Infectious Disease/Radiation Management 5-1 and 5-2

5-1

Infectious Disease/Radiation Management

5-1 The program must document its compliance with institutional policy and applicable regulations of local, state and federal agencies including, but not limited to, radiation hygiene and protection, ionizing radiation, hazardous materials, and bloodborne and infectious diseases. Policies must be provided to all students, faculty, and appropriate support staff, and continuously monitored for compliance. Additionally, policies on bloodborne and infectious diseases must be made available to applicants for admission and patients.

Intent:

The dental hygiene program should establish and enforce a mechanism to ensure adequate preclinical/clinical/laboratory asepsis, infection and biohazard control and disposal of hazardous waste.

Policies and procedures on the use of ionizing radiation should include criteria for patient selection, frequency of exposing and retaking radiographs on patients, consistent with current, accepted dental practice. All radiographic exposure should be integrated with clinical patient care procedures.

Policies and procedures should be in place to provide for a safe environment for students, patients, faculty and staff. The confidentiality of information pertaining to the health status of each individual should be strictly maintained.

This Standard applies to all program sites where laboratory and clinical education is provided.

A. Description

1. Provide policies and procedures that have been developed related to individuals who have bloodborne infectious disease(s), including applicants for admission to the program, students, patients, faculty and staff. (exhibit)

Lake Superior College is committed to the policy that there will be no discrimination because of race, creed, color, sex, national origin, sexual orientation, marital status, disability, public assistance status, age, or inclusion in any group or class protected by state or federal law. This includes the requirements of Title VI and VII of the Civil Rights Act of 1964; Revised Order 4; Executive Order 11246, 11375; Sections 799A and 845 of the Health Service Act; The Equal Pay Act; and any other act of Congress or federal regulations. The college also has an Affirmative Action/Equal Opportunity policy.

All faculty and students in the Lake Superior College dental hygiene program are required, at all times, to utilize standard precautions on all patients. Utilizing this standard of practice, no patient has been denied treatment.

2. Describe how these policies and procedures have been implemented.

The college implements this policy to assure that all opportunities are available to all individuals in accordance with federal and state laws. The college does not ask for information regarding any disease, including bloodborne infections from any faculty, staff, students or applicants. Students who have self identified with a history of bloodborne infectious disease have entered the program and graduated. All faculty, staff and students in potentially hazardous situations are required to use appropriate personal protective equipment and practice standard precautions in compliance with OSHA Federal Standard 29 CFR part 1910.1030

3. How do these policies ensure that the confidentiality of information pertaining to the health status of each infected individual is strictly maintained?

All medical information on students and employees is confidential and shared by only those who need to know. All student, employee and patient records are protected by the data privacy act. No person, group, agency, insurer, employer, or institution will be provided medical information of any kind without the prior specific written consent of the person.

4. How are these policies made available to all applicants, students, patients, faculty and staff?

These policies are in the College Catalog, Dental Hygiene Program Handbook, Dental Hygiene Program Clinic Manual, and on the college website. The dental hygiene faculty and staff receive a copy of the Clinic Manual, LSC Dental Hygiene Program Handbook, and are also provided written information and OSHA infection control training as part of staff development. Licensed dental staff at the LSC dental hygiene clinic must also complete yearly infection control continuing education requirements for renewal of their MN Board of Dentistry license.

Patients are made aware of the confidentiality of their medical history in the “Patient’s Right” document which is displayed in the clinic waiting room. The following statement is found on the college website and in application material students receive upon application to the program.

“Due to the nature of the clinical experiences in the dental hygiene program, students will be participating in a work environment that has the potential of exposure to bloodborne pathogens. All students accepted into the dental hygiene program are provided with written policy and instruction on infection control protocol to reduce the risk of disease transmission. Policies and procedures on the dental hygiene program’s infection control protocol are available to all applicants upon request. Other work related disorders associated with the practice of dental hygiene could result from repetitive activities and exposure to high decibel sounds. Advancements in design and technology in the profession are continually evolving to minimize these effects”.

