IPC Update

Sept. 17, 2020 | Health, Safety & Environment Coordinator

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Dear Staff, Faculty and Students,

Welcome to our new IPC communications tool! The COVID-19 pandemic has created infection control challenges and many necessary changes to our clinical and simulation processes and protocols. As the global and our regional COVID-19 situation evolves there will inevitably be more changes coming. This update will be sent out each week to communicate any changes and to celebrate what has been working well for us and what could use some improvement from an IPC perspective. There will be links included to provide additional information as required. You can access past weekly IPC Updates according to their date by visiting Dentranet> What's Happening?> School of Dentistry Updates

Our IPC Officer, Dr. Khaled Altabtbaei and our IPC Coordinator, Ronna Richardson-Lozano have created a new email address for all things IPC. If you have questions, concerns, suggestions or kudo’s to send please email dentIPC@ualberta.ca 

  We’ve returned to campus safely and our clinics, labs and simulation spaces are humming with the activities of staff, students and faculty! Here are some of the things we can celebrate getting right this week…

• Everyone has done a great job coming prepared for in-person learning. You’ve managed to find scrubs, hair covers and full face shields during global PPE shortage - Fantastic!

• In both the SimLab and OHC everyone is working hard to understand and follow our new IPC and PPE protocols. Here is a link to our online IPC learning resource, check back often for updates and new additions

• You’ve been using the Fit for Work questionnaire and following our illness reporting processes! Our system is working well. We’ve made some changes to the form to focus on the information we need to keep everyone safe and help with contact tracing if required. Here is a link to review the Changes to the Fit for Work Screening Form 

Learning  the “why” behind our IPC protocols is vital to helping us build confidence and compliance.  Knowing the basic concepts in the chain of infection will help you think critically and make sound clinical decisions regarding infection prevention and control. Be sure to read our weekly IPC Updates to be up-to-date during in-person learning. 

The basis of all our infection prevention and control protocols is the prevention of cross-contamination between people. We are constantly tweaking our processes to fit the current situation. This week we are sharing some vital information to help improve patient, clinician and staff safety in the OHC. 

1) What is an Aerosol Generating Procedure aka AGP?

An AGP is any dental patient care procedure that may produce fine aerosolized droplets. AGPs may be produced when you use any of the following instruments or perform these tasks:

• air-water syringe (using just air, just water or air and water together)

• slow speed handpiece

• high speed handpiece

• Cavitron

• Piezo

• Intraoral radiography - may cause gagging or coughing which in turn produces aerosols

2) Overgown use in OHC 

• • A clean overgown is defined as - one that has NOT been worn while performing an AGP or otherwise soiled during patient care (see definition above)

  • A clean overgown must be worn for all patient care, including in radiology

  • Overgowns must be changed (soiled overgown removed and placed in the soiled linens bag (blue plastic bag) and hand hygiene performed) in between AGPs involving different patients

  • Students may wear a clean overgown while moving about the clinic (ie. when going into radiology, the prosth or ortho labs and when requesting items from dispensary)

  • If unsure about leaving an operatory with an overgown on - please seek advice from an instructor or a circulator before leaving the operatory. If an AGP has been performed - the answer will be NO.  Stay in the operatory until the patient is ready to be dismissed and ask for assistance from an instructor or circulator.

  • Only clean overgowns are allowed in OHC Prosthodontic lab or Orthodontic lab areas 

  • Overgowns are to be worn as part of full enhanced PPE during operatory clean-up

3) Moving around OHC during patient care clinics

• • Once an AGP has begun, you must stay in your operatory and summon a circulator or instructor to retrieve any additional equipment or materials. When the appointment is complete, doff your soiled gown, place it in the soiled linens bag (blue plastic bag) and clean your hands before moving about the clinic.

  • Ensure that your patient is wearing a mask before escorting them anywhere in KEC. Continuous masking is a must for every person when in KEC. Immediately upon completion of dental procedures, instruct your patient to re-don the mask they arrive in. (Remember fabric masks are not to be worn in KEC)

  • If you must clean your operatory (no co-learner to clean operatory) after you discharge your patient, have an instructor or a circulator escort your patient to the nearest exit (do not go out into Patient Services with them).

  • Patients may utilize washrooms inside the clinic if necessary. The patient must be escorted there - by a student (in a clean overgown) if no AGPs were done, or by circulator or instructor if the student was involved in an AGP.

  • If you have a mobility challenged patient, use a wheelchair (stored in alcoves) to move them into and around the clinic, and to exit the clinic

4) Prosthodontics & Orthodontics Laboratory 

• • Clean overgowns (not used in an AGP or otherwise soiled during patient care) can be worn into the Prosth or Ortho Lab  **lab staff may turn you away if your overgown is soiled**

  • All lab pans and articulators must be disinfected prior to leaving the operatory when taking them to the lab

  • All impressions and/or any appliance or prosthesis must be transported to the lab in a ziploc bag

  • Fixed prosth final impressions and bite registrations must be placed in a Cidex bath just inside the lab door with timer set for 5 minutes

  • Removable prosth impressions, appliances and prostheses must be disinfected before taking them to the lab. Lab staff will direct you to use the bleach disinfection bath & timer in the Rem Prosth area of the lab, should the disinfection be deemed inadequate by lab staff

  • All lab pans and articulators must be disinfected by the student, resident or staff member for a second time in the Prosthodontics Lab. There are disinfecting stations in both the Fixed and Rem Prosth areas, ask for details

Have IPC Questions, Concerns or Positive Comments? Email dentIPC@ualberta.ca.

Sincerely,
Dr. Khaled Altabtbaei, IPC Officer
Ronna Richardson-Lozano, IPC Coordinator