Any Medical Instrument Can Be Considered A Sharp
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standard precautions
What should be used for all patient encounters?
potentially infective
We should consider all sharp items contaminated with patient blood and saliva to be what?
work practices engineering controls
What 2 things should we use to prevent injuries?
work practice controls
What is the name for procedures that reduce the likelihood of exposure?
engineering controls
What is the name for tangible items that isolate or remove the BBP hazard from the work place?
2
never recap a needle with _____ hands, whether that be the operator's or the assistant's
-scoop method -freestanding needle recapping device -re-sheathing device
What are 3 safe methods for recapping needles?
immediate vicinity
Where should sharps containers be relative to where they were used?
immediately after use
When should non-reusable sharps be disposed of?
False, it's never okay to bend a needle
T/F: Sometimes it's okay to bend needles as long as you use a mechanical device rather than your hands.
mechanical retraction (of obstructing structures i.e. the cheek)
What is recommended when administering an injection?
operator unit
turn handpieces and power scaler tips away from the _________, toward the _________ or cover with plastic sheath or protective cover to avoid puncture and scratch injuries
double-ended
use caution while handling _________ instruments
True
T/F: You should never wipe debris from instrument tips with gauze held in your hand or wrapped around fingers
False, you should never finger rest on the same tooth on which you are working
T/F: during scaling and cutting, you should rest your finger on the same tooth on which you are working
-self-sheathing needles -retractable scalpels -blunt suture needles
three types of engineering controls that could modify devices to increase safety measures in practice:
-Closable -Hard-walled, puncture proof, leak-proof (sides and bottom), spill proof sharps container. -Labeled appropriately -Remain upright throughout use -Must be located in operatories and other locations where disposable sharps are generated and used.
requirements for sharps containers:
routinely; not allowed to overfill
When should sharps containers be replaced?
FALSE; sharps containers should not be reused
T/F: One should empty a sharps container before reusing it.
1. close the container 2. dispose of as regulated waste
steps for removing a container of contaminated sharps:
OSHA
who created the Needlestick Safety and Prevention Act?
Needlestick safety and prevention act
Which part of the OSHA Bloodborne Pathogens Standard is mandated?
sharps devices
safety needles, safety syringes, safety scalpels and sutures, needleless IV catheters, ports and injection systems are all:
-annually -as they become available in the market
When should dental employers assess safer sharps devices?
office exposure control plan
If inquiries indicate safer options for sharps devices are not available, where should this be documented?
non-managerial
sharps assessment process must involve which employees that are involved in direct patient care (identifying and choosing devices)?
1. screening devices (bench test) 2. evaluating devices (pilot clinical test)
Steps of the sharps assessment process:
-Intuitive -Efficient change of carpules -Visibility of needle tip and carpule contents -Adaptable to various hand sizes -Easy, safe breakdown and disposal -Cost effective
desirable characteristics of a dental syringe/needle
before bringing them into patient-case setting
When should you make decisions concerning clinical and safety considerations of sharps?
1. review MFG instructions 2. manipulate the device to become familiar 3. test using oranges or other substitute 4. involve employees from all categories that will handle the device 5. determine proper disposal methods and practices 6. use or modify the CDC screening form
What are the steps of the Bench test screening?
injury or malfunction
A failure for a sharps safety device results in what?
staff receives training on correct use of the device
What is the first step of the evaluation phase of the pilot test?
-staff uses device -documents experience by feedback -completes eval form
What is the second step of the evaluation phase of the pilot test?
-employer, ICC or safety officer monitors if device is used properly -stops pilot test if the device is found to be unsafe
What is the third step of the evaluation phase of the pilot test?
at the end of pilot test, staff discusses and completes an eval form
What is the fourth step of the evaluation phase of the pilot test?
-findings are reviewed by employer, ICC or safety officer -decision is made about continuing the use of new device in practice
What is the fifth (final) step of the evaluation phase of the pilot test?
sheath
(simplecap) What is the clear tube that protects the needle?
hub
(simplecap) What is the colored system that holds the needle?
capsules
(simplecap) What is the colored packaging that SimpleCAP comes in?
locks
(simplecap) What opens gaps in the sheath where pins sit between injections?
channel
(simplecap) What are the slots that run the length of the sheath?
pins
(simplecap) What are the thin plastic tabs that ride inside of the channels and locks?
bloodborne pathogen exposure
What is a percutaneous injury or contact of mucous membrane or non-intact skin with blood, tissue or other body fluids that are potentially infectious?
OSHA Bloodborne Pathogens Standard 1910.1030
What mandates making hep B vaccine available to all employees who might have occupational exposure as well as the management of post-exposures to BBP according to US public health services?
employer
Whose responsibility is it to make sure that a confidential medical evaluation and follow-up are immediately available to an employee after report of an exposure incident?
consent
source individual's ________ to testing of blood to determine HBV and HIV infectivity; if this is not give, this should be documented
as soon as feasible
when should source individual's blood be tested?
exposed employee
results of the source individual's testing shall be made available to the ______________ _________
source individual infection status
What cannot be identified by an exposed employee after they receive the results of their testing?
-Whether hep B vaccination is indicated and if received by the employee -Employee has been informed of the results of the evaluation
Written opinion from HCP to employer only include:
-Results of the source individual's blood testing, if available (Usually exchanged between physicians) -All medical records relevant to employee treatment (Vaccination status)
employer must provide the evaluating HCP:
medical emergency
What should we consider a needle stick injury?
1. Immediately STOP activity 2. Wash the injured area with soap and water 3. Flush mucous membranes with copious amounts of water, if involved 4. Render FIRST AID if needed
Initial steps for post-exposure protocol:
-report the incident -complete the incident report -medical eval
What steps should be taken post-exposure?
Team coordinator and Ed Rangel or Claudia Nunes
Who should an incident be reported to?
-medical eval -medical treatment -medical follow-up
What are the components of a post-exposure evaluation?
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