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General CPD: 30 minutes
I spend an extraordinary amount of time speaking to dentists, dental practice managers and dental nurses. One question I always put to them is regarding infection control (IC) and whether they think it could become second nature. This question, not surprisingly, gives way to a whole host of interesting responses but the general consensus is…‘No’.
With this in mind, when I was asked to write this article, I decided to explore what is actually preventing effective IC becoming second nature on a daily basis and what can be done to change this. I base my thoughts around what I like to call the ‘five Ps’.
Everyone in the dental sector is under extreme pressure. It is common knowledge for people working in the industry.
There are time pressures, financial pressures, best practice regulations and legal pressures. There are also physical logistics, public perception and the real and very imminent emergence of the ‘sue-culture’. Those of you who experience these pressures on a daily basis don’t need me to go into detail.
Anyone who is forced to run up and down a flight of stairs to get the correct product in order to be compliant knows exactly what physical logistic pressures feels like. I’m sure all of you will relate to the good old-fashioned ward sister who said to the consultant: ‘I can either treat the patients or be compliant, which would you prefer?’
I believe that it is these pressures that are preventing IC ever becoming second nature. If it doesn’t, there will be the added pressure of managing the resulting risks, which of course is counter productive.
Any successful practice strives to make a profit. This can only too often become the proverbial noose around the neck of IC.
The fact that IC is not yet second nature and not always top priority makes it one of the first things targeted with regards to cutting corners and maximising profits. Unfortunately the risks and potential human cost associated with this continuing are too great to ignore.
To date, the dental sector has (fortunately) been somewhat protected against the world’s hungry litigious society, but do a Google search to find a ‘solicitor to sue dentist’ and you’ll be faced with over 300 results! Now if that’s not an unwanted revolution waiting to happen, what is?
Add this to the Care Quality Commission (CQC) inspections that place an extra and disproportionate burden on your life, the real threat of your premises being closed down (as happened in Dudley and Bridgewater), bad publicity and the risk of being sued. All the while putting aside the unthinkable effect of death or patient-to-patient hepatitis C virus cross-infection like the one recently reported in Tulsa, Oklahoma. You’ll start to see it’s essential that IC becomes second nature.
Without exception, the people I speak to want to be compliant, they work hard and do the best job they can. But the reality is that they’re under too much pressure and the whole system’s too complicated. Then just to add insult to injury, the hand gel makes them itch!
Ticking infection control boxes has become yet another burden and the temptation is to say: ‘If it looks clean, it is clean.’ As far as I am concerned, the human factors are essential to make IC the automatic daily routine it needs to be.
When IC regulations were put together, little thought went into its ergonomics (which is ironic in an industry that’s obsessed with telling you how you should sit and precisely at what angle your light should be) and that’s a real pity. To make it work, IC needs to become an integral part of your working day. You need ergonomic procedures, ones that fit reality, that fit your mindset and that fit your (sometimes) not purpose-built surgeries.
Infection control as it stands today calls for a myriad of products, all of which have a list of virtues as long as your arm (if we’re to believe everything we read on the tin).
Practice managers are faced with juggling a host of different suppliers and manufacturers, deciphering danger warnings on labels and the impracticality of not storing ‘this’ next to ‘that’. It’s a logistical nightmare.
At the end of the day, what you want is a quick simple system using highly effective, safe products that get you the tick in the inspector’s box, allowing you to get on with what you do best: treating your patients.
For my last P, I’d like to focus on possibility. In my view, what is required is a comprehensive, high quality, integrated and compliant system that places IC as a pivotal part of your daily routine.
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Steve Marshall is commercial director of Seventh Medical, which launches Surgery Clean, a comprehensive, six-stage dental infection control system that will enable the whole IC process to become second nature.