Disposal of Dental X-Ray Fixer and Developer

Q. Is it safe to dispose dental X-Ray fixer and developer down the sink?

A. Silver-bearing wastes, including X-Ray fixer, should not be discharged to the sewer unless they are first treated in a properly sized, designed, installed, operated, maintained, and serviced standard silver recovery system. Otherwise, fixer should be taken off-site for treatment and disposal. Developer solutions should not be mixed with fixer solutions, and may only be discharged to the sewer if they have not mixed with fixer. If you are not connected to a sewer system, you should have your developer disposed of by a hazardous waste company. So, the short answer is if you are connected to a sewer, developer can be poured down the sink and if you have a silver recovery system, fixer can also be poured down a sink.

HIPAA Privacy Rules in Dentistry

Q. May a physician send out appointment-reminder postcards?

A. Yes, The HIPAA Privacy Rules allow a physician to communicate with patients, including communications to the patient's home. However, privacy and confidentiality must be maintained. For example, it is A-OK to send a postcard reminder with the date and time of the next appointment. It is not acceptable to send a postcard with specific treatment information such as "Mr. Smith, your dentures are ready".

OSHA Influenza Preparedness Guidance

As reported in the newly released, Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers, OSHA strongly urges healthcare institutions (including dental offices) to stockpile N-95 respirators and other protective equipment, warning that the items will be scarce once a pandemic strikes. "Employers and employees should not count on obtaining any additional protective equipment not already purchased and stockpiled," the report said. "Therefore, it is important for healthcare facilities to consider respiratory protection for essential personnel to assure that employees are ready, willing, and able to care for the general population."

http://www.osha.gov/Publications/OSHA_pandemic_health.pdf

Pandemic Flu Leadership Blog

On June 13, Michael O. Leavitt, Secretary, U.S. Department of Health and Human Services, is convening a leadership forum on pandemic preparedness, which brings together highly influential leaders from the business, faith, civic and health care sectors to discuss how best to help Americans become more prepared for a possible influenza pandemic. The Department is hosting this five-week blog summit to expand this conversation as part of an ongoing effort by the Department to help Americans become more prepared.

See: http://blog.pandemicflu.gov

Free Handwashing Poster

Here is a free high quality poster from the CDC for placing throughout your facility. Shows bugs that can lead to infection and may be found on unclean healthcare worker's hands.

Download English Version PDF (1 page/44KB)

Download Spanish Version PDF (1 page/158KB)

First Bird Flu Vaccine

The FDA is announced the licensure of the first vaccine in the United States for humans against the H5N1 influenza virus, commonly referred to as avian influenza or "bird flu." This inactivated influenza virus vaccine is indicated for immunization of persons 18 through 64 years of age who are at increased risk of exposure to the H5N1 influenza virus subtype contained in the vaccine. This vaccine is derived from the A/Vietnam/1203/2004 influenza virus. The vaccine is manufactured by Sanofi Pasteur Inc. of Swiftwater, PA and has been purchased by the federal government for inclusion within the Nation's National Stockpile.

Should such a bird flu pandemic emerge, the vaccine may provide early limited protection in the months before a vaccine tailored to the pandemic strain of the virus could be developed and produced. "The threat of an influenza pandemic is, at present, one of the most significant public health issues our nation and world faces," said Andrew C. von Eschenbach, M.D., Commissioner of Food and Drugs. "The approval of this vaccine is an important step forward in our protection against a pandemic."

Should a Dental Office Stockpile Antivirals?

According to a report published by the Center for Infectious Disease Research & Policy (CIDRAP), “At least 5 to 6 months into a pandemic, until a vaccine can be made and distributed, antiviral drugs for influenza (ie, antivirals) will be the only pharmacologic option for potentially preventing, shortening, or reducing the severity of illness among employees. Given grim estimates of 30% absentee rates, offering employees antivirals as part of a prevention or treatment strategy could appear to be a cost-effective way of both reducing worker absenteeism and bolstering employees' confidence in their company.

In a recent poll of 120 preparedness professionals attending the CIDRAP summit on business preparedness for pandemic influenza in February, 37% of the participants (many from Fortune 500 companies), said their firms had purchased or were planning to purchase antivirals for distribution to employees during a pandemic.” (May 11, 2007: CIDRAP News: http://www.cidrap.umn.edu/cidrap/content/influenza/biz-plan/news/051107antivirals.html)

Should dental offices consider stockpiling and potentially distribute antivirals (e.g. Tamiflu) to their employees? Although it is a difficult decision based on issues such as supply, distribution and timing, Dynamic Dental Safety recommends that dental offices should at least explore this option as part of a comprehensive emergency preparedness plan.

Lead Aprons in Dentistry

On the right is a depiction of a lead apron and thyroid collar that is typically used in the dental office. This is directed to be worn by the patient in the act of taking dental x-rays.

Many dental offices are now converting to and installing digital radiographic equipment. The amount of radiation delivered to the patient during this digital type of exposure is significantly less than the traditional x-ray equipment.

