Infection Control 2020 COVID-19 01. 02. ABOUT COVID-19 - - PowerPoint PPT Presentation

COVID-19

Infection Control 2020

01.

ABOUT COVID-19

This is a new virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

PREVENTION MEASURES INFECTION CONTROL

Is the discipline concerned with preventing nosocomial or healthcare- associated infection

03. 02.

What you need to know to prevent yourself and others

• AS/NZ

NZS 4187:201 014 4 Clean aning, ing, disi sinfecti ting g and sterilisi rilising g reusab able le medic ical al and surgic ical al instr trumen ents ts and equipmen ipment.

• t. Maintena

tenance nce of associa ciate ted envir iron

• nmen

ents ts in the health th care e facilit litie ies. s.

• NH

NHMRC Infecti ction Control

• l Guidelines

ines for the preventio vention n of transmis issi sion

• n of

infec ecti tion n in the health thca care re setting tting 2010. 0.

• Australi

lian n Dental al Associatio iation n Guide delines ines for infe fect ctio ion n control l 3rd

rd Edition

tion 2015. Dental al service vice restr tric icti tions s in COVID 19

• Infection

ction Contr trol l Policie cies and Proced cedures: res: via RHHM Intranet. et.

• Infection

ction Contr trol l Presenta sentati tion n for Dental al 2018, , Wendy Bacalja ja

Infection Control References

Behind this presentation will improve staff and patient care

COVID-19 is an infectious disease caused by the recently found virus known as SARS-CoV-2 (or coronavirus). Before the outbreak originated in Wuhan, China on December 2019.

COVID-19

Policies and procedures that are put in place to prevent and minimize the risk

• f spreading infections

What is Infection Control ?

ABOUT CORONAVIRUS

01.

DRY COUGH HIGH FEVER

Irritation and constant coughing without expelling any mucus The body feels completely tired and without energy to perform normal tasks The body temperature can exceed 37.3 Celsius degrees

• r 99 Fahrenheit degrees

SYMPTOMS OF COVID-19

TIREDNESS

This disease can spread from person to person through small droplets from the nose or the mouth when the infected person coughs or exhales.

SURFACES

These small droplets land on surfaces, which means any person that touches these surfaces and then their eyes, nose or mouth can become infected.

PEOPLE

Many people infected with COVID-19 show mild symptoms, especially during the first stages of the

• disease. Thus, you can still catch the disease from

an infected person who only has a mere cough and does not feel ill.

ASYMPTOMATIC PEOPLE

HIGH FEVER TIREDNESS DIFFICULTY BREATHING DRY COUGH

INFOGRAPHICS

The body temperature can exceed 37.3 Celsius degrees The body feels completely tired, without energy Breathing actually feels more difficult Constant coughing without expelling any mucus

WHAT TO DO IF YOU HAVE SYMPTOMS

You have symptoms or flu like symptoms STEP 01 Call the designated phone number for your region STEP 02 You will be given a instructions on what to do STEP 03

Follow the instructions provided by the doctor

WHAT TO DO IF YOU HAVE SYMPTOMS

Patiently wait for the results of the test STEP 04 STEP 05

ABOUT 80% OF PEOPLE RECOVER FROM THIS DISEASE WITHOUT NEEDING SPECIAL TREATMENT

CURRENT ANTIBIOTICS DO NOT WORK AGAINST CORONAVIRUS

PREVENTION MEASURES

02

PROTECTION MEASURES FOR PEOPLE THAT ARE IN OR VISITED INFECTED AREAS 01 02

Stay home if you do not feel well, even if you feel mild symptoms such as headaches, slight fever and a runny nose If you need to go out make sure to follow and maintain a safe distance

03 04

If you have difficulty breathing and/or a high fever, seek medical advice as soon as possible Call your provider and inform them of any recent travel, especially to countries with reported cases

Cover your mouth and your nose with your bent elbow or a tissue when coughing Seek medical attention if you have difficulty breathing and a high fever Follow the directions of your national or local health authorities Wash your hands with an alcohol-based sanitizer or with soap and water Keep a distance of at least 1 meter between yourself and anyone who coughs or sneezes Try your best not to touch your eyes, your nose and your mouth

PROTECTING YOURSELF AND PREVENTING THE SPREAD OF THE DISEASE

• Before wearing a mask, wash your hands with an alcohol-based

disinfectant or with soap and water.

• Cover your mouth and nose with the mask and make sure the mask is

firmly pressed against your face.

• Do not touch the mask while you are wearing it; if you do, wash your

hands with an alcohol-based disinfectant or with soap and water afterward.

