Lynn Woods, Practice Adviser (Health and Safety) at the BDA, responds to some frequently asked questions about health and safety in general dental practice.
General
Q. How often should we update our CPR training?
A. At least annually. New members of staff should have resuscitation training as part of their induction programme.
Q. How often should we update patients' medical history forms?
A. Medical and drug histories should be formally updated at least annually and interim changes noted at treatment visits.
Q. We hold midazolam as part of our emergency drugs – do any additional requirements apply?
A. Yes, midazolam is a controlled drug (Schedule 3) and as such any invoices will need to be kept for a minimum of two years and standard operating procedures apply. However, midazolam does not need to be kept in a controlled drug cabinet and records do not have to be kept in a controlled drugs register.
Q. We have carried out our practice health and safety risk assessment – does it have to be recorded?
A. Yes, if there are five or more staff, the significant findings should be recorded.
Infection control
Q. Can we reuse endodontic files and reamers if they are not labelled as single use?
There are three levels of hand hygiene – social, hygienic and surgical scrub. Training in hand hygiene should be part of staff induction.
A. No, currently endodontic files and reamers should be treated as single use, irrespective of labelling.
Q. What tests are required before we use our steriliser each day?
A. All small sterilisers – an automatic control test in line with manufacturers' instructions. Vacuum sterilisers – Helix or Bowie-Dick test also.
Q. We are planning to install a washer disinfector; will we still need to have an ultrasonic cleaner?
A. No, it is optional.
Did you know?
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Dental unit waterlines should be flushed for at least two minutes at the beginning and end of the day and after any significant period when they have not been used (such as lunch breaks) and for at least 20-30 seconds between patients.
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Detergents used for cleaning instruments should be specifically formulated for the purpose. Alcohol has been shown to bind blood and protein to stainless steel so the use of alcohol with dental instruments should be avoided.
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Dental instruments – after cleaning, rinsing and drying – should be visually inspected for cleanliness prior to sterilisation.
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There should be a written protocol for the manual cleaning of instruments.
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There are three levels of hand hygiene – social, hygienic and surgical scrub. Training in hand hygiene should be part of staff induction.
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Practices should have one or more laminated or wipe-clean poster(s) promoting hand hygiene on display.
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Window blinds, accessible ventilation fittings and other accessible surfaces (shelving, radiators and shelves in cupboards) should be cleaned on a weekly basis.
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Intra-oral radiology film and devices used in digital radiology imaging are potential sources of cross-infection. Where reusable devices are used, they should be decontaminated in accordance with the manufacturers' instructions. For intra-oral holders, this will require the use of steam sterilisation following washing and disinfection.
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New, reusable instruments should be decontaminated prior to use.
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Patients should be seen by a dentist for a full mouth assessment before being treated by other members of the dental team unless the patient has an in-date treatment plan.
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All members of the dental team, as well as registered DCPs, should be familiar with and follow the GDC's Standards for dental professionals, a copy of which can be found on the GDC website at www.gdc-uk.org.
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Portable electrical equipment – around 95% of faults or damage can be found just by looking, so ensure that any signs of damage to the equipment, cable or plug are reported immediately.
First aid at work
Q. Do we have to have a qualified first-aider at the practice?
A. Based on the most recent guidance (October 2009), it is recommended that practices with 5-50 staff have at least one first-aider trained in Emergency First Aid at Work (1 day course) or First Aid at Work (3 day course).
Q. What should we keep in our first-aid box?
A. There is no mandatory list, the contents can be based on assessment. Medicines and/or tablets should not be kept in the first-aid box.
For consent to treatment to be valid, the patient must have received enough information to make the decision (informed consent).
Q. Recently an elderly patient had a fall at the practice which resulted in her having to be taken to hospital – what is the quickest way of reporting this under RIDDOR?
A. The quickest and easiest way is to call the Incident Contact Centre on 0845 300 99 23 (Mon-Fri – 8.30am to 5pm). An operator will complete a report form over the phone and you will be sent a copy for your records.
Patient consent
For consent to treatment to be valid, the patient must have received enough information to make the decision (informed consent).
It must be made clear to patients whether treatment is being proposed on an NHS or private basis.
Principles of practice
Do you know the six principles of practice in dentistry required of dental professionals by the GDC? They are:
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Putting patients' interests first and acting to protect them.
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Respecting patients' dignity and choices.
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Protecting the confidentiality of patients' information.
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Co-operating with other members of the dental team and other healthcare colleagues in the interests of patients.
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Maintaining your professional knowledge and competence.
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Being trustworthy.
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Woods, L. Looking for answers?. Vital 7, 45–46 (2010). https://doi.org/10.1038/vital1145
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DOI: https://doi.org/10.1038/vital1145