Taking this into account, we often get asked the question regarding the necessity for the patient to wear this protective lead apron with the usage of digital x-rays. The answer that we give is that the dental office should always consider the "worst possible scenario" in that if something were to happen to the patient at that moment or in the future......... the rememberance of not having the protective apron will be etched in the mind of the patient. The patient then might decide to take things to the next level.

The advice that we at Dynamic Dental Safety give to all of our clients is to practice "risk prevention", and in this case to always have the patient wear the lead apron during times of x-ray exposure.

For this or any other compliance issue or question, call us at Dynamic Dental Safety (888) 669-8846 ext. 701

Don't Block Your Fire Sprinklers!

Fire sprinklers are an essential and effective means of fire protec­tion for people and buildings. Often, how­ever, dental supplies and other stacked items are placed near or around sprinkler heads, blocking the range of the sprinkler and greatly reducing its effectiveness. Nothing should ever be placed any higher than 18 inches below a sprinkler or positioned in such a way as to block a sprinkler’s full range of coverage.

Hige storage of items can also create unstable loads and create a fall hazard. Pay attention to the organization of your storage closets. Minimize the storage of non-essential items and keep the area tidy.

Dental sharps container safety

Let's look at the opening at the top of the typical sharps container found in the dental office. We notice that there are multiple holes on the circumference. Most of the dental office does not even take note of these, however they are an important part of the safety solutions for the dental office.

The four holes that are similar are for the securing of the cover for the sharps container when it is deemed to be full. This is in most cases when the container is 2/3 to 3/4 full so as not to make it difficult to place something in the sharps container without undue force.

The two holes that we see on the extreme right and left of the picture are for the purpose of safely removing the needle from the syringe. This is done by inserting the needle into the opening and sliding it so as to engage the ribs on the hub of the needle. Next the needle can be disengaged by rotating the hub of the syringe and the needle will fall directly into the sharps container.

This method can be used with or without the needle being capped. We have demonstrated that the dental office has implemented "safer medical/dental devices" with the proper usage of pre-existing materials.

For compliance advice for the dental office please contact Dynamic Dental Safety at (888) 669-8846 ext. 701

Electrical Surge Protector/Power Strip Safety

Do NOT plug a surge protector or power strip into an existing surge protector or power strip. This practice is called "daisy-chaining" or "piggy-backing" and can create a serious hazard. There should only be one surge protector or power strip plugged into a single duplex electrical outlet.

- Power strips should not be overloaded. Most are rated for 15A. This equates to approximately 1500 watts of power connected to the device.

- Surge protectors, power strips, and/or extension cords are NOT a substitute for permanent wiring.

- Do NOT locate a surge protector or power strip in any area where the unit would be covered with carpet, furniture, or any other item that will limit or prevent air circulation.

- Do NOT staple, tack, or tape a surge protector or power strip.

Gas Cylinder Safety in Dental Offices

Safety is all important in the dental office. To this end it is essential that each and every employee in the dental office participate ... by observing and either correcting the issue or bringing it to the attention of an individual who has the ability to correct the offending issue.

Additionally, certain items should be checked on a regular basis. This is necessary in the documentation to "prove" that we not only say that we check items, but that in truth we do .. and place this in writing. Creating this "performance based" program in the dental office is one of the items that Dynamic Dental Safety helps to "walk the staff through" in providing our OSHA/Risk Prevention services.

One of the items to check on a regular basis are the compressed gas cylinders. These should be checked in the following way:

Compressed Gas Tanks should be visually checked to ensure:

The area of storage is clearly marked
The tanks are secured
There is no obstruction present
The regulators for the tanks are in place and functional

For further information regarding this or any compliance issue in the dental office, please contact Dynamic Dental Safety at (888) 669-8846 ext. 701

Hepatitis B Declination Statement

The following statement of declination of hepatitis B vaccination must be signed by an employee who chooses not to accept the vaccine. The statement can only be signed by the employee following appropriate training regarding hepatitis B, hepatitis B vaccination, the efficacy, safety, method of administration, and benefits of vaccination, and that the vaccine and vaccination are provided free of charge to the employee. The statement is not a waiver; employees can request and receive the hepatitis B vaccination at a later date if they remain occupationally at risk for hepatitis B.

Declination Statement: I understand that due to my occupational exposure to blood or other potentially infectious materials I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine, at no charge to me; however, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine I continue to be at risk of acquiring hepatitis B, a serious disease. If, in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me.

Employee Signature:_____________________________ Date:____________________

Adapted from OSHA etools

Safer Medical Device Implementation in Dental Offices

Since the passage of the Needlestick Safety and Prevention Act in 2000 and the subsequent revision of the OSHA Bloodbornes Pathogen Standard, all health care facilities, including dental offices are required to use safer medical devices. To assist facilities that are working through this process, The National Institute for Occupational Safety and Health (NIOSH) has asked a small number of facilities to share their experiences on how they implemented safer medical devices in their settings. These facilities have agreed to describe how each step was accomplished, and also to discuss the barriers they encountered and how they were resolved, and most importantly, lessons learned.

Click on the following link and scroll down to “Dental Facilities Results” to learn about the experiences of two different dental facilities: http://www.cdc.gov/niosh/topics/bbp/safer/Step1b.html