• Replace the mask as soon as it gets wet and do not reuse disposable

masks.

• Remove the mask from behind (do not touch its front side); throw it away

in a closed container and then wash your hands with an alcohol-based disinfectant or with soap and water.

HOW TO USE A MASK

Level 1-Restrictions All dental treatment using standard precautions for people who do not meet epidemiological or clinical risk factors for COVID-19 infection transmission. Restricted Services Level 1- Defer long services for people who do not meet epidemiological or clinical symptom criteria for COVID-19 Urgent dental treatment for people who do meet the symptom criteria for COVID-19 risk or confirmed as COVID-19 case, provided as per ADA Managing COVID-19 Guidelines.

Dental Restrictions During COVID 19

LEVEL 2 RESTRICTIONS

Provision of dental treatments that are unlikely to generate aerosols or where aerosols generated have the presence of minimal saliva/blood due to the use of rubber dam. This includes:-

• Examinations
• Simple non-invasive fillings without use of high-speed handpieces
• Restorative procedures using high speed handpieces only provided with

the use of rubber dam

• Non-surgical extractions
• Hand scaling (no use of ultrasonic scalers)
• Medical management of soft tissue presentations (such as ulcers)
• Temporomandibular dysfunction management
• Denture procedures
• Preventative procedures such as the application of topical remineralising

agents : e.g. Fluoride

• Orthodontic treatment

LEVEL 2 RESTRICTIONS

Restricted Services, Defer Treatment

• High-speed handpieces without the use of rubber dam
• Ultrasonic scalers
• Surgical handpieces
• All surgical extractions should be referred to specialist oral surgeons/
• ral and maxillofacial surgeons who will undertake these procedures

using transmission based precautions.

• Elective implant dental treatment should be delayed.

Urgent dental treatment for people who DO meet epidemiological or clinical symptom criteria for COVID-19 risk or confirmed as a COVID-19 case, provided as per Australian Dental

• Association. Managing COVID-19 Guidelines.

LEVEL 3 RESTRICTIONS

Only dental treatments that do not generate aerosols, or where treatments generating aerosols is limited to:-

• Management of patients with acute dental pain e.g. endo treatment

under rubber dam or extraction

• Management of significantly damaged upper front teeth (e.g. due to

trauma, with restorative treatment provided under rubber dam

• Soft tissue pathology e.g. ulcers
• Management of complex medically compromised patients with dental

concerns which may compromise their systemic disease.

• Management of those at a higher risk of rapid progression of dental

disease due to socioeconomic or cultural factors

• Management of patients referred by medical practitioner for medically

necessary dental care.

LEVEL 3 RESTRICTIONS

Restricted Services, Defer Treatment

• Extractions of asymptomatic teeth without swelling
• Broken or chipped tooth/teeth
• Bleeding or sore gums
• Loose teeth without aspiration risk
• Denture concerns
• Crown and bridge
• Scale and clean
• Clicking/grating in the jaw joint

Urgent dental treatment for people who DO meet epidemiological or clinical symptom criteria for COVID-19 risk or confirmed as a COVID-19 case, provided as per Australian Dental

• Association. Managing COVID-19 Guidelines.

LEVEL 4 RESTRICTIONS

Only the following dental treatments can be managed:-

• Swelling of the face, neck or mouth
• Dental trauma causing change in the position of teeth, soft tissue

damage and/or significant pain

• Significant bleeding
• Difficulty opening the jaw and/ or swelling
• Referral from a specialist medical practitioner for assessment or

management of a patient receiving urgent medical care for medically necessary dental care

• Dental pain causing loss of sleep
• Ulcers persisting for 3+ weeks

No routine dental treatment provided. All patients with acute dental pain or concerns to be directed to emergency care centres. (Hospitals)

LEVEL 4 RESTRICTIONS

Defer all dental treatments for patients not fitting the risk categories identified above.

Urgent dental treatment for people who DO meet epidemiological or clinical symptom criteria for COVID-19 risk or confirmed as a COVID-19 case, provided as per ADA Managing COVID-19 Guidelines.

INFECTION CONTROL

03

What is infection

Policies and procedures that are put into place to help minimise the risk of spreading infections from:

• Patient to patient
• Patient to staff member
• Staff member to family-community

Control?

