Dental Health Care Personnel Safety and Program Evaluation
Infection prevention programs should also address occupational health needs, including vaccination of DHCP, management of exposures or infections in personnel requiring post-exposure prophylaxis or work restrictions, and compliance with OSHA bloodborne pathogens standard. Referral arrangements for medical services can be made with qualified health care professionals in an occupational health program of a hospital, with educational institutions, or with health care facilities that offer personnel health services.
Recommendations for prevention of infections in DHCP can be found in the following documents — Guidelines for Infection Control in Dental Health-Care Settings — 2003 [PDF – 1.2 MB], Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP) [PDF – 705 KB], and OSHA Bloodborne Pathogens and Needlestick Prevention.[/vc_column_text]
- Current CDC recommendations for immunizations, evaluation, and follow-up are available. There is a written policy regarding immunizing DHCP, including a list of all required and recommended immunizations for DHCP (e.g., hepatitis B, MMR (measles, mumps, and rubella) varicella (chickenpox), Tdap (tetanus, diphtheria, pertussis).
- All DHCP are screened for tuberculosis (TB) upon hire regardless of the risk classification of the setting.
- Referral arrangements are in place to qualified health care professionals (e.g., occupational health program of a hospital, educational institutions, health care facilities that offer personnel health services) to ensure prompt and appropriate provision of preventive services, occupationally-related medical services, and postexposure management with medical follow-up.
- Facility has well-defined policies concerning contact of personnel with patients when personnel have potentially transmissible conditions.
A successful infection prevention program depends on
- Developing standard operating procedures.
- Evaluating practices and providing feedback to DHCP.
- Routinely documenting adverse outcomes (e.g., occupational exposures to blood) and work-related illnesses in DHCP.
- Monitoring health care associated infections in patients.
Strategies and tools to evaluate the infection prevention program can include periodic observational assessments, checklists to document procedures, and routine review of occupational exposures to bloodborne pathogens. The Infection Prevention Checklist for Dental Settings found in Appendix A is one tool DHCP can use to evaluate their infection prevention program. Evaluation offers an opportunity to improve the effectiveness of both the infection-prevention program and dental practice protocols. If deficiencies or problems in the implementation of infection prevention procedures are identified—further evaluation and feedback, corrective action, and training (if applicable) is needed to eliminate the problems.
- Establish routine evaluation of the infection prevention program, including evaluation of DHCP adherence to infection prevention practices.