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The Oral Health Sterilizing Orientation Manual covers key areas which provide you with a basic knowledge and understanding of safe and effective practice within Queensland Health Oral Health facilities. The manual has been divided into the following parts.

TABLE OF CONTENTS

PART 1

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Introduction

PART 2

/ 2.1.  Overview of Sterilizing Services
2.2.  Resources and Training
2.3.  Self-Assessment
2.4.  Standard Operating Procedures and Workplace Skills Assessment Sheet
2.5.  Individual Learning Plan Information

PART 3

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Attachments

3.1.  Sterilizing Services Orientation Checklist
3.2.  Manual Handling in the CSD booklet
3.3.  Standard Operating Procedures and Workplace Skills Assessments

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Introduction

Your mentor for the next three months of your sterilizing orientation program within the Oral Health Service (OHS) is INSERT NAME HERE, who will assist you during your induction phase within your facility.

The Oral Health Sterilizing Orientation Manual has been developed for staff new to the instrument reprocessing environment. The manual is to be used in conjunction with the Queensland Health Orientation Program to assist new employees gain an understanding and develop a sense of belonging in their local work area.

Oral Health Sterilizing Services Orientation Checklists have been included in part 3 for you and your mentor to work through. Once the orientation checklists are completed this information will be kept as part of your personnel file.

The Oral Health sterilizing orientation program contains:

§  The sterilizing services orientation manual

§  An individual self assessment form

§  An individual learning plan

§  Other specific information relating to sterilizing in Oral Health Services


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Recommended Resources

The table below lists additional resources for you to reference.

CHRISP website / http://www.health.qld.gov.au/chrisp/default.asp
Sterilizing Services in Oral Health
Including supporting documents specifically for Oral Health services / http://www.health.qld.gov.au/chrisp/sterilising/oral_health.asp
CHRISP website section relating to sterilizing services / http://www.health.qld.gov.au/chrisp/sterilising/overview.asp
Queensland Health Disinfection and Sterilization Infection Control Guidelines / http://www.health.qld.gov.au/chrisp/ic_guidelines/contents.asp
QH Prevention and Control of Healthcare Associated Infection - Policy, Standards, Protocols and Guidelines / http://www.health.qld.gov.au/chrisp/policy_framework/overview.asp
CHRISP Sterilizing Services Supporting Documents / http://www.health.qld.gov.au/chrisp/sterilising/sterile_support.asp
PRIME / http://connect.health.qld.gov.au/prime/
Occupational Health and Safety / http://qheps.health.qld.gov.au/safety/home.htm
Manual Handling Information Booklet – Central Sterilising Department / http://qheps.health.qld.gov.au/safety/safety_topics/guides/Mhb_csd.pdf

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2.1 Overview of Oral Health, Policy, Standards and Guidelines relating to reprocessing and sterilization.

Within Queensland Health (QH), the Centre for Healthcare Related Infection Surveillance and Prevention (CHRISP) has the statewide responsibility for the Infection Prevention and Control program (including sterilizing). The CHRISP website has a number of resources to assist Oral Health Sterilizing Services staff in the course of their work, including, QH Disinfection and Sterilization Infection Control Guidelines, Easi-Sterilise® and the Policy, Standards, Protocols and Guidelines (http://www.health.qld.gov.au/chrisp/policy_framework/overview.asp) documents.

Many associated documents and resources relating to cleaning, disinfection and sterilization of instruments and equipment are also available. To access the CHRISP website go to or click on the following link: http://www.health.qld.gov.au/chrisp

CHRISP also plays an important role in representing the interests of sterilizing services on the relevant Australian Standards committees that relate to sterilizing practice: including:

·  Australian/New Zealand Standard AS/NZS 4187:2003 ‘Cleaning, disinfecting and sterilizing reusable medical and surgical instruments and equipment, and maintenance of associated environments in health care facilities’ (AS4187);

·  Australian/New Zealand Standard AS/NZS 4815:2006: ‘Office-based health care facilities - Reprocessing of reusable medical and surgical instruments and equipment, and maintenance of the associated environment’ (AS4815).

Your role within INSERT FACILITY HERE Oral Health Service

Staff undertaking sterilizing practices in Oral Health Services are responsible for preparation, reprocessing, storage and distribution of sterile dental instruments and equipment. The process of sterilization removes or destroys potentially infectious material on reusable devices. The sterilizing role is of vital importance in ensuring that reusable instruments are handled, cleaned, disinfected and sterilized appropriately thereby eliminating the risk of infection transmission to patients and staff.

