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La bo r ato r y Saf et y
Present ation
May 7, 2004
Presented By:
Richard Perry
Marsh Risk Consulting
Sheree Duff
Director of Dental Hygiene,
Baker College of Port
Huron
Barbara Honhart
Vice President of
Academics/Systems
Today’s Agenda…
• Employees - Safety
governed by MIOSHA’s
Chemical Hygiene Plan
requirements
• Students - Doctrine of
Reasonable Care
applies
Chemical Hygiene Plan (CHP)
Purpose
Provide guidance and
protocols for the
protection of employees
from safety and health
effects of laboratory
hazardous materials.
CHP General Requirements
and
• Generic information
applicable to most
laboratory situations on
each campus; plus
• Provisions to
“customize” the CHP to
each Baker College
campus
Baker College CHP Implementation Requirements
• Personnel training
(faculty and staff; full
and part-time)
• Student training
• Documentation of
training
• Maintenance and
confidentiality
Objective
• Clinic setting
• Laboratory setting
Handbook
• Development of the “Faculty and Staff Handbook
Specific to the Dental Hygiene Program.”
Please note that the cost of all medical evaluations and procedures, such as post-exposure evaluation and follow-up including prophylaxis, will be
assumed by the student/patient. After investigating as to the cause of the exposure, a plan will be put into effect to prevent reoccurrence of the
exposure and all employees/students under this plan will be informed as to the method of prevention.
The OSHA Coordinator must be informed and appropriate protocol (i.e. Incident Report) followed. In the event the OSHA Coordinator is not
physically in the building at the time of the exposure, all above protocol must be handled by a clinical faculty member with the OSHA Coordinator
informed as soon as possible.
DEPARTMENT OF CONSUMER AND INDUSTRY SERVICES
DIRECTOR'S OFFICE
Filed with the Secretary of State on June 30, 1993 (as amended November 14, 1996)
These rules take effect 15 days after filing with the Secretary of State
(By authority conferred on the director of the department of consumer and industry services by section 24 of Act No. 154 of the Public Acts
of 1974, as amended, and executive reorganization orders nos. 1996‑1 and 1996‑2 being §§408.1024, 330.310 1, and 445.2001 of
the Michigan Compiled Laws)
R 325.70004, R 325.70005, R 325.70007. R 325.70008, R 325.70009, R 325.70012, R 325.70013, R 325.70015, and R 325.70016 of the
Michigan Administrative Code, appearing on pages 601 to 605, 612, and 613 of the 1993 Annual Supplement to the 1979 Michigan
Administrative Code, are amended to read as follows:
BLOODBORNE INFECTIOUS DISEASES
R 325.70001 Scope.
Rule 1. These rules apply to all employers that have employees with occupational exposure to blood and other potentially infectious material as defined by the provisions of
R 325.70002(c), (n), and (r).
R 325.70002 Definitions.
Rule 2. As used in these rules:
(a) "Act" means Act No. 154 of the Public Acts of 1974, as amended, being §408.1001 et seq. of the Michigan Compiled Laws.
(b) "Biologically hazardous conditions" means equipment, containers, rooms, materials, experimental animals, animals infected with HBV or HIV virus, or
combinations thereof that contain or are contaminated with, blood or other potentially infectious material.
(c) "Blood" means human blood, human blood components, and products made from human blood-
(d) "Bloodborne pathogens" means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include
hepatitis B virus (HBV) and human immunodeficiency virus (HIV).
(e) "Clinical laboratory" means a workplace where diagnostic or other screening procedures are performed on blood or other potentially infectious material
(f) "Contaminated”‑ means the presence or the reasonably anticipated presence of blood or other potentially infectious material on an item or surface.
(g) "Contaminated laundry" means laundry which has been soiled with blood or other potentially infectious materials or may contain sharps.
(h) "Contaminated sharps" means any contaminated object that can penetrate the skin. including any of the following:
(i) Needles.
(ii) Scalpels.
(iii) Broken glass
(iv) Broken capillary tubes.
(v) Exposed ends of dental wires.
(i) "Decontamination" means the use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point where
they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling. use, or disposal.
(j) "Department" means the department of consumer and industry services
(k) "Director" means the director of the department or his or her designee.
(l) "Disinfect" means to inactivate virtually all recognized pathogenic microorganisms, but not necessarily all microbial forms on inanimate objects.
(m) "Engineering controls" means controls that isolate or remove the bloodborne pathogen hazard from the workplace.
(n) "Exposure" means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result
from the performance of an employee's duties. This definition excludes incidental exposures that may take place on the job, and that are neither reasonably nor
routinely expected and that the worker is not required to incur in the normal course of employment
(o) “Exposure incident" means a specific eye. mouth, other mucous membrane, nonintact skin, or parenteral contact with blood or other potentially infectious material
that results from the performance of an employee's duties.
