Team dentistry: learning the way forward

Clontarf Castle was a great venue for our continuing professional development day. The lectures were of an excellent standard and I personally found them really relevant and interesting. The lunch was terrific and the chocolate cookies were fabulous at the coffee break! I met some lovely nurses afterwards in the bar from all corners of Ireland. It was a great day.

National oral health policy update
Mr Chris Fitzgerald, Department of Health & Children

The national oral health policy will facilitate the planning and re-orientation of oral health services in Ireland over the next 10 years. A consultation process took place as part of this process, enabling input from all interested parties who provide dental services in Ireland.

The challenge is to deliver quality oral health care to the population in a cost-effective manner.
Mr Fitzgerald thanked the IDNA for its representation in this process and highlighted the following areas, which were addressed as part of their submission:
• The question of statutory registration for dental nurses
• The composition of the Dental Council
• Educational standards and guidelines
• The role of auxiliary members of the dental team
• Skills mix
• Accountability for health and safety.     

Radiation safety and legislation
Dr Stephen Fennell, Radiological Protection Institute of Ireland (RPII)

This lecture explained the importance of X-ray machines within dental surgeries throughout Ireland and the need for them to be licensed by RPII. Dr Fennell focused on surgeries having regular servicing and inspections, and the importance of staff wearing dosimeters for our own protection.

X-ray equipment must have a licence and this should be displayed on the premises.

X-ray equipment must be installed only by people who are qualified to do so. On a national level there are a total of 2,260 licences currently issued. These areas include HSE clinics, private practices and government facilities.

Health and safety, infection control and personal injury risk minimisation
Ms Mary O’Donnell, Microbiology Department, Dublin Dental School & Hospital

We were informed that healthcare workers in Ireland suffer around 6,000 needle stick injuries (NSIs) every year. Twenty-six per cent of these are unpreventable, while 74% of these injuries were caused by incorrect working behaviour/methods.

Many of these injuries go unreported, while 59% of people who received a needle stick injury stated that when pressure mounts they feel the need to work faster, even if it means taking shortcuts.

Procedures should be put in place by employers and employees to prevent NSI. It is the employer’s duty to provide a safe working environment, as well as to provide health and safety training for all members of staff.

Code of practice for decontamination of instruments (and other stuff!)
Professor David Coleman, Microbiology Department, Dublin Dental School & Hospital

Professor Coleman outlined the main features of the draft Health Service Executive Code of Practice (5b) for Decontamination of Reusable Invasive Medical Devices (RIMD) (in our case, dental instruments) due to be published by the HSE in the near future. For the purpose of this document, decontamination areas within dental surgeries are referred to as a Local Decontamination Units (LDUs).

This code provides the standards that will be required for all aspects of decontamination of dental instruments, including dental surgeries themselves. The Code is evidence-based and details the use of standardised, efficient and reproducible processes that can be validated for the decontamination of dental RIMD. The approaches outlined provide protection for staff involved in the decontamination of dental RIMD by reducing exposure to chemicals and micro-organisms. Implementation of the Code will involve changes in work practices in most dental surgeries.

Professor Coleman commented that it is generally accepted that most existing dental surgeries (LDUs) do not meet the standards of the Code and that achievement of the required standards would take several years, requiring the provision of adequate resources for new equipment, facilities, training and infrastructure.

Nonetheless, in the short-term it is hoped that dental LDUs would cease using non-vacuum autoclaves and would clean and decontaminate all dental instruments using an approved washer-disinfector prior to sterilisation in an approved vacuum autoclave.

In addition, Professor Coleman stated that hand washing of dental instruments would be banned, as it is a high-risk activity for percutaneous injury and subsequent cross-infection, and furthermore the process cannot be validated.

Professor Coleman concluded that implementation of the new Code would standardise the decontamination of dental RIMD and provide robust quality assurance for the safety of both patients and dental staff.

All in all, a fantastic time was had by all. I would like to thank the IDNA committee for organising the day. It gives dental nurses the opportunity to meet up and catch up with all the gossip in the dental world. I look forward to the next event and I hope to see you there.

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