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Maintaining safety and efficiency in any healthcare setting relies heavily on robust infection prevention. Dental offices, especially, face distinct challenges due to the risk of contamination from aerosol-generating procedures, dirty dental instruments and equipment, and high patient turnover. Effective dental infection control practices are essential to prevent the spread of common pathogenic microorganisms [1].

As past cases have confirmed, non-compliance with infection control protocols can lead to costly errors and outbreaks with severe health implications for patients and staff[2]. Yet, with the hustle and bustle of a dental office, ensuring constant compliance with the ever-evolving infection control standards can be challenging. The solution? Choosing compatible products that seamlessly integrate into customized, effective, and standardized infection prevention (IP) programs, thus encouraging the right behaviors among staff.

Beyond the Hawthorne Effect

The Hawthorne effect refers to individuals modifying their behavior in response to being observed. Studies have shown increased adherence to IP measures when staff know they are being monitored[3]. Predictably, compliance will waver once the observation period ends, and old habits will soon return. Conscious or subconscious, this decline in adherence makes it challenging to maintain consistent infection control practices.

In other words, observation alone is not enough. Dental offices must implement strategies that transcend the temporary boost of the Hawthorne effect. This includes ongoing monitoring and feedback, regular education and training, fostering a culture of safety and accountability, and leveraging products and technologies that facilitate compliance. Adopting a set of standard IP practices makes it easier to encourage the right behaviors for achieving infection control consistency[4], resulting in a safer environment for both patients and practitioners.

Here are a few surefire ways to level up your dental infection control game:

1.   Customize your Infection Prevention Program

Every dental office is unique, with varying layouts, patient demographics, and staff workflows. While the equipment might be similar, the needs of each office differ widely. Developing an IP program tailored to your office’s specific requirements is crucial for ensuring compliance[5]. This includes establishing a culture of infection control encompassing all staff members’ shared values, attitudes, and behaviors, from dental surgeons to support personnel.

Effective communication is a key element in fostering this culture. Open and transparent communication channels allow for the circulation of information regarding dental infection control guidelines, protocol changes, and the latest updates. Frequent team meetings and educational sessions also provide opportunities to discuss the office’s infection prevention practices and address any questions or concerns.

2.   Establish IP Standard Operating Procedures (SOPs)

Creating clear and comprehensive standard operating procedures (SOPs) is a must for guiding the behaviors that keep your team and patients safe[6]. The first step in developing effective SOPs is conducting a thorough risk assessment to identify potential risks in different areas of the office or clinic, such as patient contact, instrument sterilization, and environmental cleanliness.

This helps to create comprehensive IP policies and procedures for mitigating those specific risks following evidence-based guidelines—most commonly, from authorities such as the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA).

Included should be detailed instructions for hand hygiene, instrument sterilization, labeling, the use of personal protective equipment (PPE), and the proper disposal of biomedical waste. But it doesn’t end there. Consistent and ongoing training is key to ensuring all staff members are well-informed and trained in these SOPs. Training sessions should explain proper techniques and procedures, discuss the latest guidelines, and address staff concerns. Auditing and monitoring compliance through spot-checks, observations, and periodic feedback reviews can highlight any areas for improvement and reinforce compliance with dental infection control protocols at all times.

3.   Choose the Right Products

The effectiveness of any infection prevention program relies heavily on the products used. From disinfecting wipes to enzymatic cleaners, a consistent supply of various detergents and disinfection products is necessary for maintaining a safe healthcare environment. Partnering directly with a manufacturer of compatible disinfection and cleaning solutions for your office can save valuable time from the ordering process. You’d also be availing of financial incentives that many manufacturers offer for dental practices, like cost benefits and exclusive deals.

When it comes to product selection, it is crucial to lean on products that are broad-spectrum, optimal for daily use, compatible with your office’s equipment, and user-friendly enough to facilitate compliance to internal protocols. For instance, Kerr’s EmPower multi-enzymatic detergent is ideal for manual and automated machine cleaning prior to terminal sterilization, removing a wide range of debris and protein soils from various surfaces. This way, it streamlines the disinfection process and makes it easier for staff to follow protocols consistently.

CaviWipes products, such as CaviWipes HP and CaviWipes 2.0, offer robust solutions for infection control. These wipes are designed for one-step cleaning and disinfection (except for precleaning instructions specified on the product labels), providing effective protection against a wide array of pathogens (as specified on the product labels), including Norovirus, SARS-CoV-2, and Candida auris.

The CaviWipes HP, with its 1-minute universal contact time and alcohol-free formulation, is particularly suitable for patient populations with sensitive respiratory systems. Additionally, the new lid design on these product canisters enhances ease of use with features like a strong hinge and optimal orifice, preventing wipe dry-out and ensuring no waste. These attributes make CaviWipes an excellent choice for maintaining a clean and safe healthcare environment, reinforcing the importance of using reliable and efficient disinfection products.

4.   Assign a Certified Infection Control Coordinator

Appointing a certified Infection Control Coordinator (ICC) is the most practical—and a CDC-recommended[7]—way to enhance compliance with dental infection control protocols. The ICC is responsible for creating SOPs, navigating product choices, standardizing procedures, and ensuring continuous team training. By prioritizing and emphasizing the importance of infection prevention, the ICC sets the tone and expectations within the dental office.

Plus, having a dedicated IP leader plays a pivotal role in promoting a culture of accountability and compliance. Through leading by example and implementing a structured infection control program, a trained ICC can influence the attitudes and behaviors of team members, fostering a safe and compliant workplace environment. This hands-on guidance makes maintaining efficiency and safety standards a breeze, ultimately enhancing the quality of care and overall patient experience.

 

Written by: Michelle Strange MSDH RDH, owner of Level Up Infection Prevention, brings over 20 years of dental experience and further specialization in dental infection prevention and control. Michelle offers invaluable insights and practical strategies tailored for dental settings, including in-depth training programs, specialized courses and guidebooks for Infection Control Coordinators that offer all the necessary tools and knowledge to ensure robust infection prevention. You can reach her here.

References:

 [1] Abusalim GS. Prevalence and investigations of bacterial contamination in dental healthcare associated environment. J King Saud Univ Sci, 2022;34(6).

[2] Strange, Michelle. Remember this dental infection control fiasco? Could this be you? Level Up Infection Prevention site. Published February 2, 2024. Accessed June 28, 2024.

[3] El-Saed A, Noushad S, Tannous E, et al. Quantifying the Hawthorne effect using overt and covert observation of hand hygiene at a tertiary care hospital in Saudi Arabia. Am J Infect Control, 2018;46(8).

[4] Shubayr MA, Mashyakhy M, Al Agili DE, Albar N, Quadri MF. Factors Associated with Infection-Control Behavior of Dental Health-Care Workers During the COVID-19 Pandemic: A Cross-Sectional Study Applying the Theory of Planned Behavior. J Multidiscip Healthc. 2020 Nov;12(13):1527-1535.

[5] Yang Q, Wang X, Zhou Q, Tan L, Zhang X, Lai X. Healthcare workers’ behaviors on infection prevention and control and their determinants during the COVID-19 pandemic: a cross-sectional study based on the theoretical domains framework in Wuhan, China. Arch Public Health. 2021 June 30;79(1):118.

[6] Strange, Michelle. Maximizing Dental Practice Efficiency and Safety: The Power of Standard Operating Procedures. Level Up Infection Prevention site. Published February 19, 2024. Accessed June 28, 2024.

[7] Dental Infection Prevention and Control: Administrative Considerations. Centers for Disease Control and Prevention site. Published May 15, 2024. Accessed June 28, 2024.

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