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15 08700 10 20 41 firstname.lastname@example.org 15 08700 10 20 41 email@example.com 5: decontamination in primary care dental practices It can be seen that the space requirement is of at least eight square metres (86sqft). Most existing dental practices will not have this spare space and will need to alter their layout, even possibly losing a surgery (usually a minimum of 10 square metres). To date, one solution has been to plan a decontamination area in (or in an alcove off) a back of house staff corridor. Whilst this was far more satisfactory than found in many practices, particularly those that had the steriliser in the surgery (which has not been acceptable for several years), this no longer complies with the guidelines in HTM 01-05. The reason for this is that it is possible for contaminated, ‘dirty’ instruments to be carried through the clean zone of the decontamination area. This now obviously has to be addressed and most dentists also find themselves in a situation where their practices do not conform to the guidelines, let alone ‘best practice’. Many of the existing decontamination areas can be adapted to comply with the insertion of a floor to ceiling etched glass screen and possibly an etched glass sliding or pivoting door. Below are two examples of such adaptations. Figure 5 Figures 5 and 6 show a decontamination area that can be adapted with the insertion of a glass screen and moving the steriliser into the clean area, to be compliant now, and then can be made ‘best practice’ with the introduction of a glass door to the clean area. Figure 6: A decontamination area adapted to comply with the insertion of a glass screen Figure 7: An example of a decontamination area that, to be compliant now, can be adapted with the insertion of a glass screen and door to the clean area SOME POINTERS IN THE DESIGN OF THE WHOLE DENTAL PRACTICE FOR CROSS INFECTION CONTROL 1. Smaller surgeries make room for a decontamination area. A standard surgery need not be any bigger than 3.4m x 2.75m (11ft x 9ft). Anything more makes it less efficient. 2. Twin surgeries make time for cleaning. Start working on the next patient in a clean surgery, allowing time to clean the vacated surgery properly. This also removes much of the stress from a busy practice and, unbelievably, can save up to six working weeks a year, just cleaning the surgery (five minutes/ patient = one hour/day = approx five hours/week = 20 hours/month = 240 hours/year). 3. Multiple doors to surgeries ease direction of flow of contaminated instruments, separate staff from patients and help nurture a calm environment. SOME POINTERS IN THE DESIGN IN THE DENTAL SURGERY FOR CROSS INFECTION CONTROL To maximise ease of cleaning/disinfection of surgeries: 1. Minimise worktops. The less worktop, the less to clutter and the less to clean. 2. No clutter. The less that is kept out, the less there is to clean between every patient. Everything, if possible, should be put away. 3. Glass work surfaces. Glass work surfaces can be seen to be clean. Patients can see immediately that the surgery is clean and gleaming. 4. Ample clean storage. It is most important to have easily accessible clean storage so that sterilised instruments stay in good condition for as long as possible without contamination. 5. ‘Steri-Walls’. The system of ‘Steri-Walls’ has been developed over several years to efficiently house everything that is needed during dental surgery. Figures 8 and 9: ‘Steri-Walls’, a double access, storage wall at the rear of the surgery, can be serviced from the corridor outside and house clean instruments and materials. Separate compartments for waste, services, computer and plugged in sundry appliances. As a separate decontamination area is mandatory, now it is almost as convenient to have a single sided storage wall, replacing conventional dental cabinets. These can be identical to those illustrated but only accessed from the surgery. Figure 9 shows ample clean storage in ‘Steri-Walls’ accessed from behind the surgery. For more information on Dr Richard Mitzman Cabinetry available from Henry Schein Minerva, call 08700 10 20 41. For more information on Dr Richard Mitzman Cabinetry available from Henry Schein Minerva, call 08700 10 20 41 Questions for the design planning implications of HTM 01-05 Article LEARNING AIM: Our CPD questions are designed to help dental professionals maintain and develop their knowledge by reviewing articles which highlight key areas of dentistry. This should ensure that dental professionals retain their capacity to practice safely, effectively and legally within their evolving scope of practice. LEARNING OBJECTIVES: An understanding of the design planning implications of HTM 01-05: decontamination in primary care dental practices. LEARNING OUTCOME: On completion the dental professional can confirm that knowledge has been gained and maintained on the topic of the design planning implications of HTM 01-05: decontamination in primary care dental practices. Q1. All premises will be required to achieve essential quality requirements within how many months of publication of the hard copy version and accompanying audit tool? (a) 1 month (b) 10 months (c) 6 month (d) 12 months Q2. The essential quality requirements require the practice to have written validated policies for instrument decontamination and infection control. True or False? Q3. Use of mechanical washer/disinfector is mandatory according to HTM01-05. True or False? Q4. The system of steri-walls has been developed over several years to efficiently house everything that is needed during dental surgery. True or False? Q5. HTM01-05 lists the following requirements (a) Decontamination area separated into dirty and clean zones. (b) Dirty zone has instrument washer/disinfector. (c) No contaminated instruments or personnel pass through clean zone. (d) A dirty to clean workflow should be maintained. (e) All of the above. FREE Core Verifiable CPD from Henry Schein Minerva To claim your FREE 1 HOUR CORE VERIFIABLE CPD please complete your information and return it to Sue O’Rourke, Henry Schein Minerva, Courtney House, Pacific Business Park, Pacific Road, Cardiff, CF24 5HJ. One form is required per person. YOUR ANSWERS: Q1.■ Q2.■ Q3.■ Q4.■ Q5.■ Name: ______________________________________________ Title: ________________________________________________ Address: ____________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ Email: _______________________________________________ Job Title: ____________________________________________ GDC Registration No: _________________________________ Please add any comments or feedback that you might have: _____ ________ ________ ________ ________ ________ ______ ____________________________________________________ ■ Please tick here if you do not want to receive any further information on HTM 01-05 and the issue of decontamination Replies must be received by 1st April 2011. Please note: certification of verifiable CPD is provided by post or email. By providing your email address, you are agreeing to us contacting you in this format. You may contact us at any time to unsubscribe from our communications. ANSWERS FROM ISSUE 7 “3D DENTAL IMAGING” ARTICLE Q1. (e) Q2. True Q3. True Q4. (a) Q5. True Q6. True Figure 8 Figure 9 J001-01-11HSEQ Focus:Layout 1 20/1/11 11:44 Page 15