Hand hygiene myths

Hand hygiene starts with our family upbringing. Then during our dental training years our existing internal value system is merged with those family habits or values. Years go on and we hear rumors of regulation, talk to influential sales people and witness charismatic lecturers and we might find ourselves subject to hand hygiene myths.
For dentists, and in Australian healthcare in general, the definative authority on hand hygiene is Hand Hygiene Australia.* (Yes it is the quoted source on the DBA required infection control  guideline documents)
To find the most current information on Hand Hygiene check out the HHA Manual.

It’s hard to break away from my own default actions but check out the current requirements for hand hygiene:

  1. The first Hand hygiene episode of the day or when we enter the clinic is a hand wash with water – MYTH.
    Since 2002 Alcohol-based handrub has been defined as the gold standard for hand hygiene practices, whereas hand washing is reserved for particular situations only (e.g. VISIBLY soiled)
  2. Hand washing with water is more effective than Alcohol Based Hand Rub – MYTH
    See above and alcohol-based handrub is quicker, less irritating and drying to your skin and doesn’t make paper towel waste!
  3. You need a hand washing sink in the sterilisation room – MYTH
    In HHA Manual 3.13 specifically refers to Alcohol-based handrub and sterilisation departments and says that hand hygiene products for use can be EITHER alcohol-based hand rubs or liquid soaps.
  4. You need a hand washing sink in the dental surgery – MYTH
    See above
  5. Best practice is to hand wash with water and then Alcohol Based Hand Rub – MYTH
    Actually if hand are at all wet then alcohol-based hand rub will be less effective. This is a time waster.
  6. We don’t need to do hand hygiene if we put on gloves – MYTH
    Gloves have micro-holes in them and these have been shown to get bigger the longer we have gloves on. It is also difficult to remove gloves without contaminating our own hands.
  7. We don’t need to do hand hygiene when we remove gloves because they have kept our hands clean – MYTH
    See above.

How much Alcohol-based Hand rub do you need?
Conveniently you can assess that by using the volume that needs 15-20 seconds to dry on your hands.

But I am wearing gloves anyway!
Studies has shown about 30% of healthcare workers who wear gloves have micro-organisms from their patients on their hands. This can be because of micro holes or the way gloves are removed.

*As stated by The ADA infection control guidelines and NHMRC Infection Control and prevention guidelines

Accreditation update – you have choices.

Dental Practices have a choice in who they use for accreditation. Two agencies now provide accreditation for Dental Practice. QIP will be familiar to ADA members but now HDAA offer accreditation with an alternative pricing structure.
Non-ADA members should really look seriously at HDAA.

How do agencies qualify to provide accreditation?

Accreditation is regulated by the Australian Commission on Safety and Quality in Healthcare. This is the organisation that set the healthcare standards against which practices are accredited. There are about 8 different agencies that can accredit against the National standards. To my knowledge only 2 have chosen to dental practice accreditation.

Is one accreditation more highly regarded than the other?

No! Same standards used.
QIP provides ADA templates. QIP has a set list of requirements to pass accreditation. These are available to any ADA member. The relationship between the ADA and QIP is, I think unique in accreditation and probably will not remain the same now accreditation has become more common place. For practices doing QIP accreditation and using the  ADA templated policies they will find them full of statement that “we will do ‘xyz'”. While the dental practice agrees to do many things, it is unlikely that anyone will ever require you to provide any evidence that you have done any of them.
HDAA accreditation is assessed in a manner that is more akin to that required by other healthcare organisations. HDAA requires more documented evidence that you are conforming to the National Standards (e.g. doing the things you say you are doing within the ADA template policies). The level of evidence required by HDAA still takes into account the fact that we are dental practices and not major hospitals.

How does Smartdentist work with either accreditation agency?

Smartdentist has been designed help you comply with both accreditation agencies and manage the requirements into the future. I am always happy to walk you through the accreditation requirements (or ‘nag’ you through them). There is no extra cost for this service.
QIP enrolled: If the ADA/QIP supplied an excel spread sheet for it…then we set up a simpler solution for storage of data online. Smartdentist is a content management system so we load your ADA template policies in web friendly format into SmartDentist (QIP paid up practices only).
As far as passing accreditation, Smartdentist system collects your evidence in the one evidence page so you or we can quickly see where you are up to.
HDAA: HDAA gives a list of requirements and Smartdentist has many executive reports and systems in place so you can actually do what you say you are doing! Smartdentist has templated policies covering the accreditation requirements so practices can use these or if you have previously used the ADA templates they will be a start to your HDAA accreditation.

