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. 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

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.

Sometimes bad things happen to good dental practices

SWAM-Month-Year-StackedIt doesn’t matter how well you work together or how smart or how skilled we are…sometimes bad things happen in the delivery of our health care to patients.

As part of Safe Work Australia Month we are recommending staff and dental teams look at two of our CPD/training exercises:

  1. Endodontic accidents with sodium hypochlorite No.53*
  2. Team Talk: Using TCA (TrichloroAcetic Acid) in the dental clinic No. 46

Being prepared for the unexpected is part of quality and safety.

If you aren’t a SmartDentist subscriber yet we encourage you to read the following articles and set up your own staff training.

SmartDentist: Safety and Quality dental practices.
* A recent CRA study reported that 28% of dentists surveyed had reported having a sodium hypochlorite accident.

NOTE: SmartDentist subscribers have a simple system to email staff about new training with automatic recording of staff activities. Dental practitioners with Dental Board of Australia CPD commitments can also use this training.