As the primary site for dental procedures, an office assessment will focus on the treatment operatories. Cleanliness, patient safety and compliance with legal standards for material use, equipment and activities will be emphasized.
An assessor will begin with a general assessment of each operatory. In considering issues around cleanliness, they will be separated into housekeeping surfaces, clinical contact surfaces and storage areas.
Observation of infection prevention and control procedures in the operatories during set up; initial clean up; transport and storage will occur and be compared with written office policy and accepted standards of practice.
Handwashing is critical in the reducing the spread of microorganisms. The convenience of handwashing stations and options in each operatory and their use by all dental office personnel will be reviewed during an assessment.
Use of barriers including personal one’s like masks, gloves, or eyewear and surface barriers on equipment and fixtures will be observed throughout the assessment process.
Equipment used intraorally like radiographic alignment devices, intraoral cameras or digital sensors must be cleaned and reprocessed according to manufacturer’s instructions between uses. The use of barriers may reduce reprocessing requirements for certain equipment if recommended by manufacturer.
An assessor will not observe an operatory during active patient care. In order to review certain infection prevention activities that occur during treatment - like instrument retrieval from storage, disinfection of multi-use dental material containers or amalgamator use, an assessor may speak with dental office personnel about how they perform these activities to prevent cross contamination.
Similarly, infection prevention activities in the operatory that may not coincide with the scheduled assessment as they normally need to be done daily or weekly like water or suction line disinfection or floor cleaning will be reviewed by a discussion with office personnel involved in those activities.
Although infection prevention and control is the primary focus of treatment operatory assessment, the function and safety of equipment used for patient care will be reviewed. All equipment must carry appropriate Canadian or provincial safety certification (CSA or CancerCare Manitoba).
Equipment – amalgamators, light curing units, radiograph machines – will be examined for obvious physical defects or dangers to patients or office personnel.
Dental materials including local anaesthetic cartridges will be examined to ensure appropriate use and compliance with manufacturer’s instructions.
It is important to note that office protocols can vary. In assessing these protocols, the focus will be on ensuring office systems and activities minimize the risk of contamination of sterilized instruments and prevent cross contamination between patients and between patients and dental office personnel.