29 November 2004 - Fund for Training Programme to Improve Dental and GP Practice Hygiene
The SSRG looked at 837 independent Scottish dental practices, of which 179 took part and found the results to be very alarming. The report from the survey, Survey of Decontamination in General Dental Practice, reveals the following:
- 50% of practices do not have a dedicated sink for decontamination;
- 50% of staff use no eye protection when cleaning instruments;
- 15% of staff clean instruments under water to prevent aerosols;
- 60% have no instruction manuals available for steam sterilisers;
- 65% don't test their steriliser daily;
- 65% change the steriliser water less than daily;
- 70% have no record of staff training in decontamination
In answer to the findings within the report, the Scottish Executive Health Department (SEHD) Working Group recommended the following:
- SEHD urgently needs to increase NHS Trusts’ and other healthcare providers’ awareness of the importance of good decontamination practices;
- no new guidance is required;
- Trusts, hospitals and primary care organisations require to audit their achievement of decontamination standards;
- Trust senior management should undertake an assessment of the infection and decontamination risks associated with their services, ensure that overall standards of decontamination practice are monitored and co-ordinate decision-making on decontamination, infection control, health and safety and the acquisition and disposal of surgical instruments;
- Trusts should ensure that decontamination of re-usable medical devices is managed and undertaken only by suitably trained personnel. Trusts need to assess the recruitment, retention and training requirements of Central Decontamination Units and put in place measures which motivate staff to deliver an improved level of service;
- SEHD should collaborate with other UK Health Departments in investigating the efficacy of washer disinfectors in removing potentially infective tissue.
Scotland's Chief Medical Officer commented:
"There is no need for public alarm and there is no evidence that patients are being harmed. What we are doing here is identifying areas of concern before a problem arises. We commissioned the survey and we are acting on its findings - working with the professions - to protect patients.
"It isn't rocket science - it is more about basic housekeeping. And following basic rules: clean hands, clean instruments and clean working.
That's how we can minimise risk of transmission of all blood-borne infections and maximise protection for patients."There are also wider lessons here for GP as well as dental practices and that is why we are writing to all health care professionals in primary care.
"We have written to all dentists, GPs and Health Boards in Scotland to highlight the concerns identified in this study and to make clear that we expect action on ten priority areas as a matter of urgency.
It is the legal and professional responsibility of all dentists, doctors and nurses working with re-usable instruments in primary care to ensure that this happens."
Chief Dental Officer also commented:
"This isn't about the quality of service it is about quality assurance - to make sure that set procedures are being followed and practice is as safe as it can and should be for patients.
"We have now set up an expert group to take this forward. It will provide a comprehensive training programme, in association with NHS Education for Scotland and Health Protection Scotland.
"As well as providing training for staff in their practices, it will provide clear and consistent information and help them systematically audit their decontamination practices.
"We have asked NHS Boards to provide us with action plans how they plan to address any shortcomings identified through this process."
The Sterile Services Review Group survey can be accessed by clicking the following: Sterile Services Review Group Survey
Article by Alexandra Johnston
