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Are we in capable hands?

The steri room

Probably the most important area of a dental practice is the one that you don’t often see – the steri room. The area where contaminated instruments are cleaned, processed and sterilised for re-use. A perfectly normal practice that takes place every day in clinics across the world, surely we’re in capable hands? Most likely yes, the vast majority of dental workers complete an outstanding job, efficiently, effectively and in compliance with standards and regulations. But not always.

Proper conduct

There is an underestimated and somewhat hushed risk in this area of dentistry. To receive accreditation, a dentist must prove they are conducting their practice in adherence to industry standard. Critical to this is the expectation that all staff will be trained to standard operating procedures, including those concerning reprocessing instruments, though this is not always the case.

Stretched too thin

When new employees begin work within a dental unit they will likely spend a large portion of their time in the sterilisation room learning the processes. Eventually, they will know how to operate the room but until that comes about there is often a ‘buddy’ system in place where another clinician will supervise. An adequate method of training however during busy periods supervisors will leave new staff members to fend for themselves.

An accident waiting to happen

This training method gives the role with the greatest risk to the most inexperienced individual. Patients attend dental appointments fearing the pain and discomfort they will endure at the hands of the dentist when in reality this may not be the worst thing they experience. If non-sterile instruments make it into surgery, patients are at risk of being exposed to diseases including HIV, Hepatitis or Creutzfeldt-Jacob Disease (CJD).

Previous outbreaks due to employee error

Even the smallest error can jeopardise the health of patients and staff. In 2009 a week passed before hospital employees realised non-sterile instruments had been used on patients. A staff member had forgotten to turn on the autoclave and the slip-up potentially exposed 235 people to HIV and Hepatitis. Usually, this would have been detected when the machine was unloaded as the indicator tags attached to the equipment hadn’t changed colour. This however also went unnoticed.

Failings within staff practice

Clinics depend heavily on the autoclave to eliminate prions and bacteria. Often these automated methods can create a false sense of security and these important processes are often left to the least experienced staff members. Regrettably, the autoclave can’t remove the risks posed to us 100% of the time. There is no way to be certain of the sterility of an instrument once it has been taken from the machine.

Sterilisation and precautionary methods such as indicator tags are all of extreme importance to the safe running of a dental clinic. Though none of these are effective when human errors occur.  

Who is accountable?

Overall the burden of sterilisation is placed on the employer. They must provide all employees with the necessary training to ensure understanding and diligence in their responsibilities when complying with health and safety laws. Training must be planned, systematic and assessed to properly determine ability before staff are deemed fit to perform such important tasks.