We want you to be safe while you work in our practice. OSHA has guidelines for all dental practices and we follow them – and we even invite OSHA to come into the practice every 3-5 years to check our work practices and answer questions so that all our staff and dentists are safe. This plan is designed to minimize our staff exposure to blood or other potentially infectious material.
These blood borne pathogens ‑ particularly the human immunodeficiency virus (HIV) that is responsible for AIDS and the hepatitis B virus (HBV) are serious diseases. This plan, based on recently developed universal precautions, assumes that body fluids (such as saliva and blood) are potentially infective with blood borne pathogens.
This outline of the exposure plan will be kept in General Level I. A copy of the OSHA Blood borne Pathogens Standard (CFR 1910.1030) is located in _________________________. You may review it anytime you wish. Although this document can be difficult to read, you should be familiar with its contents and be in compliance with its requirements. This manual will be reviewed annually and updated as changes occur.
Each member of the staff falls within one of four categories of employees:
Each category will have a series of training manuals that outline all safety procedures in detail. These manuals are located ____________________. Dentists, hygienists, and chairside/EFDA’s are “at risk” and will need to follow strict infection control standards to avoid occupational exposure. Secretaries are much less exposed to these infectious incidents, and their preventive requirements are correspondingly less stringent. Each employee must be “checked off” on correct, safe approaches to performing each task in their job. The employee should not enter into any task without an employee already trained helping them practice this task until it is performed satisfactorily. No staff member should ever perform any task that isn’t safe or healthful. If you have any questions about a particular job, ask your doctor. This won’t “irritate” your doctor. It’s our job to try to be aware of all potential hazards here. Your cooperation in informing us of potential hazards is an important part of your job.
Your health and safety is more important than treating clients. After all, we’re a “health” facility! Everyone here must pitch in and cooperate to protect everyone else. Don’t be shy about questions. Don’t be afraid of “rocking the boat” with your ideas. We all need to keep our safety in mind constantly. We have never had a serious injury here. With your help we’ll keep our record clean.
Our safety and health program will include: Providing mechanical and physical safeguards to the maximum extent possible. Conducting a program of safety and health inspections to find and eliminate unsafe working conditions or practices, to control health hazards, and to comply fully with the safety and health standards for every job. Training all employees in good safety and health practices. Providing necessary personal protective equipment and instructions for its use and care. Developing and enforcing safety and health rules and requiring that employees cooperate with these rules as a condition of employment. Investigating, promptly and thoroughly, every accident to find out what caused it and to correct the problem so that it won’t happen again. Setting up a system of recognition for outstanding safety service or performance.
We recognize that the responsibilities for safety and health are shared: The doctors accept the responsibility for leadership of the safety and health program, for its effectiveness and improvement, and for providing the safeguards required enduring safe conditions. Senior staff (level 4 and above) are responsible for developing the proper attitudes toward safety and health in themselves and in those lower level staff personnel, and for enduring that all operations are performed with the utmost regard for the safety and health of all personnel involved, including themselves. All staff is responsible for wholehearted, genuine operation with all aspects of the safety and health program including compliance with all rules and regulation ‑and for continuously practicing safety while performing their duties.
Dentistry requires the use of many hazardous materials. One of your primary responsibilities will be to protect yourself, the rest of the staff, and your clients from the harmful effects of those materials. The Occupational Safety and Health Administration (OSHA) has established standard 29 CFR 1910.1200 to set guidelines for our safety. A copy of this regulatory standard is available online at www.osha.gov. You may look at it and/or copy it any time you wish.
We have a 6-step program that you will be expected to follow exactly.
The following information is required on labels:
Here are some general precautions:
All labels should contain:
Everyone has read about AIDS and Hepatitis. These are only two of many infectious diseases we may be exposed to. An exposure can occur in an obvious manner ‑ getting cut by an instrument or some other sharp object that was contaminated by an infected client. However, you could also be infected by just touching an infected object and then rubbing your contaminated finger over your eye, nose or mouth. Many infected people look perfectly healthy. The only way to protect yourself is to follow all the guidelines established.
All employees will be provided with training before they begin work involving occupational exposure. Thereafter, training will be provided at least annually and whenever changes in tasks or procedures require. Training will be provided during work hours at no cost to the employee by someone who is familiar with the standard as it relates to the dental office
Training will cover:
The employee will maintain a record of all training sessions. The training record will include:
The following exposure determination has been prepared for this office: All employees in the following job classifications have occupational exposure.
expanded function personnel
Some employees in the following job classifications have slight occupational exposure, when handling client charts.
public relations coordinator
front desk manager
Universal precautions is an approach to infection control that treats blood and certain body fluids (including saliva in dental procedures) from all patients as infectious for HBV, HIV, and other bloodborne pathogens, regardless of the patient’s perceived infectious status. Universal precautions are one of the most important measures for preventing transmission of bloodborne pathogens. This office uses universal precautions, and all employees are trained to understand this concept.
Engineering controls isolate or remove a hazard from the workplace. Examples of engineering controls that might be used in a dental office are sharps containers, rubber dams, and high volume evacuators. Engineering controls must be examined routinely and maintained or replaced as needed to ensure their effectiveness (e.g., inspecting sharps containers daily to make sure they are not overfilled). In this office, engineering controls are inspected and maintained by our cleaning/sterilization person and oversight is provided by the clinical coordinator.
Work practice controls
Breaks in skin that become infected chemical splashed into eye, or physical injury
Due to the potential of infection, be sure to let a dentist or team leader know if there is any possibility of infection. Even a small infection can lead to a serious health problem if not treated.
