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infection control checklists

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infection control checklist 1 – opening the surgery

This checklist applies where a surgery is being used for the first time on any given day.

1. Switch on the electrical supply to the compressor and suction unit (in staff room).

2. Put on your clinical footwear before you go into the surgery.

3. Switch on surgery lights.

4. Open blinds on windows.

5. Switch on surgery music system.

6. Switch on the surgery electricity supply at the consumer unit in the surgery (push the three breakers on the right into the “on” position).

7. Switch on the air conditioning.  If it is already on due to timer operation, switch it off and back on again to reset to normal operation.

8. Ensure that the dentist’s patient list for today has been placed next to the computer.

9. Lower patient’s chair to exit position using foot controls on the chair itself and take the dentist’s foot pedal off the seat, placing it back on the floor.

10. Return the operators’ stools to their working positions.

11. Wash your hands at the hand wash basin. Dry them. Apply alcohol hand-rub. Put on a pair of examination gloves, face mask, glasses and apron.

12. Wipe down the protective Perspex cover, the surround, the on/off switch and replace the handles on the operating light.

13. Wipe down the entire “over the patient” delivery unit. Wipe down the outlets on the delivery unit (both the leads and the couplings on the end of them). Replace the rubber mat on which the handpieces rest. Replace the handles on either side of the delivery system and the dentist’s tray and tray holder. Wipe down the arm supporting the aspirator and saliva ejector tubes, together with the nozzles on the end of each tube.

14. Replace the filters on both suction tubes and the filter in the base of the cuspidor.

15. Wipe down the patient’s chair and head rest.

16. Flush and wipe out the cuspidor.

17. Wipe down all work surfaces, working from the hand wash basin around the room to the decontamination sink.

18. Make up a bottle of Alpron solution with RO water and attach to the bottled water system on the treatment unit.  Make up a bottle of Alpron solution with RO water and attach to the EMS scaler unit.

19. Fill the autoclave tank with RO water.

20. Fill the ultrasonic bath to the ¾ full level with detergent solution (add 10ml of Alkazyme to each litre of RO water). Using a thermometer, check that the temperature of the solution is less than 45 degrees centigrade. Place the lid on the ultrasonic bath and run for 5 minutes to de-gas the solution.

21. Fill the soaking bowl with manual cleaning solution (add 10ml of Alkazyme to each litre of RO water). Using a thermometer, check that the temperature of the solution is less than 45 degrees centigrade. Fill the rinse bowl with plain RO water.

22. Make up bleach solution for disinfecting prosthodontic appliances and impressions (use RO water).

23. Remove and discard your gloves and apron. Apply alcohol hand-rub. Put on a fresh pair of examination gloves.

24. Place a paper liner on the tray attached to the “over the patient arm”. On top of this lay out an examination pack (mirror, probe and perio probe) and a piece of gauze.

25. Set up clean triple spray tip, ultrasonic insert, electric motor hand piece, aspirator and disposable cup for patient mouth rinse.

26. Lay out protective eye wear, mask and gloves on the work surface (for the dentist).

27. Lay out protective eye wear and paper bib on the work surface (for the patient).

28. Check the dentist’s patient list for the day to see what procedure you will carry out on the first patient of the day.  Set the surgery up for this procedure.

infection control checklist 2 – closing down the surgery

This checklist applies where a surgery is being closed down for the last time on any given day.

1. When treatment is complete, put on a fresh pair of examination gloves and a disposable plastic apron.  Keep your eye protection and mask on.

2. The dentist will push the “over the patient” delivery arm back across the patient to the nurse’s side.  The nurse must remove all instruments from the tray attached to the arm, together with the paper tray liner.  Place the instruments in the ultrasonic bath basket unless they are grossly contaminated, in which case place them in the soaking bowl. Place the tray liner and any other waste (eg extracted teeth, cotton wool rolls, etc) in the appropriate waste container.

3. Remove the aspirator tip, triple spray tip, ultrasonic handpiece and scaling tip, electric motor hand piece and patient’s mouth rinse cup. Remove the rubber mat on which the hand pieces rest and the sleeves from the handles on either side of the delivery system. Remove the sleeves from the handles on the operating light. Place the aspirator tip, triple-spray tip and the patient’s mouth rinse cup in the hygiene waste bin. Place the rubber mat and handle sleeves in the soaking bowl. Place the ultrasonic hand piece and electric motor hand piece neatly on the work surface at the back of the decontamination basin. Place the scaling tip in the basket of the ultrasonic bath.

4. Next, remove any dirty instruments from the work surface to the left of the decontamination basin and place them in the ultrasonic bath basket unless they are grossly contaminated, in which case place them in the soaking bowl. Place the lid on the ultrasonic bath and SWITCH IT ON.   Place any paper products and any other waste in the appropriate waste container.

