Eastern Shore Mission of Mercy 2015
Infection Control and Sterilization Plan
Mission of Mercy adheres to the Centers for Disease Control and Prevention’s (CDC) Guidelines
for Infection Control. This document is based on information from OSAP’s Guiding Principles of
Infection Control for Dental Settings Using Mobile Vans or Portable Dental Equipment.
Hepatitis Vaccine for Volunteers
All volunteers who work in patient care, instrument sterilization and waste management must
be vaccinated against Hepatitis B.
Hand Hygiene
Hand hygiene is the single most important way to reduce the risk of disease transmission.
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Alcohol based hand sanitizer will be available at every station.
WASH HANDS with antimicrobial soap and water if hands are visibly dirty or
contaminated. Sinks and soap are located in the sterilization area.
Use hand sanitizer or wash hands
o Before donning gloves and after removing gloves
o Before leaving the treatment or sterilization area
o After handling objects that may be contaminated
o Before eating and after using the restroom
Personal Protective Equipment (PPE)
Personal protective equipment is provided for all clinical volunteers except for eyewear.
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PPE includes exam gloves, heavy duty utility gloves, masks and disposable gown.
Volunteers must bring their own protective eyewear (and loupes if desired).
Wear fresh gloves with each new patient and sooner if gloves become compromised.
Disinfect eyewear and reusable utility gloves when visibly contaminated. Disposable
gloves should be discarded and never disinfected.
Disposable gowns should be discarded when visibly soiled and should not be worn off
the clinic floor.
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Environmental Surfaces: Clinical Contact Surfaces
Clinical contact surfaces become contaminated by dirty instruments, devices, hands and gloves.
These surfaces include light handles, chair, headrest, instrument tray, curing light and other
surfaces touched during treatment.
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Tables will be covered with plastic. Limit the number of items set on table.
Disinfect all clinical contact surfaces after treating patient and at the end of the day.
Autoclaves will be loaded by volunteers working on the contaminated side of the
sterilization area. Doors will be disinfected after loading and starting sterilization cycle.
At the completion of the autoclave sterilization cycle, autoclaves will be unloaded by
volunteers working on the clean side of the sterilization area.
Tuberculocidal disinfectant will be located next to all stations and in the sterilization
area.
Follow manufacturer’s directions for cleaning and contact kill time of disinfectants used.
Housekeeping
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Waste will be separated into bio-hazardous and regular trash. To avoid increased waste
disposal costs, it is important not to put regular trash into the red bags.
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Red bag containers for bio-hazardous waste will be located in the clinical areas, in the
sterilization area, at the exit doors of the clinic floor and in patient bathrooms.
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Regular trash containers will be located at various points throughout the Civic Center.
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Designated individuals will empty these containers as needed.
Safe Handling of Sharp instruments and devices
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Handle sharps with care. Treat every patient as though they are infectious.
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Use the one handed “scoop” technique to re-cap the needle or a recapping device.
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All sharps must be disengaged at the chair and placed into the sharps container before
transporting dirty instruments to the sterilization area or transport cart.
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A transport cart for dirty instruments will be located at the end of each treatment area.
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Sharps containers will be between every 4 chairs and in the sterilization area.
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Sharps include suture needles, unusable burs, syringe needles, anesthetic carpules and
scalpel blades. Extracted teeth without amalgam can be put in red bag trash containers.
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Pass instruments with care and announce instrument passes so the person knows a
sharp instrument is coming into his/her work space.
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Use instruments instead of fingers to retract tissues during suturing and anesthetic
injections.
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Designated volunteers will remove sharps container when ¾ full for disposal.
Instrument Management
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Return all instrument set ups to their cassettes and close cassette securely.
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Place loose single instruments in plastic biohazard box and close lid securely.
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Transport dirty instruments to the sterilization area or transport cart wearing gloves.
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If volunteer returns sharps to sterilization area, please advise NOT to do so in the future.
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Plastic biohazard boxes will be disinfected and returned to clean supply area.
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Bins for clean storage of sterile instruments will be cleaned and disinfected prior to use.
Ultrasonic Cleaners
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NOTE: Sterilization techs must wear utility gloves to reduce risk of injury.
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No hand scrubbing is recommended. If necessary, use a long handled brush.
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Sterilization techs will wear heavy duty utility gloves for processing instruments. These
gloves are reusable and must be disinfected, as indicated above.
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Fill ultrasonic unit with water to fill line adding enzymatic cleaner according to
manufacturer’s directions.
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Load instruments into the basket.