Eating and drinking
Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses is prohibited in where there is a reasonable likelihood of occupational exposure (dental, operatories, laboratory, sterilization area, medical waste storage area). Food and drink may not be stored in refrigerators, freezers, shelves, cabinets, or on countertops or bench tops where mold or other potentially infectious materials are present. In this office, food and drink may be stored ______________________.
Personal protective equipment (PPE)
The standard defines personal protective equipment (PPE) as specialized clothing or equipment worn by an employee to protect against a hazard.
In this office, potentially biohazards material are color‑coded red or identified with the following biohazard symbol and the word “biohazard” in contrasting color on a fluorescent orange or orange‑red label.
A confidential medical record is maintained for each employee with occupational exposure. The medical record includes: The employee’s name and social security number. A copy of the employee’s hepatitis B immunization status and any of the following that apply: Exposure incident report, Written opinion of health care professional Form refusing hepatitis B vaccination Form refusing post‑exposure evaluation and follow‑up (not required by OSHA, but highly recommended)
Employee medical records for this office are maintained ___________________________. Employee medical records are kept confidential and will not be disclosed without the employee’s consent or as required by law. Employee medical records are retained for the length of employment plus 30 years.
OSHA standard 1910.20 gives employees the right of access to their own medical and exposure records.
Certificate of Hazard Assessment
I, Dr. ___________________ , certify that the dental office was evaluated on _____________ for hazards, which are present, or likely to be present, which necessitate the use of personal protective equipment.
Most injuries in dental practices can be prevented. Most of these injuries are caused by physical mistakes made repeatedly – a secretary doesn’t sit correctly facing her computer, or a hygienist uses poor hand positions. Watch for these risk factors.
Even though there is no smoking in the building, fire is always a potential hazard. All trash should be emptied into bags and placed in the utility room. The janitorial staff will remove this trash and place it in the shed away from our main building. All nitrous/oxygen tanks should be chained against the walls. Not only could the gases ignite, but if a tank fell over, it could explode. Watch out for cords (equipment, telephone, etc.) If you see any that aren’t tied down, tell your team leader.
If a tornado watch (condition is right for a tornado) is issued, everyone should listen to the local radio station over the intercom system. If an actual emergency exists (tornado warning –actual sighting in the area), the fire department will activate their siren. Tornadoes have a ground speed of 30MPH.
Under no circumstances should you exit the building. The safest location during a tornado is; _______________________________. All staff, clients, and doctors should form along this wall. Bring one of our portable radios so we will know when the all clear has sounded. Stay away from the utility room and the nitrous/oxygen storage room. These tanks could explode if they are violently knocked around. Don’t worry about opening any windows. They will probably break during the tornado anyway! When the siren sounds, get all patients against the safe wall. Every second counts. If you have time, grab the first aid box located _________________________ and bring it with you. Ask your dentist for a map of the building that shows exits for emergency exit routes.
Work Place Fire Hazards: Lab area and Nitrous oxide/oxygen storage area
If a fire occurs we will use 2 approaches – put it out or evacuate the building.
Snow EmergenciesWhat is a snow emergency?
According to Ohio law, a sheriff may declare a snow emergency and temporarily close county and township roads when reasonably necessary to preserve public safety. The sheriff may vary the level of warning issued to the public. To distinguish mere warnings from actual roadway closure, the County Sheriffs in Oho have established different levels of snow emergencies. You can check on weather/road conditions by calling 511, a free phone service. For instance, the guidelines established for our County are as follows:
Level 1. Roadways are hazardous with blowing and drifting snow. Roads are also icy. Drive very cautiously.
Level 2. Roadways are hazardous with blowing and drifting snow. Only those who believe it is necessary to drive should be out on the roadways. Contact your employer to see if you should report to work.
Level 3. All roadways are closed to non-emergency personnel. No one should be out during these conditions unless it is absolutely necessary to travel. All employees should contact their employer to see if they should report to work. Those traveling on the roadways may be subject to being charged with a misdemeanor.
Level 1 and level 2 Snow Emergencies
If you elect to stay home during a Level 1 or 2 snow emergency, despite being asked to report to work, it’s ok. We don’t want you on the roads when you are afraid.
Level 3 Snow Emergencies
Once a Sheriff has declared a Level 3 Snow Emergency, the roads are closed and anyone (non-emergency) traveling on them is subject to being charged with a fourth-degree misdemeanor. Stay home. We will send all staff home when a Level 3 snow emergency has been declared. Usually we know a day in advance when a snow emergency may occur. You’ll be alerted the day before if possible. Around 6:00 a.m. the doctor that opens will call the opening secretary to decide if the practice should not open or not. If not, we will delay opening until 10:00 a.m. The opening secretary will call several secretaries and team leaders who will have taken schedules home with them. They will start a call chain with each team leader calling her team. We always try to call those further away first.
If the roads are not good and you haven’t heard anything, be sure to call your team leader before you leave for work. At 9:15am the opening doctor and the opening secretary will discuss road conditions again. This time if there’s not enough improvement we’ll close until 1:00p.m. Again the phone chain will be activated, so you should check with your team leader before driving to work. Finally, if we are still closed, the opening doctor and the opening secretary will talk again at 12:00. This time if the roads aren’t safe we’ll close for the rest of the day. The phone chain will be activated. Call before coming in.
Watch Video “If Saliva were Red”
Doctor to call TL’s – TL’s to call team
Team Leader_______________________________________ Date_________________________