Transcript Changes to HTM 01-05 Presentation

CHANGES TO HTM-01-05
Decontamination in primary care
dental practices
By Sandra Holt – Infection Control
Specialist Nurse
Health and Social care act 2010 – Code
of practice.
• The 2010 revision to the Code of Practice
establishes a duty to provide and maintain a
clean and appropriate environment for
healthcare within which a specific
requirement for effective arrangements for
the appropriate decontamination of
instruments and other equipment is given.
• HTM01-05 is designed to assist all dental
providers in meeting these requirements.
KEY CHANGES TO HTM-01-05 (2013)
Instrument storage
• Shelf life of wrapped instruments has been
extended from 21 and 60 days to a maximum
of one year.
• Unwrapped instruments in the clinical area
can be stored for 1 day.
• Unwrapped instruments in a non-clinical area
can be stored for 1 week.
SINKS
• Guidance on manual cleaning and rinsing of
instruments has been amended to allow the use
of a removable bowl.
• Manual washing and rinsing of instruments
can be achieved by either:
• Two dedicated sinks or
• One sink with a removable bowl that can be
contained within the sink for instruments to be
rinsed. (this is least preferred option)
• The room design example has been amended to
indicate a second wash hand basin is optional.
AUDITS
• The frequency of audits has been relaxed from
every 3 months to now only every 6 months.
• The use of the Infection Prevention Society/
DH audit is strongly recommended.
HANDPIECES
• Guidance clarified on this
• Practices can “seek the advice on the
decontamination of hand pieces from the hand
piece manufacturer. The use of a validated
washer-disinfector may be successful provided
that the hand piece and washer-disinfector are
compatible. Where this is established,
sterilisation using a type B or S steriliser is likely
to be useful, although it should be accepted that
it is unlikely that sterility will be achieved,
whatever steriliser is used, due to the presence of
lubricating materials”.
ENDODONTIC REAMERS AND FILES
• “Where endodontic reamers and files are
designed reusable they should be treated as
single patient use or single use to reduce the risk
of prion transmission. Practices must have
effective procedures in place to exclude errors.
• Care must be taken in the cleaning of these if
reusable.
• If an automated washer disinfector used the risk
of cross contamination to other instruments
would be low, can be put in with other
instruments.
• If manual washing the file/reamers should be
washed separately from other instruments.
STERILISER DAILY TESTS AND
VALIDATION
• Daily tests – Can follow manufacturers advice
on whether a steriliser`s daily tests can be
conducted whilst instruments are being
reprocessed.
• Equipment validation – Manufacturers
instructions can be followed in relation to the
validation of all decontamination equipment.
MICROFIBRE CLOTHS/REFILLING SPRAY
BOTTLES
• States “ it is not good practice to refill spray
bottles used to apply cleaning or disinfecting
solutions. Bacteria can contaminate the
bottles and become adapted to these
solutions and grow in the sprat mechanisms.
Such bottles, whether supplied pre-filled or
empty, should be single use”.
UNIFORMS
• Guidance has removed regarding reference to
60 degree C washing for uniforms.
• Now states “wash uniforms and work wear at
the hottest temperature suitable for the fabric
to reduce any potential microbial
contamination.
BLOOD SPILLAGES AND HEPATITIS B
VACCINE
• Guidance amended to require sodium
hypochlorite to be available in tablet form. It
now states “hypochlorite should be made up
either freshly, using hypochlorite-generating
tablets or at least weekly in clean containers”.
• Occupational health has been amended to
concentrate on Hepatitis B and subject to local
policy, tetanus.
TOWARDS BEST PRACTICE
• Every practice should be capable of meeting
essential quality requirements.
• To demonstrate best practice :
1. A cleaning process that should be carried out
using a validated automated washer disinfector.
2. Decontamination facilities clearly separate form
the treatment area.
3. Storage of instruments in a simple but carefully
designed facility clearly separate from the
clinical treatment area.