Current through Register Vol. 24-18, September 15, 2024
The use of barriers and sterilization techniques is the
primary means of assuring the least possible chance of transmission of
communicable diseases from denturist and staff to patients, from patient to
patient, and from patient to denturist and staff. To prevent patient to patient
cross contamination, instruments and supplies contaminated, or likely to be
contaminated, with blood or saliva and touched during treatment must be
sterilized between patients or discarded, except as otherwise listed in this
section. Surfaces and equipment that are likely to be contaminated with blood
or saliva and touched during treatment must be decontaminated or covered with a
barrier that is discarded and replaced between patients, except as otherwise
set forth below:
(1) Denturists shall
comply with the following barrier techniques:
(a) Gloves must be used by the denturist and
direct care staff during treatment that involves intraoral procedures or
contact with items potentially contaminated with the patient's bodily fluids.
Fresh gloves must be used for every intraoral patient contact. Gloves must not
be washed or reused for any purpose. The same pair of gloves must not be used,
removed, washed, and reused for the same patient at the same visit or for any
other denturist or nondenturist purpose.
(b) Masks must be worn by the denturist and
direct care staff when splatter or aerosol is likely.
(c) Unless effective surface decontamination
methods are used, protective barriers must be placed over areas that are likely
to be touched during treatment, not removable for sterilization, and likely to
be contaminated by blood or saliva. These procedures must be followed between
each patient including, but not limited to:
(i) Delivery unit;
(ii) Chair controls (not including foot
controls);
(iii) Light
handles;
(iv) Head rests;
(v) Instrument trays;
(vi) Treatment areas and laboratory
countertops and benches.
(d) Protective eyewear shields must be worn
by the den-turist and direct care staff and provided to all patients during
times when splatter or aerosol is expected.
(2) Denturists shall comply with the
following sterilization requirements:
(a) Each
denturist office must have the capability to ultrasonically clean and sterilize
contaminated items by autoclave, dry heat, unsaturated formaldehyde/alcohol
vapor (such as MDT Chemiclave) or ethylene oxide, where adequate ventilation is
provided. Sterilizers must be tested with a biological spore test, on a minimum
weekly basis. In the event of a positive biological spore test, the denturist
shall take immediate remedial action to ensure the objectives of (a) of this
subsection are accomplished. Documentation must be maintained either in the
form of a log reflecting dates and person(s) conducting the testing or copies
of reports from an independent testing entity. The documentation must be
maintained for a period of a minimum of five years.
(b) The following items must be sterilized by
an appropriate autoclave, dry heat, unsaturated formaldehyde/alcohol vapor
(such as MDT Chemiclave) or ethylene oxide sterilization method between
patients:
(i) Hand instruments;
(ii) Air-water syringe tips;
(iii) High volume evacuator tips;
(iv) Nose cone sleeves;
(v) Metal impression trays.
(c) Gross debris must be removed
from items prior to sterilization. Ultrasonic solution cleaning must be used
whenever possible.
(d)
Nondisposable items used in patient care that cannot be sterilized by
autoclave, dry heat, unsaturated formaldehyde/alcohol vapor (such as MDT
Chemiclave) or ethylene oxide must be immersed in a chemical sterilant. If such
a technique is used, the solution must be approved by the Environmental
Protection Agency and used in accordance with the manufacturer's directions for
sterilization.
(e) Items such as
impressions contaminated with blood or saliva must be thoroughly rinsed,
appropriately disinfected, and placed in and transported to a denturist
laboratory in an appropriate case containment device that is properly sealed
and separately labeled.
(f) In the
laboratory:
(i) Ragwheels must be sterilized
or disinfected;
(ii) Patient pumice
must be discarded after each use; and
(iii) Patient burrs and stones must be
sterilized or disinfected.
Statutory Authority: RCW 18.30.070(3). 98-20-068, §
246-812-520, filed 10/2/98, effective 11/2/98; 95-22-062, § 246-812-520,
filed 10/30/95, effective 11/30/95.