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Do not place instruments into the ultrasonic cleaner without a basket as this can cause
damage to the transducer of the unit.
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Do not place Cavitron tips or hand pieces into the ultrasonic cleaner. Wipe with
disinfectant to remove debris.
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Operate the unit for 15 minutes with the lid on.
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Lift basket out of ultrasonic and rinse instruments in sink.
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Dump rinsed instruments from ultrasonic basket onto clean absorbent toweling.
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Do not reach into basket with hands. Use forceps if needed to retrieve instruments.
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Remove excess moisture with several thicknesses of towels. Bag instruments/cassettes
for sterilization. Use permanent marker to label pouches with autoclave identification in
case tracking of instruments is necessary.
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Dentists may bring their own instruments, but must supply labeled pouches.
Burs
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Contaminated reusable burs are placed in mesh bur holder for ultrasonic cleaning.
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Rinse, package and heat sterilize.
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Check burs and when in doubt of further use, dispose of burs in sharps container.
Handpieces
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Flush high speed handpiece chairside.
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Remove the bur chairside.
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Wipe handpiece with disinfectant to remove debris.
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Disconnect handpiece and transport to sterilization area or transport cart.
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Sterilization techs will attach handpiece cleaner/lubricant spray and flush debris from
the handpiece, then use Midwest Air-station to remove excess cleaner/lubricant.
Autoclaves/Sterilization
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All autoclaves will be spore tested to ensure the sterilization process and documented
on ESMOM Autoclave Log.
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Spore test ampules will be run through a sterilization cycle in each autoclave and
incubated with a control in a block incubator to assure sterilization.
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Use distilled water only in the autoclaves. Check /refill periodically.
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Processing of instruments will proceed from decontamination to sterilization to clean
area keeping dirty separated from clean at all times.
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Place absorbent pads under autoclaves and on tables where needed.
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Volunteers on the contaminated side will load trays in single layers for the autoclave
and mark each pouch with identifier for autoclave. Once the door is shut and secured,
they will start the autoclave and decontaminate the front, especially the handles.
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Run all loads on the “handpiece” cycle.
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After cycle is complete and air drying, volunteers on the clean side of the sterilization
area will wear clean gloves to remove instruments to clean storage tubs.
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All volunteers must use hand sanitizer prior to picking up sterile instruments and clean
supplies.
Evacuation lines
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DO NOT ALLOW patient to close and form a tight seal around the saliva ejector or HVAC
tip to prevent backflow.
After each patient, flush the lines with a peroxide solution. Obtain a Dixie cup with 3 oz.
of solution from a 5 gallon cooler located adjacent to each treatment area. The solution
is made by adding 8 oz. of 3% peroxide to a 5 gallon bucket of tap water.
Water Quality
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Self- contained 20 gal water tanks will supply water to the event.
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Surgical extraction sites will be irrigated with syringe of sterile or saline water if needed.
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Distilled water will be located in the sterilization area.
Management of Occupational Exposures
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In the event of an exposure to blood or other potentially infectious material, this is a
medical emergency.
o Cleanse wound or affected area with soap and water immediately.
o Flush eyes or mucous membranes with water for 15 minutes.
o Report the event immediately to your area lead and the Medical Lead.
o See protocol for blood and body fluid exposures.
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MSDS sheets for all chemicals used during the event will be available in the sterilization
and First Aid areas.
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In the event of a chemical splash or exposure to skin or mucous membranes:
o Rinse exposed areas thoroughly with water for 15 minutes.
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o Flush eyes or mucous membranes with water for 15 minutes.
o Report the event immediately to your area lead and the Medical Lead.
o Consult MSDS for additional treatment for exposures.
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Eye Wash station is located in the rear of the Civic Center and sinks with running water
are located throughout.
Spills of Blood and Body Substances
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Wear all personal protective equipment and isolate the area
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Notify your area lead.
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Obtain a spill kit from the sterilization area, first aid area or central supply.
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Collect waste and dispose in bio-hazardous waste.
Amalgam Recycling
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An amalgam filter on vacuum pump will collect amalgam waste and be sent to Solmetex
for proper disposal at the end of the event by ADCF.
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Scrap/contact amalgam, amalgam capsules and extracted teeth containing amalgam will
be placed in labeled containers on tables adjacent to restorative and oral surgery chairs.
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Amalgam in containers will be recycled at the end of the event by Dental Recycling of
North America, a dental recycling company.
Radiography
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Barriers will be used on sensors for infection control.
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X-ray equipment will be disinfected between patients.
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Shielding will be used on all patients.
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