(p) "Handwashing facilities" means a facility that provides an adequate supply of running, potable water, soap, and single‑use towels or a hot air drying machine.
(q) “Licensed health care professional" means a person whose legally permitted scope of practice allows him or her to independently perform the activities required
by the provisions of R 325.70013 concerning hepatitis B vaccination and post‑exposure evaluation and follow‑up.
(r) "Other potentially infectious material“ means any of the following:
(i) Any of the following human body fluids:
(A) Semen.
Sharps Injury Log Book
Date Type of Injury/ Location Description of Incident
Device Used Clinic/Lab/ Incident Report
Other Number
1.
2.
3.
Incident Report
SHARPS INJURY LOG # ___________
II. Labeling:
A. The Program Director will be responsible for seeing that all containers (including portable) in the clinic are properly labeled. (Note:
although the Director has the final responsibility in this matter, this day to day task may be delegated to a trained work study student,
under the direction of the Director.)
B. All in-coming labels will be checked for: identity, hazard warning, name and address of responsible party.
Guidelines regarding removal and storage of medical waste, including sharps will follow Federal, State and Local guidelines and
will be updated as needed. Medical waste will be disposed of at regular intervals not to exceed 90 days. Waste will be collected in
OSHA approved red containers marked medical waste. Storage of these bags will be in room 111A , which is a restricted area
with limited access. They will be collected by the Facilities Department of Baker College, who are fully informed of the potential
risks and who have been trained in Universal Precautions, following all the appropriate guidelines, and within 24 hours. At
designated schedules, "Waste Management" company will pick up Baker College's BIO-waste. The dental clinic is a "small"
generator of medical waste.
Stericyle
P.O. Box 9001588
Louisville, KY, 40290-1588
All local, state, and federal regulations for hauling medical waste are followed. The required forms and documents for transport
and disposal are kept in the office of Ralph Jordan, Director of Safety/Facilities.
The following is a list of disposable items that will be placed in the student's trash bag during and at the completion of patient
treatment:
Face masks, cotton rolls, patient gloves, articulating paper, finger cots, prophy cup, patient big, prophy brush, prophy paste
containers, floss/tape, dappen dishes, pit and fissure brushes, cotton tip applicators, saliva ejector, headrest cover, bitewing tabs,
all plastic barriers, x-ray film packets, gauze squares.
All sharps (needles etc.) will be placed in the Sharps container located on the countertop in the sterilization area of the Clinic.
Upon closing the container, it will be stored in room 111A until pick-up at regularly scheduled intervals.
Following manufacturer's instructions, the suction cleaner (currently Vacusol Ultra) will be run through the suction system daily.
Clinic Emergency Evacuation
BAKER COLLEGE OF PORT HURON
DENTAL HYGIENE CLINIC FIRE EVACUATION PLAN
FOR THE DENTAL HYGIENE STUDENTS AND FACULTY
A plan has been created to provide easy exit from the building in case of a fire. A fire drill will take place during the Fall quarter. Responsibilities have
been assigned to eliminate confusion in the event of a real fire.
NOTES:
1. If you cannot get out of your area for whatever reason, close the doors and windows.
2. Do not use the elevator for any reason.
Clinical Quality Assurance Document
As part of a faculty orientation meeting, I was updated on the following OSHA issues:
• Revision of the “Exposure Control Plan” to include the use of “Metri-Wipes” for use as a surface
disinfection. A new MSDS sheet is filed in the log book.
• Maintenance of the policies for the “Needle Stick Safety and Prevention Act” which was explained
at the Fall 2001 faculty orientation. I have been given the opportunity to discuss and have input
into any recapping devices I think might be appropriate for the Dental Hygiene Clinic.
• Review of Annual Training Modules:
– Infection Control Procedures
– Waste Management
– Hazard Communication
In addition, I have had the opportunity to update my “Latex Allergy Survey” to document any changes.
Faculty Signature: ____________________________________Date:______________________
Trainer: Sheree Duff RDH, MS
Faculty Folder for Credentials
• Membership: www.osap.org
P.O. Box 6297
Annapolis, MD 21401
Student Training for MIOSHA and
Safety Procedures
• Student Handbook
• Curriculum Content
• Testing and Assessment
• Weekly Grading Criteria
• Laboratory Safety Rules for:
– Oral Anatomy
– Dental Radiology
– Dental Materials
Dental Hygiene Student Handbook
• MIOSHA section
• Sign-off sheet
Student Waiver Form for Potential
Latex Allergy
STUDENT WAIVER FORM
Latex Allergy
The goal of Baker College is to have a latex “safe” environment. However, because latex can be found in a variety of products and materials (i.e.,
erasers, wallpaper, computer terminals, etc.) it is difficult to ensure a latex “free” environment. Therefore, the following information is being
presented to fully inform all students of the potential risks of this exposure to latex.