Personal protective equipment and Infection Control protocol

• Use gown, gloves ( mask and safety glasses if doing a

procedure that may generate aerosol)

• Hair must be tied back if below shoulder length
• No jewellery, watches to be worn except a wedding

band

• No nail polish or artificial nails
• Suitable enclosed footwear

5 MOMENTS OF HAND HYGIENE

+

Wash your r hands:-

• Before touching a patient
• Before clean/aseptic procedures
• After body fluid exposure/risk
• After touching a patient
• After contact with patient

surroundings

HAND HYGIENE

Hand hygiene is the most important step in preventing cross-contamination germ transfer 20-30 second hand wash

PERSONAL PROTECTIVE EQUIPMENT

Glove ves

• Non sterile gloves

are used for routine clinical procedures

• Sterile gloves are used for invasive/sterile

procedures

• Heavy duty gloves are used for cleaning

instruments and environment

PERSONAL PROTECTIVE EQUIPMENT

Masks ks

• Mask must be worn appropriately to cover nose

and mouth for all procedures where aerosols or splashing may occur

• Not to be touched by the hand whilst being worn
• Removed as soon as practical after soiling

Must not be worn around the neck

• Must be discarded at the end of the procedure
• Not to be worn outside the clinical area

PERSONAL PROTECTIVE EQUIPMENT

Gowns ns

• Plastic aprons or single-use disposable gowns are worn for

sub-gingival scale and root debridement or a procedure.

• Involving excessive splashing of blood/body fluids.
• All dental aveoli surgery, Endodontics and Periodontal

surgery must use sterile gowns.

• Use of appropriate personal protective equipment including

gloves, fluid impervious disposable gowns and fit-check P2 respirators must be used for all COVID-19 patients.

PERSONAL PROTECTIVE EQUIPMENT

Safet fety Glasses ses and Shield elds

• Must be worn for all procedures where aerosols
• r splashing may occur
• Must be fitted with side shields
• Must be cleaned between patients
• Prescription glasses should be fitted with clip
• n shields

Aseptic Technique

Aseptic technique is a framework of aseptic practice. It aims to prevent pathogenic organisms from being introduced to susceptible sites by:

• Hands
• Surface

aces

• Equipmen

pment

Terminology

• Sterile- Free from microorganisms
• Asepsis- Free from infection or infectious (pathogenic) material
• Clean- Free from dirt, marks or stains

1.

Key Part/Site Identification and Protection

2.

Hand/Hygiene

3.

Glove Use

4.

Aseptic Field

5.

Environment

6.

Sequencing

6 Core Components

Key Sites/ Parts Identification

• Key

y Site te-

Open n wound, und, tooth th sockets ts in plan anne ned d extra tracti tion

• ns.
• Key Part-

Parts ts of the procedur cedure and d equipme pment nt that t come into to direct t or indirect t contac tact t with h key sites s or other key parts ts eg eg: Instruments truments, , needle dles, s, force ceps, ps, retracto actors, , scalpe pels ls etc.

• Key Site

e and Key ey Part rt-

Identi ntifi ficati cation

• n- The best

t way to protec

• tect

t is not to touch h it. Only ly asepti ptic key parts ts can contact tact other key parts ts or key sites. .

If it is neces cessary ary to touch h key ey parts rts or key ey sites es directly ectly as a a critical al or surgica ical / procedure, edure, steril rile gloves loves are e used d to minim imis ise e the e risk of contamin aminat ation ion. Othe herwis rwise e non-sterile sterile glove

• ves are used

d in line ne with h standard dard prec ecaut aution ions. .

Gloves Use

Aseptic Fields

Provi

• vide

de a controlle trolled d aseptic ptic work rking ing space e - Th The aseptic ptic field ld needs eds to to fit the the purpo rpose se of

• f treatment

atment. Standa ndard rd Asepsis sis or Surgical ical Asepsis sis with th eithe her

• Gener

eral l Fields ds

• Critical

tical Fields ds

• Micro

ro Critic tical al Fields lds

Asept ptic ic Field ld- Promo motes Aseps psis is

• Non-ste

terile le glov

• ves.
• Main

n field eld is the brac acket ket table ble and the kimguar guard, , dental tal bib, , or laminar inar peel. el.

• Examina

minations, tions, restorations, torations, scale le & clean, an, endodo

• dont

ntic ics, s, fixe xed d & remova

• vable

ble prost sthod hodont

• ntics

ics, , orthod hodont

• ntics

ics, , periodont iodontics ics, , oral l medic icin ine, e, domicilia iciliary ry care. e.

Standard Asepsis

• Large

ge complex lex procedure cedures

• Long

g duration ation

• Best

t preforme formed d in dedicated icated opera ratin ing thea eatre tre

• Controlle

trolled d envir ironment

• nment
• Sterile

ile gloves

• ves and

d gown

• Sterile

ile drape apes s to cover er procedure cedure

• Key critic

tical al parts rts are e to be placed ced in the dedicated icated area ea on the procedure cedure trolle lley to protect tect agains inst t oper erativ ative e contamina taminates. tes.

