WellOne Primary Medical and Dental
Bloodborne Pathogens Standard
 The Bloodborne Pathogens Standard applies to all
employers with any employees who are exposed to
blood or other potentially infectious materials in the
office.
 Designed to protect health care workers from exposure
to bloodborne pathogens such as HIV, hepatitis B virus
(HBV) and hepatitis C (HCV).
 Bloodborne viruses may be found in human blood,
saliva and certain other bodily fluids that have become
infected.
Types of Occupational Exposure
 OSHA defines occupational exposure as, “reasonably
anticipated skin, eye, mucous membrane, or
parenteral contact with blood or other potentially
infectious materials that may result from the
performance of an employee’s duties.”
Types of Occupational Exposure
cont.
Occupational exposure to blood and saliva may occur in
several ways:
 Parenteral exposure (exposure occurring as a result of
piercing the skin barrier, e.g. needlestick or cut with a
sharp instrument.)
 Contact with mucous membranes, such as the eyes.
 Contact with skin.
 *Parenteral exposure poses a greater risk of infection
than does exposure through mucous membranes or
nonintact skin.
Sources of Occupational Exposure
 Needles
 Burs and suture needles
 Scalers and other dental
instruments
 Scalpel blades
 Air-water syringe
 Saliva ejector
 High-speed evacuator
 Surfaces of water lines
 Radiographs
 Chairbacks
 Countertops
 Drawer handles
 Light and equipment switches
 Disposables used in patient care
Standard Precautions
 Standard precautions is an approach to infection
control in which all human blood and certain body
fluids (saliva in dental procedures) from all patients
are treated as if they were infectious for HIV, HBV and
other bloodborne pathogens.
 Application of standard precautions reduces the risk of
transmission of bloodborne pathogens.
 Frequent hand washing, proper handling and disposal
of contaminated needles, and the use of gloves and
other personal protective equipment greatly reduces
risk of transmission.
Handling Contaminated Needles
and Other Sharps
 According to the Bloodborne Pathogens Standard,
contaminated sharps include any object exposed to
blood or saliva that can penetrate the skin including
needles, scalpels, broken glass, broken capillary tubes
and exposed ends of dental wires.
Handle Contaminated Sharps as
Follows:
 Contaminated needles and other sharps must not be bent,
recapped or removed by hand.
 Shearing or breaking of contaminated sharps is never
permitted.
 Recapping/removal may be permitted for the procedures
listed below if there is no other alternative or
recapping/removal is required by the specific dental
procedure (e.g. administering multiple doses of an
anesthetic to the same patient.)
 In cases where recapping/removal of contaminated sharps
is permitted, employees must use a mechanical device or
one-handed technique.
One-Handed Recapping Technique
(Video)
http://www.youtube.com/watch?feature=player_detailp
age&v=JLxvnmz5zhA
Sharps Injury Prevention
 About half of all percutaneous injuries are
preventable.
 Properly following workplace controls is the most
important way to prevent these incidents from
occurring.
 In the dental department we are exposed to many
different kinds of sharps and must always practice safe
workplace controls to protect ourselves and others.
 Some of the sharps that we encounter are
contaminated burs, patient anesthetic syringes,
scalpels and suture needles.
Contaminated Burs
 They are a part of every procedure where a dental
handpiece is used.
 While the operator is using the bur it is important to only
retract the patient’s mucosa using an acceptable retraction
tool. (i.e. Mirror, suction tip, Minnesota retractor)
 Once the procedure is finished and the handpieces are no
longer needed, the operator must carefully remove the
contaminated burs and place in the disposable medicine
cup on the doctor’s bracket tray. This makes carrying the
burs into the sterilization area a safe practice.
Patient Anesthetic Syringe
 It is important that caution is always taken when handling a
contaminated patient anesthetic syringe. Whether you are the
operator or the assistant, full attention must be paid to the task at
hand.
 As the operator, only retract the patient’s mucosa with an acceptable
retraction tool. (I.e. Mirror, suction tip, Minnesota retractor) Use a
mechanical device or the one-handed scoop technique when recapping
the needle.
 When disassembling a patient syringe, only start to disassemble the
syringe while you are directly in front of the sharps container. Do not
bend the needle when you are disassembling the syringe, this is not a
safe practice. It is essential that while performing this task full
attention is being paid. Do not rush, this is how accidents happen.
 If the syringe hub comes loose while you are trying to remove the
needle, dispose the entire syringe into the sharps container. * Your
safety comes first and the syringe can be replaced!
Scalpels
 Never pass a contaminated scalpel between operator
and assistant.
 While using a scalpel only retract the patient’s mucosa
using an acceptable retraction tool. (i.e. Mirror,
suction tip, Minnesota retractor)
 Place the contaminated scalpel carefully on the
bracket tray.
 When disposing of a contaminated scalpel, take
extreme caution.
Suture Needles
 Never pass a contaminated suture needle between operator
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and assistant.
While using a suture needle, only retract the Patient’s
mucosa while using and acceptable retraction tool. (i.e.
Mirror, suction tip, Minnesota retractor)
Place the contaminated suture needle carefully on the
bracket tray.
When disposing of a suture needle, while using cotton
pliers, carefully place the suture needle into a disposable
cup.
Carry the cup to the sharps container and carefully dispose
the suture needle into the sharps container.
Sharps Safety
 There are many other sharp instruments that we are
exposed to in the dental department. All loose
instruments should be placed in an instrument basket
before being placed in the ultrasonic cleaner.
 Utility gloves should be worn while transferring
contaminated instruments in and out of the ultrasonic
cleaner.
 We are all responsible for continuing to make
improvements to keep our dental department injury free
and a safe working atmosphere. If you observe a work
practice that is not safe, it is your responsibility to report it
to the Dental Office Manager. We then can take a focused
look at the observation and improvements can be made to
prevent injuries from occurring.
Sharps Disposal
 Immediately after use
contaminated reusable
sharps (such as scaler or
explorer) must be placed
in appropriate containers
until they are processed.
 Containers must be
puncture resistant, marked
with biohazard label or
colored red, leak proof and
designed so that employees
do not need to reach by
hand into the containers.
If a Needle Stick Should Occur…
 Immediately wash the area thoroughly with soap and
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water.
Report incident to Dental Office Manager and notify Cathy
Haringa (ext 197) so that she can notify Beacon Insurance
to file a claim (must be done within 24 hours of injury.)
Report incident to Wellness Coordinator.
Following a report of an exposure incident, a confidential
medical evaluation and follow-up will be available to the
employee at no cost to the employee.
All exposure incidents will be reported to WellOne’s
Worker’s Compensation Insurance Carrier.
Medical records will be kept in accordance with OSHA,
HIPPA, and Rhode Island Rules and Regulations.
For More Information:
 Please consult the
WellOne Exposure
Control Policy and
Procedure Manual
located on your
computer desk top.
 Visit
http://www.osha.gov/SL
TC/bloodbornepathogen
s/index.html
Resources
 ISIPS | ISIPS | International Sharps Injury Prevention
Society. (n.d.). ISIPS | ISIPS | International Sharps Injury
Prevention Society. Retrieved November 9, 2012, from
http://www.isips.org/
 OSHA training for dental professionals. (2007). Chicago,
Ill.: American Dental Association.
 Safety and Health Topics | Bloodborne Pathogens and
Needlestick Prevention. (n.d.). Occupational Safety and
Health Administration - Home. Retrieved November 9,
2012, from
http://www.osha.gov/SLTC/bloodbornepathogens/index.h
tml
You have reached the end of this
program…
Once you are confident that you are comfortable
with all the materials presented, proceed to the
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