Students at Higher Risk: previous history of allergies
numerous previous exposures to latex of any kind
» health care workers
» spina bifida patients
» rubber plant employees
Methods of Exposure: skin/mucosal contact, glove wearing, and via airborne particles in the air.
Symptoms: From a simple runny nose to a life threatening anaphylactic reaction.
General symptoms include: sneezing, coughing, itching, asthma, rash, headaches, shortness of breath.
Systemic reactions: hives, swelling, edema, coughing, asthma, shock, laryngeal edema, cardiovascular changes and
gastrointestinal changes.
Caution: Students with a mild sensitivity to latex may, at any time, develop a serious life threatening reaction to latex.
Baker College has attempted to ensure your safety; however, students developing serious reactions to latex may not be able to complete their
specific program of study at Baker College.
I understand the risks involved in using and being exposed to latex products. I understand I will have the opportunity to request latex free
products gloves, etc.), to the extent possible from Baker College. I have the responsibility of notifying an instructor if I suspect a latex allergy
condition, as soon as the symptoms occur. Additional information regarding latex free/safe products will be available to me at my request.
Student Signature: _______________________ Name: (print)___________________________
ID Number____________________________ Date:_________________________________
Student Training
• HANDBOOK INFORMATION
SIGN-OFF
• I have received and read the
information provided in the
2003-2004 Baker College of
BAKER COLLEGE OF PORT HURON
Port Huron Dental Hygiene’s
DENTAL HYGIENE PROGRAM
Program Student Handbook.
Student Handbook
2003-2004 • Student name (print):
_______________________
• Student signature:
_______________________
• Date:___________________
Curriculum Content
• Videos
• Lectures
• Demonstrations
• Class Handouts
• Tests/Assessments
Weekly Grading with Rubrics
STANDARDS OF CARE
*Infection control
Professionalism
Time management
Patient management
*D.H. Assessment / Tx. Planning
PROCESS
Obtain camera, retractors, and mirrors.
Inform patient about the procedure and rationale for use.
Describe and demonstrate the use of the retractors and mirrors for an anterior view, a buccal view, an occlusal view and a full
face view.
Dry the teeth and/or mirror.
*Remove lens cap.
Note: Do not turn the power on by setting the Mode dial until the lens cap is off!
Hold the camera firmly with both hands while keeping your elbows at your sides to prevent the camera from moving.
Note: Do not wear gloves while operating the camera.
Set Mode dial to P for full face profile or A/S/M for intraoral images. Check display for battery power.
View the image in the LCD monitor and rotate the Zoom lever toward T for a close-up picture or W for a wider view.
Note: Do not hold the camera closer than 9 inches from the subject to be photographed.
Press the shutter release button halfway to activate the focus and exposure lock then fully to take the picture.
Display the recorded pictures by setting the Mode dial to
Laboratory Safety Rules
LABORATORY SAFETY RULES
They will be enforced by the laboratory instructors. The rules are for the safety and follow-up care
for all individuals.
1. Injuries
• Follow emergency procedures as specified in the Student Handbook (p. 111-113).
• Report all injuries to the instructor.
• File an Incident Report (Appendix A, p. 152-153) of the Student Handbook.
2. Safety precautions
• Follow universal precautions by wearing the appropriate personal protective
equipment (PPE) during procedures:
• Eyewear
• Masks
• Gloves
• Clinic jacket
• Clinic shoes are worn during laboratory periods.
• All long hair must be pulled back.
• Clinic scrubs or dress attire will be worn during laboratory periods.
• Jewelry can include a wedding ring, one necklace tucked in laboratory coat, and one
pair of small earrings.
• Do not carry any instruments in clinic coat pockets
• Follow "Work Practice Controls", (p. 128-129) in the Student Handbook.
• Follow "Work Area Restrictions", (p. 129) in the Student Handbook.
• Follow "Housekeeping regulations", (p. 129) in the Student Handbook.
• Follow "Guidelines for Instrument Sterilization", (p. 130) in the Student Handbook.
• Follow "Guidelines for Surface Disinfection", (p. 130-131) in the Student Handbook.
• Follow "College Policies", listed in the appropriate syllabus.
• Follow "Infection Control in Radiography Lab", (p. 137-139) in the Student
Handbook.
