Healthcare providers have a duty of care to maximise the separation of decontamination work from clinical activity within the constraints of space and room availability. The Care Quality Commission will involve Infection control - policies, procedures and records within their inspection, utilising the Health Technical Memorandum 01-05; which is intended to raise the quality of decontamination work in primary care dental services by covering the decontamination of reusable instruments within dental facilities.
At Eclipse Dental Engineering our staff participated in a CPD course on Dental Infection Control and Decontamination delivered by Schulke – see the article here. During the course, Sarah Green (the Schulke trainer) pointed out the benefits of having a separate decontamination room and the display in the Eclipse Dental showroom was presented as an example of best practice layout and design.
For this reason, we feel that we are in a good position to consult with and design your decontamination area, with the correct and up-to-date standards for HTM and CQC compliance.
The decontamination process should be carried out by ensuring that a dirty- to-clean workflow is maintained. This is a one-way process that can be achieved by temporal separation or physical segregation.
This is the method of separating the ‘decontamination activities’ from ‘patient consultation’ within the treatment room at different times. Where instruments are reprocessed in the same room as the patient treatment area, the reprocessing area should be as far from the dental chair as practicality allows. This area would have to include a dedicated sink or two, regular disinfection of surfaces and adequate ventilation / air extraction. However, such an approach should only be an interim measure before a planned move to a dedicated decontamination facility. As dental practices progress towards higher standards, removing the decontamination process from the treatment room should be a priority.
Where a dedicated decontamination area has been developed, separated from the patient treatment area in another room; enhanced dirty–clean separation should be a priority in design and operation.
The provision of two separate rooms is the preferred option as it provides for a higher degree of separation between dirty instruments awaiting decontamination and cleaned/sterilized instruments that are to be placed in trays, packs or containers for use. One room for dirty activity (cleaning and preliminary inspection of instruments); and one room for clean activity (inspection, sterilization and wrapping instruments). The clear intention is to reduce the risk and extent of recontamination as well as providing for a very clear operation distinction between clean and dirty.
Ventilation and air quality are very important considerations. Through-wall / fan-based ventilation and extraction units will often be used and where possible, air movement should travel from clean to dirty areas.
Physical segregation (within essential quality requirements) means using different areas for different activities. A decontamination area should be set up which preferably comprises a single run of sealed, easily cleaned worktops. The following key design points should be observed:
The environmental conditions in decontamination facilities should be controlled to minimise the likelihood of re-contamination of sterilised instruments. Key considerations include the clean-ability of surfaces, fittings and equipment.
The steriliser should be situated well away from the other activities/facilities.
After sterilisation, the steriliser will need to be unloaded into another clean, well-lit area.
A wash-hand basin should be provided for use by staff at the completion of each stage in the decontamination process. Where this work is conducted adjacent to the treatment area, it is acceptable for a single wash-hand basin to be used for this and clinical hand-washing. However, this basin should be distinctly separate from the sinks used in decontamination.
Fabrics should not be used, including curtains. Instead, purpose built and fitted blinds are recommended.
Proper segregation and management of waste and linen.
Contact us on 01322 293333 or email firstname.lastname@example.org or use our contact form to find out how we can help to improve your infection control, we even provide a free design service.