The Oral Health Environment

Oral Heath Services are delivered in a number of types of facilities with varying types of instrument reprocessing areas, for example:

§  fixed clinics with a single room instrument reprocessing area

§  fixed clinics with 3 room sterilizing area

§  mobile dental clinics with a separate sterilizing area

Infection Prevention and Control

The role of infection control is primarily to prevent healthcare associated infections. The ongoing use of the Easi-Sterilise Standard Operating Procedures (SOP) and Workplace Skills Assessments (WSA) is one way of ensuring safe practice and minimising the spread of infection to patients and staff.

In your work area it is important to take care when handling instruments to prevent sustaining a sharps injury. Items that have been attributed to sharps injuries within a sterilizing service include but are not limited to:

·  Blades that have not been removed and disposed at the point of generation,

·  Dental needles and fine sharp instruments such as burs, scalers, and probes.

One of the most important strategies to prevent injuries and occupational blood and body fluid exposures whilst working in the cleaning area is wearing appropriate personal protective equipment such as waterproof gowns/aprons, utility gloves, goggles and masks or face shields.

Within the district there is an Infection Prevention and Control Practitioner who can be contacted by phone on INSERT PHONE NUMBER HERE or by paging INSERT PAGE NUMBER HERE.

For further information about Infection Prevention and Control go to the following link via the District Intranet site: INSERT LINK HERE.

Building Maintenance and Engineering Services (BEMS)

This information may not be relevant to your facility – delete or modify to suit your facility.

Within this facility BEMS personnel are responsible for steam and water supply to the large steam sterilizers, as well as the coordination of maintenance and repairs for all equipment, machinery. If any equipment in sterilization service fails a required test (e.g. large steam sterilizer fails the leak rate test). The failure is to be reported to your shift supervisor. The machine is to be placed out of order until reviewed by BEMS or by the service contractor.

Biomedical Technical Services (BTS)

Within each district there is access to Biomedical Technical Services (BTS). The scope of services provided by local BTS may vary. Within this district BTS is responsible for (please add or delete as required):

§  Instrument and handpiece maintenance and repair

§  Maintaining biomedical equipment

Insert details of local servicing representative

Occupational Health and Safety (OHS)

Queensland Health is committed to providing a safe, supportive and healthy environment for its staff, volunteers and other persons at the workplace. Workplace incidents are to be reported to the local Occupational Health and Safety Unit (http://qheps.health.qld.gov.au/safety/communications/contact_us2.htm) as soon as possible following their occurrence. Within each facility there are Occupational Health and Safety Officers who can be contacted by phone on INSERT PHONE NUMBER HERE or by paging INSERT PAGE NUMBER HERE.

As part of QH’s commitment to ensuring staff safety the Occupational Health and Safety Unit has developed a Manual Handling Booklet for Central Sterilizing Departments (CSD). This booklet is equally applicable for use in Oral Health facilities that undertake reprocessing activities. This booklet has been included in part 3 of this manual and will be discussed with you by your mentor.

Patient Safety Officer

  • Within each district there is a designated Patient Safety Officer who provides advice and resources to units/departments to assist manage patient incidents and implement strategies to prevent reoccurrence of incidents.

CHRISP in consultation with the Patient Safety and Quality Improvement Service have developed a fact sheet to assist oral health staff report potential and actual patient incidents. Patient incidents are reported electronically on PRIME http://connect.health.qld.gov.au/prime/.

Your mentor will assist you to organise PRIME incident reporting training during your three month orientation period.

2.2 Resources and Training

When you commence working in your facility you will be orientated to the reprocessing and sterilizing processes in a planned and systematic manner. Your mentor will assist you by providing training and skills assessments as you move through each process.

Your mentor will assist you to complete the requirements of the Queensland Health Orientation Program, the Standard Operating Procedures (SOP) and Workplace Skills Assessments (WSA). Each week your mentor will discuss and arrange for training and supervision within the reprocessing area. These discussions will include your education and training needs, workload and service expectations.

CHRISP Resources

In 2010, CHRISP developed in consultation with Oral Health Staff a set of Standard Operating Procedures and Workplace Skills Assessments. These resources are available on the CHRISP website at Sterilizing Services, Oral Health section (http://www.health.qld.gov.au/chrisp/sterilising/oral_health.asp).

The Standard Operating Procedures (SOP) and Workplace Skills Assessments (WSA) have been developed in accordance with published guidelines and standards. They recognise the importance of the role of Oral Health staff performing sterilizing and assist them to perform their duties safely and efficiently. The Oral Health SOPs and WSAs provide a framework for the minimum set of standards required for sterilizing practice within Queensland Health Oral Health facilities. They are a key component in the ensuring that staff performing sterilizing tasks have the necessary skills, knowledge and experience to undertake the allocated activity, task or job.