5. One at a time, pull forward each of the outlet arms on the over-the-patient bridge and flush them into a plastic cup for 2 minutes each.  Do this for each outlet which has been used during the session.  This will usually be at least the triple-spray and the electric motor outlet, but may also include the air turbine and scaler unit.  Do the same with the benchtop ultrasonic scaler, too.

6. Ensure that any waste material is placed in the appropriate waste container. When clearing away waste products, remember that all surgery waste products are to be treated as hygiene waste (AKA offensive waste) and placed in the large foot-operated bins EXCEPT the following items which must be placed in the appropriate waste containers:

a) partially discharged local anaesthetic cartridges – in their own special waste container

b) fully discharged local anaesthetic cartridges – in the sharps bin

c) needles, scalpel blades or other sharp objects – in the sharps bin

d) amalgam or extracted teeth that have been filled with amalgam – in the special amalgam waste container

e) precious metal waste – in its own special container

f) gypsum waste – in its own special container

g) contaminated items – items that are contaminated with blood or have been used in the treatment of a patient known to be infectious are to be placed in the small contaminated waste bin located behind the hygiene waste bin in the foot-operated unit beneath the decontamination sink.

7. Remove and discard your gloves. Apply alcohol hand-rub. Put on your heavy-duty gloves and plastic apron.

8. Sterilise all contaminated instruments, hand pieces, etc. following the detailed guidance in the infection control policy.  The autoclave should be running at this point.

9. Remove, clean and dry your heavy-duty gloves. Apply alcohol hand-rub. Put on a fresh pair of examination gloves.

10. Empty the spittoon filter and both aspirator filters into the clinical waste bin taking care to ensure that if they contain any waste amalgam this is removed and placed in the appropriate container. Then place the filters in the soaking bowl.  Clean, rinse and replace them.

11. Drain the soaking bowl and the rinse bowl.  Rinse them out under the tap.  Make up a solution of Orotol in the soaking bowl.  Draw the solution through each of the two aspirator hoses to flush them.

12. Empty all surgery bins.  Place the bags at the far end of the surgery until you finish cleaning.

13. Place both operators’ stools at the far end of the surgery.

14. Wipe down x-ray tube and arm, x-ray control unit & hand switch, digital x-ray sensor, capsule mixer, clock, telephone, operators’ stools, patient chair (upholstered part, base and around headrest), delivery unit and foot controls.

15. Wipe down the entire “over the patient” delivery unit. Wipe down the outlets on the delivery unit (both the leads and the couplings on the end of them). Wipe down the dentist’s tray and tray holder. Wipe down the arm supporting the aspirator and saliva ejector tubes, together with the nozzles on the end of each tube. Flush and wipe out the cuspidor (spittoon).

16. Wipe down the protective Perspex cover, the surround and the on/off switch on the operating light.

17. Wipe down the patient chair and head rest.

18. Switch off the ultrasonic bath at the socket and empty it. Empty the detergent from the end furthest away from the mains flex. Clean the ultrasonic bath and dry it. Pour the bleach solution used for disinfection of impressions and prosthodontic appliances down the sink and clean and dry the container. Wipe down the autoclave, Assistina and towel dispenser.

19. Remove the water bottles from the dental unit and the benchtop ultrasonic scaler. Empty them down the sink, rinse with RO water and store the bottles inverted.

20. Wipe down the whole surgery, working from the hand wash basin around the room to the decontamination sink. This includes all work surfaces, cupboard & drawer fronts, the desk area, the hand wash sink and tap, the decontamination sink and tap.

21. Remove and discard your gloves and plastic apron. Apply alcohol hand-rub. Put on a fresh pair of examination gloves.

22. Bag and date any sterilised instruments and put them away. Replace the operating light handle sleeves and the rubber mat and sleeves from the handles on the “over the patient” arm.

23. Drain the autoclave tank and wipe out the inside of the autoclave drum and door.

24. Check that the dentist’s patient list for the following day has been placed next to the computer.

25. Ensure that the surgery is fully restocked with all necessary materials.

26. Switch off the surgery music system.

27. Switch off the air conditioning system (in the winter, set it to timer mode when the surgery is in use the next day).

28. Lift the dentist’s foot control from the floor and place it on a piece of Tork roll on the seat of the patient chair. Elevate the patient chair to its highest position to facilitate easy cleaning of the surgery floor.

29. Close the blinds on the windows.

30. Switch off the surgery electricity supply at the consumer unit in the surgery (push the three breakers on the right into the “off” position).

31. Remove and discard your mask and gloves. Wash your hands with soap and dry them. Remove, clean and stow your protective eyewear.

32. Switch off the surgery lights.

33. Switch off electrical supply to compressor and suction unit (in the staff room).

34. Remove your clinical footwear and place it in the staff room.  Moisturise your hands.

35. Tie the top of any waste bags and take them to the waste bins.  The hygiene waste bags must be placed inside a yellow & black “tiger” waste sack.  The infectious waste bags must be placed inside an orange infectious waste sack. Once a waste sack is three-quarters full, it should be sellotaped shut.  Ensure that the bins are locked afterwards.

infection control checklist 3 – cleaning the surgery between patients

This checklist applies where a surgery is being cleaned during the course of a working day, after one patient’s treatment has been completed and before the next patient’s treatment begins.

