Infection Prevention and Safety 1 P A T I E N T S P O P U L A T I O N S P R O V I D E R S I N T E G R A T I N G I N F E C T I O N P R E V E N T I O N A N D S A F E T Y I N T O P U B L I C H E A L T H P O L I C Y A N D P R A C T I C E OSAP 2012
Presentation Created by: 2 Kathy Eklund, RDH MHP, The Forsyth Institute Therese Long, MBA CAE, Executive Director of OSAP Kathy Mangskau, RDH MPA, ASTDD Consultant Don Marianos, DDS MPH, ASTDD Consultant OSAP 2012
Infection Prevention and Control 3 State oral health programs have a shared responsibility for the safe delivery of oral health care. ASTDD is partnering with the Organization for Safety, Asepsis and Prevention (OSAP) to link states to technical assistance, educational materials, information on policy development and other resources on infection prevention and safety. http:/ / www.osap.org/ ?page=DentPH_IpAndSafety OSAP 2012
Background 4 Reports of actual and potential cross contamination in dental healthcare settings, including one involving a public health outreach program to deliver care to a population that has difficulty gaining access to the traditional dental care delivery system underscores the need for strong, integrated infection prevention and control policies and continued vigilance in administration and enforcement. OSAP 2012
ASTDD Response 5 ASTDD determined that it was necessary to: articulate infection prevention and safety efforts as part of already existing ASTDD programs and codify their importance as part of all state oral health program’s (SOHP’s) infrastructure and competencies ASTDD requested and received supplemental funding from the Centers for Disease Control and Prevention, Division of Oral Health to enhance infection safety and prevention efforts with SOHPs to complement the SOHP Infrastructure Enhancement Project. OSAP 2012
ASTDD Partnered with OSAP 6 ASTDD partnered with OSAP, the leading non- governmental organization focusing exclusively on infection prevention and safety for oral healthcare, to link SOHPs with other infection prevention and safety agencies and resources foster coordination of efforts with public/ private partners to manage emergency response requirements provide leadership in assuring the safety of oral health services for which the states have responsibility OSAP 2012
Core Team 7 The core team consisted of infection control experts and a consultant; and the advisory team included ASTDD staff and consultants, a CDC epidemiologist, a representative of a dental supply company, and webmasters of ASTDD and OSAP. The core and advisory teams developed a program work plan as well as an evaluation plan to assess short, intermediate and long term outcomes of the project. OSAP 2012
Purpose 8 To assess the status of infection control in state oral health programs and develop recommendations to integrate current resources and policies into ASTDD programs, projects and emergency response activities. OSAP 2012
Assessment of State Oral Health Plans 9 An initial review of state oral health plans revealed only four of the available plans mentioned infection control; however, data from other surveys (PEW, State Synopsis) indicated that 24 state programs provide direct preventive or restorative clinical services and 46 states collect Basic Screening Survey data. OSAP 2012
Assessment of State Oral Health Plans 10 In the summer of 2011, an ASTDD survey of SOHPs indicated 20 of the 30 states responding reported having programs that include direct patient care through screening, surveys, sealant and varnish programs and community clinics. Twelve of the states reported being involved in infection prevention and safety activities by providing training, conducting clinic inspections, handling complaints of disease transmission and assisting in the development of oral health infection control rules and protocols. Infection control challenges/ issues identified by state oral health program directors were varied, with the majority relating to mobile-portable programs OSAP 2012
Assessment of State Boards of Registration In Dentistry 11 A review of the 2011 edition of “Composite”, a publication of the American Association of Dental Boards, showed that all states address regulation of infection control as “Established Board regulation or official Board guidelines to control the spread of infection to patients in the dental office”. States communicated this regulation either by specifying compliance with CDC guidelines and OSHA regulations or by providing state-specific guidance. OSAP 2012
Assessment of State Boards of Registration In Dentistry 12 The publication also addressed infection control as part of continuing education (CE) requirements for licensing renewal. Twenty states specifically list infection control and/ or HIV/ HBV courses as required for at least one member of the dental team. Six states make infection control a requirement for dentists, hygienists and assistants (Arkansas, Maryland, Massachusetts, Minnesota, New Mexico and North Dakota) North Carolina requires that dentists and hygienists take a sterilization/ infection control exam. OSAP 2012
Assessment Of ASTDD Surveys, Guidelines, Policies and Competencies 13 To assess the current status of infection prevention and safety efforts in SOHPs and within ASTDD, the core and advisory teams looked at current ASTDD surveys, guidelines, policies and competencies and reviewed OSAP information for relevant applications. OSAP 2012
Assessment Of ASTDD Surveys, Guidelines, Policies and Competencies 14 The team reviewed the current ASTDD policy statements and issue briefs, the ASTDD webpage on infection control, the Safety Net Dental Clinic Manual, the Mobile-Portable Dental Clinic Manual and the Basic Screening Survey documents and identified gaps in infection control information Each document was scrutinized to determine if infection control information was included, if the content was adequate, and recommendations for additions/ changes were noted Images were reviewed for infection control accuracy A tickler file of infection control enhancement opportunities beyond the scope of this project was created for future referenc OSAP 2012
Recommendations 15 The review of ASTDD documents found that a number of issue briefs, strategy documents and the infection control area of the website needed to be updated to include current infection prevention and safety information. Recommendations were developed specific to each of the ASTDD documents reviewed. In order to assure continued integration of infection control information, the team concluded that an infection control review protocol should be included in the final review of all ASTDD documents and projects. OSAP 2012
Progress/ Dissem ination and Prom otion 16 General information about the ASTDD/ OSAP Infection Prevention and Safety Program was shared with members of the Associations through their newsletters. The findings of the documents review were shared with the ASTDD Board of Directors, committees and consultants to inform them of the recommended changes. OSAP 2012
Progress/ Dissem ination and Prom otion 17 The Policy Committee updated the policy statement review form to include the infection control review protocol and the ASTDD Board of Directors agreed to consider the need for infection prevention and safety information in future projects and contracts. OSAP 2012
Progress/ Dissem ination and Prom otion 18 ASTDD collaborated with OSAP to develop Guidance on Infection Control Considerations for Dental Services in Sites Using Portable Equipment or Mobile Vans to include a checklist and program assessment form. These documents were shared with ASTDD members via the listserv, at the annual meeting state sharing session, to attendees of the 2011 National Oral Health Conference and the AACDP meeting, and posted to the ASTDD website. http:/ / www.astdd.org/ infection-control-and-worker-safety/ http:/ / www.osap.org/ ?page=ChecklistPortable OSAP 2012
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ASTDD and OSAP Websites 20 Information to update the Infection Control area of the ASTDD website to include all the latest infection control guidelines was prepared, but as a result of HRSA funding cuts, the core team was concerned that there may not be adequate infrastructure in ASTDD to maintain the web page. The team determined it would be better to create a link to the OSAP website where the information could be maintained on a regular basis. OSAP 2012
ASTDD and OSAP Websites 21 In order to keep the ASTDD information current, OSAP provides a quarterly update to post on the ASTDD infection control page. http:/ / www.astdd.org/ http:/ / www.astdd.org/ infection-control-and- worker-safety/ The team also discussed the importance of having current infection control information available to all public health providers and as a result a public health portal was created on the OSAP website. http:/ / www.osap.org/ ?page=DentPH_IpAndSafety OSAP 2012
22 Sharing Project work products were shared with Oral Health Stakeholders… ADA, ADHA, NDA, HDA, ADAA, NNOHA and the ASTDD members, committees, consultants and to those companies that market products and equipment to portable and mobile oral healthcare programs. OSAP 2012
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