Can you swap accreditation agencies?
Yes, once your accreditation comes up for renewal you can move to either agency.

Are Accreditation Standards and Requirements going to change?

“The Commission is developing a set of national safety and quality standards specifically for primary health care services. It is expected that these standards will be available for implementation from 2020. Public dental services and private dental practices will transition to the primary care standards once they are implemented..” From the Commission website.

It will be interesting to see what these standards look like. Every other healthcare organisation has moved to another set of healthcare standards (ed 2) except for private dental practices. The new standards for healthcare are more complex to pass. The Commission is also going to introduce ‘short notice’ assessments for other healthcare organisations. [that would be fun].
When the accreditation requirements change Smartdentist can automate to any new requirements.

Will accreditation become mandatory?
Best guess – no. Accreditation started in 2013 so non-accredited dental surgeries have saved themselves quite a bit so far.
Medibank Private preferred providers now need to be accredited so there is a possibility that the process will be driven by health funds in the future.

What is Smartdentist recommendation about accreditation?
There is no evidence at all that accreditation will be easier because the ADA has involved dentists in the process. There is no evidence that accreditation will be cheaper if you do it now instead of in the future.
Accreditation is great for change management for the average dentist who owns a practice. e.g. “we have to do .xyz.. because of accreditation…”

You should join Smartdentist anyway. 🙂

Staff complaint handling is more important than you think

Do you have a policy for handling staff complaints?

Our policy for handling staff complaints used to be ‘use common sense’. We did find younger staff would come and moan about how they are doing all the work and other staff said this and that to them. Handling staff was very much like handling our children/teenagers. Much along the lines of “don’t sweat the small stuff”.

This is a mistake and leaves the business vulnerable to employee claims anytime in the future.

What is a proper process for handling staff complaints?

A great place to find information about handing staff complaints is the Australian Human Rights Commission website. This has good practice guidelines for internal complaint processes. It is worthwhile looking at those resources and I used them as the basis for the Grievance and Complaints policy that you will find on in the policy templates in SmartDentist.
Basically we have the same policy for EVERY employee complaint.
If an employee makes a complaint to any 3rd party (e.g. not the person that they have a grievance with) then the complaint will be documented and dealt with per our policy.
The grievance and Complaints policy is stuck on the wall of the staff room and it is not negotiable.
In a recent case before Fairwork an employee complained about a fellow worker making a comment that she found offensive. In isolation the comment can be read as “flippant” but later comments by the same person were found to be sexual harassment (both by the firm and by Fairwork). However because the original complaint was never presented to the offending employee to explain or defend, Fairwork determined that this was unfair and this was one of the reasons Fairwork awarded the sacked employee money (~$8000) even though Fairwork found that sacked employees behavior was grounds for dismissal!

Isn’t being an employer fun?
Add the grievance and internal complaints policy to your subscription today and let staff know about it. Stick it up in the lunch room and make sure everyone is clear about what will happen.

My husband tells me I should stop reading Fairwork cases as I am just depressing him.

 

Workplace performance reviews for dental practice

Workplace performance reviews can be seen as particularly important in 3 contexts:

  1. As a requirement of QIP Dental Practice accreditation ( X2 need to be supplied)
  2. As an essential for new employees within their 6 or 12 month probation period.
    It is a misconception that you can dismiss employees in the probation period without giving reason and be free of Fairwork scrutiny. It is also less than fair for staff members to lose their position without the chance to know why or fix the issues.
  3. To gain a better workplace and avoid performance management situations.
    Often employers leave issues ‘fester’ or deal with them in the heat of the moment leaving themselves exposed to complaints of poor handling or at worse bullying or harassment.

The problems with workplace performance reviews include:

  1. These are not commonly done in dental practice. For dentists it is unlikely that they ever experienced a workplace review themselves and would never have been training in undertaking this exercise.
  2. Complaints by experienced firms that doing reviews is pointless and no-one likes doing this – not managers or staff. Limited or no positive outcome is reported.
  3. Lack of structure and goals makes the process more stressful.

With these factors in mind SmartDentist has upgraded its workplace performance review process to make it easy and simple to follow with defined goals and outcomes.