Critical Aseptic Field

A small l area ea within hin gener eral l aseptic ptic field ld to isolate late key parts: ts:

• Space

e on bracke acket t table le

• Sterile

ile kidney dney dish

• Caps

s and cover ers

Micro Critical Aseptic Field

Health lthcare care work rker ers must ensur ure e there re are e no environ ironment ment risk k factors.

• tors. The more

e critical ical the proc

• cedur

edure is, the more e important

• rtant it is to control

trol the envi vironme ronment nt. Ex Examples mples:

• Ensure

re that at all l fans are e off

• Ensure

re Open en doors

• rs are

e closed ed

• Surgical

ical procedures cedures are in an enclos losed ed area ea

• Ensure

re people

• ple are not

t walki king ng around

• und in the area

ea

• Aerosols
• sols from
• m adjoi

joining ning rooms ms cant t come in

• Surgical

ical trolle lley is in a safe e area ea

• Caps

s and cover ers s are on corre rectly tly

Environment

Use a safe e logic ical al and d effic icie ient order der of events ents to comple lete te the procedure cedure. Example mples: 1. 1. Clean aning ing the e work k surface face area ea 2. 2. Hand d hygie iene ne before

• re gather

hering ing equipment uipment 3.

• 3. Placing

cing on PPE in partic ticula ular r order er 4.

• 4. Set equipme

uipment nt before fore commencing encing 5.

• 5. Dispos

posal al of used d equipme uipment nt approp ropri riately tely 6.

• 6. Remove
• ve sharps

rps when en no longer ger required quired

Sequencing

Sharps Management

Responsibi ponsibilit lity

The person son who uses s the sharp rp is respons ponsible ible for its remova

• val

l and disposal posal (NHMRC RC Infec ection tion Cont ntro rol l Guidel deline ines) s)

• Ne

Never er hand nd sharps rps to anot

• ther

her perso son

• Never

er leav ave e sharp rp sittin ing on the bracket cket table le

Sharps

What at are e sharps: arps:

• Needle

dles

• De

Dental tal Burs

• Endo
• Files
• Matri

rix bands ds

• Scalpe

pel l blade ade

• Instru

ruments ents

• Steel

l Crowns

• wns
• Orth

tho

• bands

ds and wire res

Classification

Handl ndling ing of sharps rps

• Hand

d or finger gers s must not be used d for retrac tracting. ting.

• Appropr

ropriate iate designa gnated ted instrument rument to be used d to avoid

• id a sharps

rps injury. ury.

Sh Sharp rps s co containe tainers rs

• Must

t be located ated close e to point nt of use.

• Must

t be secure re.

• Containers must be removed when ¾ full.
• Sealed

led immediately. diately.

• Remove
• ved

d from

• m the bay and placed

ced in designa ignated ted area ea.

Handling and Containers

After er Local cal Anaest aesthe hetic c is co comple pleted ed

• Needle

dle must be remov

• ved

ed using ng artery tery forceps ceps

• Must

t be dispos posed ed in a sharps rps container tainer once e the e LA is completed pleted

• Ensure

re needl edle e is fully ly within hin the sharps rps containe tainer

• Used

d needle dle must not remai ain on bracket cket table le

• Irriga

igation tion syringe inges s must be placed ced in endo

• sponges

nges

• Ne

Needles dles and syringes inges used d for irri rigat gatio ion n are dispos posed ed as one e unit t into

• sharps

rps contai ainer er

• Re

Re-sh shea eath thing ing any needl edle e is not permit mitted ted

Syringe/Needle Management

• Instru

ruments ents must be packe ked d carefully efully ensuri uring ng no items s are protruding

• truding

from m cassettes ettes

• Casset

sette te hinges nges must be aligne igned d and latch ches es secure red d prope

• perly

rly

• Damage

aged d cassettes ettes and instruments truments must be tagged ged and repor

• rted

ted to CSSD CSSD

• Instru

ruments ents must be free ee from blood

• od and debri

bris at all times es

• Instru

ruments ents must be plac aced ed neatly atly and spaced ced apart rt on the bracke acket t table le ensuri uring all the e items s are visual ual

Instrument Management

CREDITS: This presentation template was created by Slidesgo, including icons by Flaticon, and infographics & images by Freepik

Stay safe!

Do you have any questions?

• tc@dhsv.org.au

Business Development & Commercial Services