health-Care Settings – 2003” –<br />

Guideline Document: www.cdc.gov/mmwr/PDF/rr/rr5217.pdf or<br />

http://www.cdc.gov/oralhealth/infectioncontrol/guidelines/index.htm<br />

Other CDC <strong>Infection</strong> <strong>Control</strong> <strong>Resources</strong>:<br />

http://www.cdc.gov/oralhealth/infectioncontrol/index.htm <strong>and</strong><br />

The Bloodborne Pathogens St<strong>and</strong>ard (29 CFR 1910.1030) sets rules <strong>for</strong> protective attire, sharps<br />

safety <strong>and</strong> more. To find OSHA documents <strong>and</strong> other materials on-line:<br />

o BBP St<strong>and</strong>ard 1910.1030,<br />

http://www.osha.gov/pls/oshaweb/owadisp.show_documentp_table=STANDARDS&p_id=10051<br />

o Bloodborne pathogens [related topic page<br />

http://www.osha.gov/SLTC/bloodbornepathogens/index.html<br />

o Other OSHA <strong>Resources</strong> specific to Dentistry<br />

http://www.osha.gov/SLTC/dentistry/index.html<br />

http://www.osha.gov/SLTC/dentistry/control.html<br />

http://www.osha.gov/SLTC/dentistry/st<strong>and</strong>ards.html<br />

Excellent Resource: Organization <strong>for</strong> Safety, Asepsis <strong>and</strong> <strong>Prevention</strong> (OSAP)<br />

OSAP is a unique group of dental practitioners, allied healthcare workers, industry<br />

representatives, <strong>and</strong> other interested persons with a collective mission to promote infection<br />

control <strong>and</strong> related science-based health <strong>and</strong> safety policies <strong>and</strong> practices. OSAP supports this<br />

mission through collaborations with many agencies <strong>and</strong> professional groups.<br />

Website: www.osap.org<br />

NOTE: For an more extensive <strong>Infection</strong> <strong>Prevention</strong> <strong>and</strong> Safety resource list contact Kathy Eklund<br />

keklund@<strong>for</strong>syth.org<br />

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