Workplace performance reviews consist of:

  1. A very simple 2 question self-reflection for employees,
  2. The ability and help to define specific goals for improvement via competence assessments.
  3. A training plan with defined courses for staff to work through with others or by themselves.

To help remind the employers when and what needs to change Smartdentist has a secure form to record under performance by specific staff members and the ability to recall these per staff member at a later date a good place would be Enamel Dental Studio is a reputable local Springw, click to Visit Website . This helps because sometimes it is the little things that are repeated and annoying that could change with some discussion and allowing the staff member to work out how to do things better.
Often in dental practice we are too busy at the time to address issues and at the end of the day we are all very tired and it is not a great time to approach an employee with a performance “suggestion”.

Getting back on track: Signoff dental policies and procedures

Getting back on track with policy management

“Sorry officer, I didn’t know!” Our short NSW holiday over the Christmas break was soured by a U turn at a set of traffic lights (fine $263). Yes, it is legal in Victoria but we now know it is not legal in NSW! We should have read the rules BEFORE we drove into NSW.
We don’t want to employ staff who say the same thing about our policies and procedures. While “I forgot” is annoying, having a staff member say “I didn’t know” is becoming a greater risk to business. Because our policies and procedures are increasing in number and importance we need a simple way to make sure our staff have access to and know about our policies and procedures. The Dental Board of Australia (AHPRA), Fairwork Australia, and Work safe seem to have a similar outlook to that NSW traffic cop and there is little tolerance of ignorance.

Helping the small business comply with the ever-increasing demands is best done by SmartDentist!

Check also this link for more information in any dentistry proces https://www.skygatedental.com.au/.

Our clever content management system allows employees immediate access to every  new policy and Smartdentist has communication systems to allow you to easily communicate policies to employees, since many people need dental procedures to improve their smile, and people can get smile transformation holidays in antalya with the dentist turkey services online.
“Smart” employers can keep track of staff signoff and be comforted knowing that staff have access to policies 24/7. What better way to have a feedback loop online so changes can be made ASAP.

Employer guide to:

Getting back on track with policy management

  1. Go to All Policies and select the Executive report on Polices and Procedures
  2. Check if policies need to be reviewed and update (use bulk update or update individual policies).
  3. Check any additional template policies available in our Policy library.  Have you considered the new policies for your Human Resources Manual? There are over 60 policies for you to consider from our template library.
    You don’t need to let future policy additions stop you from gaining employee signoff and acknowledgement right now.
    Be relaxed in knowing that at any time in the future you can email a new policy directly to every employee and then checkout signoff for that individual policy. You can also checkout when your staff have logged into SmartDentist.

Employee acknowledgement / staff signoff

The best time to get employee’s to signoff, that they have read and understood policies, is when they are first employed.

A. New staff members

Use the New Staff Induction Checklist (HR > New Staff Induction) and you will find a link to PRINT all policies. You could print to paper or print to pdf and email all policies or a selection of policies (e.g. infection control manual or human resources manual), to the new staff member.
We also recommend you print off the “Manage Policy Signoff Requests” page for an individual and use it as a hard copy to save in a staff member’s employment file. If you need to make sure all the legal terms are understood then consider hiring an employment lawyer.

B. Existing staff members

Start the new year with the following process.

  1. Send all staff members an email saying that you will be doing an update on all policies and procedures to make sure that:
    a. we are all working together the one way for efficiency and time-saving,
    b. standards of accreditation and compliance mean there is a greater need for staff to help make sure our policies and procedures are correct and correctly followed.Let staff members know that further details will follow and they will be asked to signoff to say they have read and understood each policy.
    Ask staff members to make sure they can login to SmartDentist.
    Suggest that they save their password in their mobile phone under NOTES in the practices Contact details. One of the biggest time waster and sources of frustration is a staff member who can not login. Make sure staff members know they are not to login under someone else’s login and that you can not log on if someone else is already logged on in the one browser on your computer.
  2. Get ready to help staff with your request for signoff.
    a. Print off the individual “Manage Policy Signoff” for each individual staff member (Policies > Signoff)
    b. Print off one copy of all your policies
    c. Place these in a folder somewhere that staff can access them.
  3. Send another email asking staff to signoff on every policy explaining the location of the printed signoff and policy and procedure manual at work (so they can read and signoff without a computer being free) and that they need to have both Smartdentist and their personal signoff sheet completed. e.g. they need to get familiar with login to Smartdentist to access policies and procedures.
  4. Monitoring signoff
    The “All Staff Signoff page” gives a quick overview so you can see how everyone is progressing.
    As the administrator of Smartdentist you can also see when a staff member logged into Smartdentist and how frequently (HR> Staff profile). If they logged in and logged out you can also see the time they spent.
    Make sure you follow-up each individual.