1. When treatment is complete, put on a fresh pair of examination gloves and a disposable plastic apron.  Keep your eye protection and mask on.

2. The dentist will push the “over the patient” delivery arm back across the patient to the nurse’s side.  The nurse must remove all instruments from the tray attached to the arm, together with the paper tray liner.  Place the instruments in the ultrasonic bath basket unless they are grossly contaminated, in which case place them in the soaking bowl. Place the tray liner and any other waste (eg extracted teeth, cotton wool rolls, etc) in the appropriate waste container.

3. Remove the aspirator tip, triple spray tip, ultrasonic handpiece and scaling tip, electric motor hand piece and patient’s mouth rinse cup. Place the aspirator tip, triple-spray tip and the patient’s mouth rinse cup in the hygiene waste bin. If used, place the ultrasonic hand piece and electric motor hand piece neatly on the work surface at the back of the decontamination basin. Place the scaling tip in the basket of the ultrasonic bath.

4. Next, remove any dirty instruments from the work surface to the left of the decontamination basin and place them in the ultrasonic bath basket unless they are grossly contaminated, in which case place them in the soaking bowl. Place the lid on the ultrasonic bath and SWITCH IT ON.   Place any paper products and any other waste in the appropriate waste container.

5. One at a time, pull forward each of the outlet arms on the over-the-patient bridge and flush them into a plastic cup for 30 seconds each.  Do this for each outlet which has been used during the patient’s appointment.  This will may include the triple-spray, the electric motor outlet, the air turbine outlet and scaler unit.  Do the same with the benchtop ultrasonic scaler, too.

6. Ensure that any waste material is placed in the appropriate waste container. When clearing away waste products, remember that all surgery waste products are to be treated as hygiene waste (AKA offensive waste) and placed in the large foot-operated bins EXCEPT the following items which must be placed in the appropriate waste containers:

a) partially discharged local anaesthetic cartridges – in their own special waste container

b) fully discharged local anaesthetic cartridges – in the sharps bin

c) needles, scalpel blades or other sharp objects – in the sharps bin

d) amalgam or extracted teeth that have been filled with amalgam – in the special amalgam waste container

e) precious metal waste – in its own special container

f) gypsum waste – in its own special container

g) contaminated items – items that are contaminated with blood or have been used in the treatment of a patient known to be infectious are to be placed in the small contaminated waste bin located behind the hygiene waste bin in the foot-operated unit beneath the decontamination sink.

7. Wipe down the entire “over the patient” delivery unit. Wipe down the outlets on the delivery unit (both the leads and the couplings on the end of them) and the rubber mat on which they rest, paying particular attention to ensure that no blood, restorative materials or other debris remain. Wipe down the handles on either side of the delivery system and the dentist’s tray and tray holder. Wipe down the arm supporting the aspirator and saliva ejector tubes, together with the nozzles on the end of each tube.

8. Wipe down the protective Perspex cover, the surround, the on/off switch and both handles on the operating light.

9. Flush and wipe out the cuspidor (spittoon).

10. Wipe down the upholstery on the patient chair.

11. Wipe down any non-autoclaveable materials or equipment which has been laid out for use on the previous patient and place it into the correct storage drawer.

12. Wipe down all work surfaces and the capsule mixer (if it has been used while treating the last patient).

13. Remove and discard your gloves. Apply alcohol hand-rub. Put on a fresh pair of examination gloves.

14. Replace the tray liner. Place an examination pack (mirror, probe and perio probe) on the tray liner. Place a fresh aspirator tip and triple spray tip in position. Set up a fresh cup of mouth rinse for the patient.

15. Check the dentist’s patient list to see what procedure you will carry out on the next patient of the day. Set the surgery up for this procedure.

16. Remove and discard your gloves. Apply alcohol hand-rub. Put on your heavy-duty gloves and plastic apron.

17. Sterilise all contaminated instruments and hand pieces following the detailed guidance in the infection control policy.

18. Remove, clean and dry your heavy-duty gloves. Apply alcohol hand-rub. Put on a fresh pair of examination gloves before you put away sterilised instruments or assist with the treatment of the next patient.

infection control checklist 4 – spring cleaning

This checklist has been defunct since January 2013.  For details, refer to the practice infection control policy and, in particular, the section on environmental cleaning and the links to the various specifications, checklists and schedules in use.

Web version 8: 5.8.2016
Previous web versions published: 2.8.2006; 31.10.2008; 27.2.2011 (reviewed 26.1.2012); 18.12.2012; 11.1.2013 (reviewed 5.6.2015)

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