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Appendix B: Relevant Recommendations Published by CDC Since 2003

Administrative Measures

  1. Develop and maintain written infection prevention policies and procedures appropriate for the services provided by the facility and based upon evidence-based guidelines, regulations, or standards.
  2. Infection prevention policies and procedures are reassessed at least annually or according to state or federal requirements.
  3. Assign at least one individual trained in infection prevention responsibility for coordinating the program.
  4. Provide supplies necessary for adherence to Standard Precautions (e.g., hand hygiene products, safer devices to reduce percutaneous injuries, personal protective equipment).
  5. Facility has system for early detection and management of potentially infectious persons at initial points of patient encounter.

References

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines.pdf [PDF – 1.4 MB]

Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care
http://www.cdc.gov/HAI/settings/outpatient/outpatient-care-guidelines.html

Infection Prevention Education and Training

  1. Maintain training records according to state and federal requirements.

Reference

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines.pdf [PDF – 1.4 MB]

Respiratory Hygiene/Cough Etiquette

  1. Implement measures to contain respiratory secretions in patients and accompanying individuals who have signs and symptoms of a respiratory infection, beginning at point of entry to the facility and continuing throughout the visit.
  2. Post signs at entrances with instructions to patients with symptoms of respiratory infection to—
  • Cover their mouths / noses when coughing or sneezing
  • Use and dispose of tissues.
  • Perform hand hygiene after hands have been in contact with respiratory secretions.
  1. Provide tissues and no-touch receptacles for disposal of tissues.
  2. Provide resources for performing hand hygiene in or near waiting areas.
  3. Offer masks to coughing patients and other symptomatic persons when they enter the dental setting.
  4. Provide space and encourage persons with symptoms of respiratory infections to sit as far away from others as possible. If available, facilities may wish to place these patients in a separate area while waiting for care.
  5. Educate DHCP on the importance of infection prevention measures to contain respiratory secretions to prevent the spread of respiratory pathogens when examining and caring for patients with signs and symptoms of a respiratory infection.

Reference

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines.pdf [PDF – 1.4 MB]

Safe Injection Practices

  1. Prepare injections using aseptic technique in a clean area.
  2. Disinfect the rubber septum on a medication vial with alcohol before piercing.
  3. Do not reuse needles or syringes to enter a medication vial or solution, even when obtaining additional doses for the same patient.
  4. Do not use single-dose (single-use) medication vials, ampules, and bags or bottles of intravenous solution for more than one patient.
  5. Dedicate multidose vials to a single patient whenever possible.
  6. If multidose vials will be used for more than one patient, they should be kept in a centralized medication area and should not enter the immediate patient treatment area to prevent inadvertent contamination.
  7. If a multidose vial enters the immediate patient treatment area it should be dedicated for single-patient use and discarded immediately after use.
  8. Date multidose vials when first opened and discard within 28 days unless the manufacturer specifies a shorter or longer date for that opened vial.

References

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines.pdf [PDF – 1.4 MB]

CDC: Injection Safety, Information for Providers
www.cdc.gov/injectionsafety/providers.html

Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care
http://www.cdc.gov/HAI/settings/outpatient/outpatient-care-guidelines.html

Sterilization and Disinfection of Patient-Care Items and Devices

  1. Have manufacturer instructions for reprocessing reusable dental instruments / equipment readily available, ideally in or near the reprocessing area.
  2. Label sterilized items with the sterilizer used, the cycle or load number, the date of sterilization, and (if applicable) the expiration date.
  3. Ensure routine maintenance for sterilization equipment is performed according to manufacturer instructions and maintenance records are available.

Reference

Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines.pdf [PDF – 1.26 MB]

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