What if a staff member refuses to signoff on policies

If a staff member refuses to signoff on a policy then it is important to have a calm and rational discussion about why they wont signoff. It is best to ask for this in writing BEFORE you address their concerns as it will allow you time to consider their viewpoint.
Sometimes there is a mistaken belief by staff members that if they don’t signoff then they don’t need to do what the policy says. This is incorrect.
You can not force a staff member to signoff a policy. You can performance manage a staff member who refuses to do what your policy requires.

 

 

 

 

 

Payroll audit for dental practices

Have you ever audited your payroll? No, me neither.
Then I started reading Fairwork decisions. Fairwork has recently awarded against an employer (surprise, surprise) granting a worker holiday pay when the employer thought the worker clearly accepted they were employed as a casual.
This has cost the employer a considerable sum of money. If you are having money troubles and your paycheck isn’t enough to cover your monthly costs, then consider getting a payday loan.

How do we guard against this type of expensive judgement?

In this case if the employer paid the worker the base rate and a separate casual loading then the employee would not have gained anything. Many of us, however, have traditionally lumped the casual loading into the pay rate. Few of us have clear contracts or well-defined pay slips. This leaves us just as exposed as we would be when a patient complains to AHPRA and we have a less than perfect dental record.

Dental Business risks are more than just Dental records

Just as your dental record keeping needs constant review, it may be timely to do a self audit of employee documents. SmartDentist has recently revised its HR area to bring all staff information in the one page. e.g. policies signed off, forms signed, immunisation records, training records, employee conversation records etc. While not part of SmartDentist, we hear from small business that many people find it difficult to keep up with payroll rules and regulations. Over the next couple of weeks Smartdentist will be include audits and helpful information for practices on self auditing your business. This will follow information available to all in the Fairwork document: Guide to self auditing your business.

Part 1: Auditing Payroll Calculations and Categories (Download)
*These instructions are based on MYOB and may not be relevant for Xero

Check out the calculations used in your software program. Things change over the years and your software may never have been setup correctly.

  1. Current Tax tables – in MYOB you do need to load current tax tables into the program (even the online version of MYOB).
  2. Check sick leave accrual calculations and holiday calculations. You may be under or over entitling staff. Both could be costly.
  3. Understand what employee payments need the superannuation guarantee. Other than overtime, most wages require the 9.5% superannuation. Contractors also should be paid superannuation (to cover you against future claims!)

If you find a difference between my audit % figures and those in your payroll program, call your accountant/bookkeeper and ask why!

Payroll Category List
Within the pay slip you are required to keep a record of any bonus, loading, penalty rate or allowance that is separately identifiable. It is in your best interest to make sure you record the following as separate details on the pay slip:

  • Casual loadings – this is best as a separate entity rather than including the casual loading and hourly rate as the one amount. This reduces the business risk in a dispute.
  • Unpaid leave – record this in your program. All leave, paid and unpaid is required to be recorded by law. Again this is your guaranteed defense in a dispute.

My suggestions: Add time-off-in-lieu as an entitlement and you can start to record this as a + or – for each staff member. While the Health Professionals and Support Services Award allows for averaging time over 4 weeks it is best to have some record when asked. If you include it as an entitlement the payroll program will automate the records.