3. Heat producing devices (Vacuformer and Sterlizers)
• Exercise caution.
• Follow recommended rules and regulations according to the manufacturer.
4. Electrical devices (light curing unit, oven)
• Turn off all electrical units when not in use.
• Do not operate electrical devices when running water.
• Report electrical defects as soon as noticeable.
Laboratory Safety Rules Continued
5. Model trimmers
• Use safety glasses and a mask while operating or standing near a model trimmer.
• Remove all rings and bracelets and keep hair tied back.
• Keep knuckles, fingernails, and fingers away from the blade during operation.
• Operate the trimmer with water.
• Do not operate model trimmer if the blade is wobbling.
• Do not try to stop the cutting wheel if it is still moving.
• Clean and disinfect the area (countertops, trimmer, and shield) after usage.
• If you smell a trimmer overheating, turn it off at once, inform instructor, and fill out
a maintenance report slip.
• Shut off equipment after usage.
• Sweep floor after usage.
• Wipe any spilled water during/after usage.
• Shield must be in place at all times.
6. Materials used during the finishing and polishing of amalgams
• Use safety glasses and a mask while operating or standing near a motor, sheath, latch
angle, burs, points or cups.
• Insure that the latch is holding the bur, point, or cup before inserting into the mouth.
• Clean handpiece and latch angle after use.
• Report all malfunctioning equipment (motors, latch angles, etc.) to the instructor and
fill out a maintenance report slip.
7. General considerations
• Cleanliness of work areas will be maintained by the students during and after
sessions.
• Absences will be handled according to the school policy.
• Damaged equipment due to improper handling will be the financial responsibility of
the student.
• All laboratory equipment will be returned to its proper place after usage.
I have read and will abide by these safety rules.
Signature_________________________________________Date_________________________
Laboratory Safety Rules
INFECTION CONTROL IN RADIOGRAPHY LAB
I. Considerations:
A. Infection control procedures must include guidelines for dental radiographic procedures in dental settings.
B. Thorough review of the patient's medical history is necessary.
C. All infection control protocols should be followed.
II. Procedure: NOTE: You must be wearing a mask, gloves, and safety glasses during disinfection.
A. Preparation for exposing radiographs in the operatory:
1. Disinfect anything that you will touch by wiping the following with Caviwipes:
• lead apron and thyroid shield
• sink and faucet handle and knobs
• viewbox
• trays inside and outside of operatory
• on/off switch on x-ray unit
• door knob (inside and outside)
2. Cover, utilizing the barrier technique, the following items:
• chair: headrest cover
• tubehead and cone: clear plastic bag
• control panel buttons (outside operatory): clear plastic
• sensor, keyboard, and mouse (digital operatory)
3. Obtain needed armamentarium using an aseptic technique.
• Use sterile cotton pliers to retrieve stabes, cotton tip applicators, and bitewing loops from containers.
• Obtain two plastic cups: label the outside of one cup "E" for exposed and one "U" for unexposed. Place the cup labeled "E"
furthest from the radiography room door and the one labeled "U" closest to the door.
• Obtain film from the radiography instructor. Place in the tray outside of the operatory.
• Obtain the Rinn XCP devices if necessary.
• Obtain two mounts. Label each with the patient's name and date.
B. Safety:
1. Always drape the patient with a lead apron and cervical collar.
2. Use yoke or back of tube head to make adjustments.
3. Close the door before activating exposure button. Be careful not to close too hard because it may jar the tubehead.
C. Exposure:
1. Always wear gloves and protective eyewear.
2. Wearing a mask is optional but recommended.
E. Darkroom procedure:
1. Follow the above steps (1-3) for carrying the film to the darkroom.
2. Enter the darkroom only if the outside red light is NOT lit.
3. Turn on the safelight and close and lock door.
4. Donn new gloves.
5. Follow the above steps (7-11) for opening the film packets.
6. Place film on a film hanger which has been labeled with the patient’s name, date and number of films taken. Be sure the
films are secure on the hanger.
7. Once all films are on the film hanger, place the films into the developing solution following the recommended time for the
temperature of the solution, rinse, then place in the fixer solution for a minimum of 4 minutes.
8. Set the timer appropriately.
9. Properly dispose the contaminated cup and empty the lead foils into the appropriate container.
10. Turn off the safelight and return to the radiography room, wash hands, donn nitrile gloves and begin disinfecting
procedures.
11. When films are dry, take films and mounts to the mounting area and place in mounts.
“Work-Study” Students
• A process
• A mindset
• An attitude
No single event or an
occasional decision
Thank-you!
Final Comments
Final Comments
Barbara Honhart - VP of Academics/System
“Where do we go from here...?”