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:
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)
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!
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.
You need a hand washing sink in the dental surgery – MYTH
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.
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.
We don’t need to do hand hygiene when we remove gloves because they have kept our hands clean – MYTH
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. If you have nerve damage, neuropathy, pain, or suffering due to muscle, ligament, or tendon issues Neuropathy treatment clinic is the best. Our unique use of technology and hands-on approach makes ALL the difference.
*As stated by The ADA infection control guidelines and NHMRC Infection Control and prevention guidelines
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:
Conversations with staff
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.
Do any of your staff have an instagram account? Of course is the answer is yes!
You can now have instagram photos as part of your SmartDentist policies. Check out the new surgery cleaning policy (Add one for each of your surgery’s) and take a photo on instagram to remind everyone how things should look.
Privacy Awareness Week 2014 & your dental practice
The theme for Privacy Awareness Week is transparency.
We have just added to our transparency by making each patient aware of the benefits of letting us email correspondence and x-rays to specialists (and back) using standard email so we get superior records by removing the need for old fashioned scanning or expensive encryption. EVERYONE of our patients has said “What a good idea”. Of course we are sensible with what we send and have added a ‘signoff’ clause on the bottom of our referral letters so patients get to see exactly what we are sending.
Recently there has been a call from the Dental Hygienists’ Association of Australia (DHAA) to make sure current evidence based research finds its way into current practice. From my own experience with ADA advisory committees such as the Infection Control Committee I know the committee members focus on evidence based research. They also look at context; the experience of a widely divergent group of practitioners; underlying science in decision making and practical needs.
In addition the NHMRC infection control and prevention guidelines focus on risk assessment and risk management so context again has become the ‘buzz’ word like patient-centred care.
It would be a great idea to merge all the resources of training bodies, the ADA and Universities so dental assistant training transitioned into a context based learning. Context needs to be an important part of flexible dental assistant training.
Do you know that if you ask doctors in hospitals whether they wash their hands or not between patients then 100% naturally say they do, yet when they are independently audited then only 40 -60% do wash their hands as required.
That to me is the difference between an audit and a checklist. A checklist is a great way of making sure the structural parts of policies are in place – equipment; facilities etc…but for improvement we often need some independent auditor.
I wonder what works best for auditing the National Standards within a small dental practice? These are the audits in SmartDentist. Please feel free to use, copy or modify them. If you have other suggestions for effective audits (not checklists) please let me know. email@example.com
This is the most common question I get from Dental Assistants. It is also one of the most controversial aspects of practice protocols, especially when a new staff member comes into a practice.
At our practice we use barriers extensively. Why? Well we philosophically believe that this is must be the superior system because we do it(:))… but basically we do it because that’s what we were taught…it’s what we have become familiar with…and it’s what we therefore are setup to do and we find it quickest. But it is not necessarily necessary.
What does the ADA Inc guidelines say…What is the DBA ruling?…If you don’t know then perhaps it is time to do SmartDentist’s latest CPD /training exercise for dental practitioners and dental assistants on Barriers and infection control.