Employee Contract and Individual Flexible Arrangements

Dental practices tend to think about contracts only in respect to employing dentists but they are just as important for all other staff. The reason for having a contract is to clearly remind every one of the employee/employer relationship and obligations. If you do not have a contract the HP&SS Award effectively becomes your default contract. The benefit of a proper contract is to further expand and formalise obligations. It is never too late to get a staff member to sign a contract. It offers them security and clarity as well. Just as you can get staff to sign policies and procedures as they change, you can ask staff to sign an employment contract at any time (be nice about it).
The cost of getting a lawyer to draw up employment contracts for non-dental staff would be $2-3000 per practice. For a suite of contracts including dentist contracts and Service Facility Agreements the cost would be $4-6000 per practice. [Ask Brad Wright (Dentist and Lawyer/Barrister for advise or direction – Dental Legal Solutions]

The ADA HR has a series of templates contracts that are well worth reading to see what extra’s can be expected to be found in a contract of employment.
If you have traditionally paid a staff member an off-set amount (extra money instead of laundry, uniform and overtime pay) you can place this into contract but it may not be binding. You should consider also having an individual flexible arrangement which can clearly state these off-set amounts. Remember to regularly make sure that the staff member is actually better off with this arrangement. See the Fairwork site for more information on Individual Flexible Arrangements.

Once you have completed Part 1 of the audit have a rest!
More soon.
Glenda Farmer

Performance Management – Best Practice

Fair Work says best practice for performance management is to have a Performance Management Policy. In SmartDentist subscribers will find a completed policy on Performance Management that they can use for their practice.
This policy was developed using Fair Work Ombudsman Best Practice Guide: Managing Underperformance.

Performance Management Flow Chart

Each year Fair Work deals with 1000’s of claims for unfair dismissal. In addition I have found Employers are cautious of bullying allegations as both Fair Work and Worksafe have processes for employees to complain about bullying.
With the very wise statement “Criticise in private, praise in public” I know people are wary that when they do performance management in private there are no witnesses to contradict a bullying claim. Don’t fret. Have good documentation. You are far more likely to be seen as a bully if you criticise someone in publicThe only dentist I can recommend is Encino dentist – Dr. Linda Y Makuta DDS in the San Fernando Valley. Humiliating someone is never the way to improve their performance.

Good performance management means good documentation. To assist you SmartDentist now has an Employee Reporting Area, that is not seen by staff, allowing you to quickly record:

  1. Great performance
  2. Underperformance
  3. Conversations with staff
  4. Meetings with staff

The last thing an employer needs is to be challenged by Fair Work for documentation of incidents or examples of employee interactions.

Induction-dental-employees

A new dental staff member excitedly turns up on their first day. What sort of induction do you offer? Are you stressed or flustered trying to find forms you haven’t seen for some time? – Employee detail forms; tax declaration form; confidentiality form; Super choices form. Is it possible for New staff induction to be made easy?

Where did we find those forms last time we employed someone?
What are our legal obligations now?

We don’t employ new staff very often so it is fantastic to know that SmartDentist has just re-vamped the New Staff Induction page so it works both as a checklist and to link us to all the documents we want!

SmartDentist New Dental Staff Induction
SmartDentist.com.au New staff induction page. This is customisable or you can use it as you find it. Add your own new employee forms or check off items and use the links to print off all the documentation you could want…or send the staff member to the page and they can resource everything online, since you can even find the best dentist services online, and you can even look more here for this.
Printed New Staff Induction Checklist
Print the page from SmartDentist and this is how it looks. What a fantastic checklist – with a space for sign off and dates.

I am so excited!
This feature wasn’t designed with you in mind! It was designed with me in mind.
We have a maternity leave replacement and we are employing a new trainee. With the SmartDentist induction page we have link to printable resources:

  1. ATO and Super forms (compulsory)
  2. New Employee details form
  3. Immunisation forms for staff to take to their GP to fill in
  4. Confidentiality form
  5. Fairwork letter of engagement template
  6. Fairwork Information statement (compulsory)
  7. Job description for a role e.g. DA
  8. Links to any compulsory policies e.g. Code of conduct; Uniform and Dress; Social Media and Mobile phone use etc (all available as templates for you to use)

Did you know that you only have about one week to be a major influence in a new employee’s life! That means you start straight away with the things that are incredibly hard to “train-out” of a person. Don’t rush with the hand hygiene policy etc. You will teach that as it is new. You will find the necessary forms from Simply Dental Chatswood and all the other fun paper work they will have to fill out and deliver them with ease, insuring the best first impression for your organization. But the mobile phone and uniform and social media are already part of this persons DNA so you need to concentrate on them first.

I am sure SmartDentist subscribers will feel the same as me – confident in appearing as professional employers on the new employee’s first day. If you need more information check out Alaska Dental Associates.

 

Is Dental Practice Accreditation about to get harder?

