Roles of the Infection Control Coordinator

Marie T. Fluent, DDS

In March 2016, the Centers for Disease Control and Prevention (CDC) released a new publication to promote infection prevention and safety in dentistry. This document, Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care¹ reflects existing evidence-based guidelines provided in the CDC document, Guidelines for Infection Control in Dental Health-Care Settings—2003.² The summary is written in “plain language” and is intended to reinforce existing CDC guidelines as it summarizes the basic expectations for safe care in the dental setting. This includes the need for a written, office-specific infection control program and the recommendation for an infection control coordinator. An infection control coordinator (ICC) has training in infection prevention and should be responsible for developing written infection prevention policies and procedures based on evidence-based guidelines, regulations, or standards.²

The infection control coordinator may have responsibilities within a larger job position, (safety director, employing dentist, dental assistant, office manager, etc.). At a minimum, the ICC should have a basic understanding of modes of cross-contamination in dentistry, infection prevention, and general safety procedures, and products and equipment available to maintain employee and patient safety.³

Leadership Role

The entire dental team must be committed and accountable for infection prevention within a facility. However, the ICC has the overall responsibility of coordinating the individualized and written infection control and prevention program. OSHA’s Hazard Communication Guidelines for Compliance states: “In order to have a successful program, you must assign responsibility for both the initial and ongoing activities that have to be undertaken to comply with the rule.⁴ Early identification of responsible employees and their involvement in developing your action plan will result in a more effective program design.”⁵

Maintain Relevant Documents

The CDC recommends that dental facilities develop and maintain a written health program for DHCP based on evidence-based guidelines, regulations, and standards. The written program should include policies, procedures, and guidelines for education and training; immunizations; exposure prevention and post exposure management; medical conditions, work-related illness, and associated work restrictions; contact dermatitis and latex hypersensitivity; and the maintenance of records, data management, and confidentiality.¹ OSHA mandates that the bloodborne pathogens standard (BPS)⁵ and hazard communication standard⁴ be available to all employees. Other documents such as the exposure control plan, hazard communication program, safety data sheets, and list of hazardous chemicals (and others) must be written and current. In addition, state and local regulatory agencies may require further documentation.

Maintain Current and Relevant Permits and Licenses and Other Documents

Relevant permits and licenses include manifests from medical waste haulers, radiographic equipment certifications, fire extinguisher certifications, and others.⁶ The ICC ensures that disposal of regulated and medical waste follows federal, state, and local regulations and all personnel who handle and dispose of regulated medical waste are appropriately trained and informed of possible health and safety hazards.

Maintain Safety-Related Records and Logs

The ICC generates, updates, and maintains logs of other safety-related records in compliance with federal, state, and local regulations. These may include training, sterilization records, employee medical records, and other equipment maintenance logs. The ICC should also ensure that equipment (sterilizers, eyewash stations, instrument washers, x-ray units) are functioning correctly, adequately maintained, and that certification is current.

Provide Infection Control Training

Training for all dental personnel must occur at least annually. The ICC may provide or coordinate infection control and OSHA mandated training to include updates on new information, equipment, products, chemicals, procedures, and technology. Initial training shall be upon hire, when there is a change in responsibilities of staff that may affect the employee’s occupational exposure, or in response to changes in recommendations or regulations.

Monitor Compliance

A checklist is useful for monitoring infection prevention compliance. The ICC can use the two-part checklist included as a companion to the Summary to provide an assurance of quality control and facilitate improvement and compliance with CDC guidelines and an office specific infection control program.¹ The checklist provides a review of practices for basic expectations for safe dental care and assesses the correct performance of infection control protocols by dental personnel.

Verify Employee Immunizations

Immunizations are an essential part of an infection control program and a written comprehensive immunization policy should be implemented for all dental facilities.² The recommended immunizations include the hepatitis B virus vaccination (and others). It is recommended to follow U.S. Public Health Service/CDC recommendations for hepatitis B vaccination, serologic testing, follow-up, and boosters.¹ The ICC should confirm and maintain documentation that employee immunizations are current.

Ensure Availability of Infection Control Equipment

The ICC should ensure that all infection prevention equipment and supplies are available to ensure a safe work environment for DHCP and patients. OSHA indicates that the employer must ensure that appropriate personal protective equipment in the proper sizes is readily accessible at the worksite.¹

Be an Infection Prevention Resource

To perform these responsibilities, the ICC must have adequate time to complete responsibilities, access to relevant publications, continuing education, topic specific workshops and seminars, professional membership, and support of top management/administration.³ Opportunities to network with other IC professionals may also be beneficial.

Resources for the ICC

The Organization for Safety, Asepsis and Prevention (OSAP) resources available for the ICC include training programs, toolkits, videos, slide decks, and a CDC interactive online training course.³ Advantages of OSAP membership also include updates regarding regulations, emerging diseases, vaccines, and new safety devices and products.

Establish a Culture of Safety

An ICC should help exemplify a culture of safety—the shared commitment of the employer and employees toward ensuring the safety of the work environment, the office personnel, and the patients. In a culture of safety, all employees are empowered to voice safety concerns and implement solutions to prevent harm.⁷ The ICC plays a vital role in patient and personnel safety, compliance with relevant guidelines and regulations, and efficient use of resources to ensure the safest dental visit for all.

References

1. CDC. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care, Accessed June 14, 2016 at: https://www.cdc.gov/ oralhealth/infectioncontrol/pdf/safe-care.pdf

2. CDC. MMWR Guidelines for Infection Control in Dental Health-Care Settings—2003. Accessed June 2016 at: https://www.cdc.gov/mmwr/preview/mmwrhtml/ rr5217a1.htm

3. OSAP: The Role of the Infection Control/Prevention Coordinator. Accessed June 2016 at: https://www.osap.org/?page=RoleofICPC

4. OSHA. Hazard Communication Guidelines for Compliance. Accessed June 2016 at: https://www.osha.gov/Publications/osha3111.html

5. OSHA. Bloodborne Pathogens Standard. Accessed June 2016 at: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051

6. OSAP. Infection Control in Practice. 2015;14(3).

7. OSAP. Team Huddle: Who is Managing Your Safety Culture? Infection Control in Practice. 2014;13(1).

About the Author

Marie T. Fluent, DDS, has enjoyed over 30 years of clinical practice. She is an educational consultant for OSAP and has written peer-reviewed articles and given lectures on infection control in dentistry.