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Decontamination in dental practice – Essential Quality Requirements
As a minimum, dental practices need to demonstrate Essential Quality Requirements (EQR) in relation to decontamination procedures. Decontamination is required to minimise the risk of cross-infection between patients and between patients and staff. It is a complex process that involves several stages, including cleaning, disinfection, inspection and sterilisation.
In order to demonstrate EQR dental practices should have a nominated lead member of staff responsible for infection control and decontamination. An infection control policy should be in place and this should be updated annually. Practices should have a clear procedure for ensuring appropriate management of single-use and reusable instruments. There should be provision of a dedicated hand-washing facility. The storage, preparation and use of materials should take full account of the requirements of the Control of Substances Hazardous to Health (COSHH) Regulations 2002. Particular care should be taken in the storage and preparation for use of decontamination chemical products. Instruments may be cleaned using an ultrasonic bath, but this should be covered during use to restrict the release of aerosols. Manual cleaning may also be carried out in a dedicated scrubbing sink with an additional rinsing sink or bowl. Good lighting and magnification should be available to ensure that instruments are visibly clean and free of debris. Decontamination processes should not be carried out in clinical areas whilst patients are undergoing treatment. Staff carrying out decontamination procedures should have appropriate personal protective equipment provided. Unwrapped instruments can be stored in lidded containers in clinical areas for 1 day. They can also be stored in non-clinical areas for 7 days. Wrapped instruments can be stored for 1 year.
Staff training records should be available for all relevant members of the team. Waste transfer and consignment notes, as well as safe storage of clinical waste and sharps, should be in place. All staff involved in decontamination should have current immunisation records. Dental practices are required to establish and operate a quality assurance system that covers the use of effective measures of decontamination and infection control. This may best be demonstrated by undertaking audits and assessments of their infection control and decontamination practices. Audits should be carried out every six months and results should be stored for at least two years.
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