Copies of the Oral Health Easi-Sterilise SOPs and WSAs have been provided for you in part 3.3. You can also access the current version of these resources on line via the CHRISP website using the following link: http://www.health.qld.gov.au/chrisp/sterilising/oral_health.asp.

The sections of the SOP and WSA modules included as part of the manual include:

Cleaning Procedures
Packaging and Wrapping Procedures
Sterilizing Procedures
Sterile Storage Area Procedures
Quality Assurance

A Standard Operating Procedure & Workplace Skills Assessment Checklist has been designed to assist you, your mentor and your line manager to determine which SOPs and WSA need to be undertaken during your 3 month orientation period. On completion, this checklist can be included as evidence for your performance planning and review and can be included in your personnel file.

Certificate III in Sterilizing Services

Queensland Health’s (QH) is committed to ongoing education and training. There is an expectation that staff that perform sterilizing functions will undergo formal training in the reprocessing of reusable medical devices known as Certificate III in Sterilising Services.

There are numerous advantages when you undertake formal study and gain a Certificate III in Sterilising Services, which include:

§  ability to work in other areas such as hospital Central Sterilizing Department (CSD)

§  the theoretical knowledge associated with the duties you are to perform within the facility

§  confidence to participate in discussions that relate to service improvements and work environment improvements

§  potential to participate in the establishment of a portfolio within your role

CHRISP Forums and Training

CHRISP Sterilizing Program established DAS-Net, a Dental Assistant Sterilizing Network in June 2010. This network provides an opportunity to communicate and implement new initiatives and information through a network of District-based representatives to Dental Assistants and other personnel undertaking sterilizing activities.

Each District has a DAS-Net representative INSERT NAME OF THE DAS NET REP whose role is to communicate information and training requirements from the Network back through your district. Our facility communicates to the DAS NET representative via INSERT HOW YOU CO-ORDINATE THE FACILITIES QUESTIONS/ COMMUNICATIONS TO THE DAS NET representative . e.g communication book.

CHRISP also liaises with medical industry when coordinating statewide inservice programs. Information is distributed by INSERT NAME OF SDA to all staff within the department as these programs become available within your department.

What’s Next: After your three month orientation program

Once you have completed your three month Oral Health sterilization orientation program you will now plan your ongoing learning needs with your manager in line with the Workplace Skills Assessments (WSA).

2.3 Self Assessment

This tool has been designed to assist you to assess your level of knowledge and skills in key functions of sterilization. It is important that your self assessment is completed on or before day 1 of your sterilization orientation as we believe this process assists us to streamline your training needs.

The idea of the self assessment is to identify your specific learning needs.

Step 1: Please complete the following questions to assess (1) your current level of knowledge and (2) your current skill level by circling the most appropriate response. It is expected for new staff members who have never reprocessed oral health instruments to self assess as ‘Nil’ or ‘Limited’.

Step 2: You are to discuss the results of your self assessment with your mentor/manager and the results will be used to develop your individual learning plan for the next 3 months.

2.3 Self Assessment cont.

Cleaning

Knowledge in sorting instruments prior to cleaning / Nil / Limited / Some / Extensive
Skills in sorting instruments prior to cleaning / Nil / Limited / Some / Extensive
Knowledge in Chemical & Detergent Mixtures / Nil / Limited / Some / Extensive
Skills in replacing and checking Chemical & Detergent Mixtures / Nil / Limited / Some / Extensive
Knowledge in pre & post rinsing of dental instruments / Nil / Limited / Some / Extensive
Skill in pre and post rinsing / Nil / Limited / Some / Extensive
Knowledge of manual cleaning processes / Nil / Limited / Some / Extensive
Skill in manual cleaning including cleaning of complex and cannulated instruments (handpieces) / Nil / Limited / Some / Extensive
Knowledge of how Batch Type Washer Disinfector Machines operate (where present) / Nil / Limited / Some / Extensive
Skill in operating Batch Type Washer Disinfector Machines (where present) / Nil / Limited / Some / Extensive
Knowledge of how Ultrasonic Cleaners operate / Nil / Limited / Some / Extensive
Skill in operating Ultrasonic Cleaners / Nil / Limited / Some / Extensive
Knowledge of De-Staining instrument processes / Nil / Limited / Some / Extensive
Skill in De-Staining instruments / Nil / Limited / Some / Extensive
Knowledge of how and when to use an air pressure gun / Nil / Limited / Some / Extensive
Skill in Operating the air pressure gun / Nil / Limited / Some / Extensive
Knowledge of how a Drying Cabinet operates (where present) / Nil / Limited / Some / Extensive
Skill in operating a Drying Cabinet (where present) / Nil / Limited / Some / Extensive

Preparation and Packaging