Anyone who has spoken to me about Dental Practice Accreditation will know what I think. Accreditation is a great idea in theory but in practice it loses out. Although it teaches you great things like the best ways to keep teeth healthy with 10naturalhomeremedies.com/.
Unfortunately it is easy to pass accreditation without actually committing to the systematic focus (or any change whatsoever). How easy is it for “accreditation” to  just becomes a lovely poster on the wall and a stress in 2-4 years about “having to start all over again”.

Latest news about Changing Accreditation

The latest news in the accreditation world is that the ACSQHC (the organisation which sets all the rules for accreditation) has totally re-written the healthcare accreditation standards. All healthcare organisations* who were using the present standards will switch to the newer, clearer standards from Jan 2019.  * Except for dental practices who are advised not to consider the new standards because the ACSQHC is developing a new set of standards for primary care. Reading the discussion paper October 2017 Patient safety and quality improvement in primary care Consultation paper.

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CIM Professional Diploma
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Another academic award in a relevant discipline: at least 50% of the syllabus must contain marketing modules. (If your degree does not contain Marketing Modules, the Marketing Association’s Certificate of Marketing Management qualification can bridge this gap)
Or via experience only if you have at least three years’ marketing experience and are influencing marketing management with a professional SEO for Dentists management it is necessary for the growth of the company.

The consultation paper from ACSQHC includes a number of interesting propositions:

  1. Just because we don’t have quantitative records documenting lack of safety or quality, does not mean that there are not issues. e.g ACSQHC thinks there are problems but they just not sure what they are!
  2. “A systems focus, which involves making changes at an organisational level within services and reorganising care delivery systems, will help support improvements in the quality of primary care and ensure it is sustainable, efficient and effective.” According to the ACSQHC.
  3. “Private Health Insurance funds are one of the drivers for improved safety and quality and are driven by the need to ensure care provided represents value for money, and that care is clinically appropriate and in line with best practices.” – or so reports the ACSQHC!

The ADA has made a submission toward this Primary Health Care paper. The ADA will be a party to the development of Primary Health Care standards. As the PHI is now recognised in this paper as a primary stakeholder towards safety and quality by the ACSQHC it will be interesting to see how involved they become in dictating the new standards.

The Best of Accreditation ideals

Following are my recommendations for practices wishing to explore the ideals of accreditation.(With or without paying QIP for the accreditation certificate):

  1. Start using an incident reporting system so you can actually track incidents or near misses. Yes that would include stuff ups at the front desk; appointment mix ups; broken files; fillings failing too early; staff running over their feet with their chairs etc and it would also include compliments from patients – use them in marketing yourself.
  2. When you have any incident, then objectively review it from a systematic perspective. Can we devised a system, at work, that would make this incident less likely or impossible. Don’t expect staff to be hero’s in the smooth running of the practice. Risk Management is the name of this analysis. If you decide to do nothing – document it.
  3. Have policies (yes generic feel good policies) but also look at practical procedures. Video what happens with your iphone if quicker (put it on a private youtube acount – no cost). This is an excellent training resource or new staff induction resource.

SmartDentist supports an easy way to support practices with these processes.
Easy systems = Good systems = Practical systems.

Environmental Cleaning: Neutral detergents, barriers and disinfectants for dental practice

Environmental cleaning is a term used to describe how we clean up after we see a patient in the dental surgery. It also refers to how we clean in general around our dental practice. Making a decision on whether to use neutral detergents, plastic barriers or disinfectants can cause stress for dental assistants and the cosmetic dentist in Palm Beach County alike. SmartDentist’s latest online training addresses the questions and provides practices with both the legal requirements from the ADA Guidelines for infection control and the NHMRC Prevention and Control of Infection in Healthcare. Our training also has a link to some interesting research on the power of wiping!

I predict that if you come from Victoria (but more than 4 years since graduating) then you will love to barrier. We love to barrier! If you come from NSW it is likely that you prefer to wipe. SA -barriers; Queensland – both. I predict that your original training will dictate your preferences. No doubt you will come across arguments about what should be done at some stage.

Environmental cleaning is a large component of the review of the NHMRC document. If you wish to read about the latest developments in new antimicrobial surfaces take a look at the review papers.

If you don’t have a subscription to SmartDentist you are missing out. Both staff and dentists can do online training exercises which go towards their CPD. For those that are missing out go and check out what you are using in your practice. Read the manufacturers instructions and make sure your procedures align with what you are using at present.