5. State or append a copy of the program’s policies on:

a. selection criteria for radiography patients;

b. frequency of exposing radiographs on patients;

c. retaking radiographs; and

d. exposing radiographs for diagnostic purposes

The programs policy on selection, frequency, and retakes, can be found in the document, “Guidelines for Prescribing Dental Radiographs” developed by the ADA and FDA (Exhibit EEE ) in combination with the clinical judgment  of the supervising dentist, are utilized in determining whether radiographs  should be taken on the patient. The program has developed a policy on the  use of ionizing radiation, including exposing radiographs for diagnostic purposes that is stated in the Clinic Manual and can be found in the Lake Superior College Dental Hygiene Program Radiographic Protocol found in  Exhibit FFF.

6. Describe how students acquire an understanding of radiation safety prior to exposing radiographs on patients.

A detailed description of the topic outline and laboratory exercises for DENH1530 can be found in the Curriculum Document. This course prepares the students as they proceed through a series of lectures and laboratory experiences, which they must complete at 80% or better, to develop competency in radiation safety and exposure of quality radiographs prior to exposing radiographs on patients. All proper radiation safety procedures are reviewed and monitored during the laboratory and clinic sessions while students are exposing films.

7. Describe how patient radiographs are utilized:

a. while patient services are being provided.

b. for integration of radiography with clinical procedures.

The dental hygiene student must place the most current set of radiographs in the viewbox prior to seating the patient which are reviewed by the student and the dental hygiene clinic faculty. The radiographs are used by the student to observe alveolar bone level, horizontal and vertical bone loss, calculus, caries, overhangs, pathology, etc. Students and faculty refer to the radiographs when performing the assessment, planning and treatment phase of patient care. The radiographs are also used to insure dental charting accuracy. During the dental screening, the dentist reviews the medical, dental, radiographic and clinical history of the patient and determines the dental needs of the patient. All radiographs are taken in duplicate so that one set remains in the patients’ clinic record and the other set is sent to the patients’ primary dentist.

8. Describe the program’s asepsis, infection and hazard control protocol. How are students, faculty and appropriate support staff informed about these procedures? Describe how student, faculty and staff compliance with this protocol is monitored within the institution and affiliated sites. Provide a copy of the protocol as an exhibit.

The department complies with the CDC guidelines for infection control for patient safety and follows standard precautions. All patients, including student partners, are treated using standard precautions and are treated equally.

Faculty, students and staff are given the necessary information on infection control and hazard control protocols in all preclinical, laboratory and clinical courses. These protocols are contained in the Clinic Manual in the section, Infection Control. This document is reviewed and revised annually by the program faculty.

Federal, state, local and program policies are followed. Students are informed of infection control policies in both didactic and lab classes. Students must complete periodic practical exams on infection control. Students are also evaluated on infection control on each patient on the clinical evaluation form. Faculty and staff are required by the Minnesota Board of Dentistry to comply with infection control education for licensure. Faculty and staff are required to be informed of these policies yearly through in-service education by the institution.

Please refer the Clinic Manual, which contains the infection/hazard control protocol.

9. Describe how the institution documents compliance with applicable regulations for radiation hygiene and protection.

Minnesota state law requires that ionizing radiation-producing equipment be registered and inspected every two years. The Minnesota Department of Health requires that all ionizing equipment be monitored on a regular basis and that daily records are kept.

Compliance records are kept in the Lake Superior College Dental Hygiene Program Radiographic Protocol logbook which is located in the radiographic viewing area. This logbook containing data on inspection visits, equipment repairs, quality assurance records, registration information required by the Minnesota Department of Health, and results of daily monitoring activities. This document will be available to view on-site.

B. Supportive Documentation

1. Exhibit Z: Clinic Manual (separate document)

2. Exhibit EEE: Guidelines for Prescribing Dental Radiographs

3. Exhibit FFF: Dental Hygiene Program Radiographic Protocol

4. Exhibit QQQ: Copy of policy and procedures related to individuals who have bloodborne infectious disease(s).

5. Exhibit RRR: Copy of Infection/Hazard Control Policy (also refer to the Clinic Manual (separate cover)

5-2

5-2 Students, faculty and appropriate support staff must be encouraged to be immunized against and/or tested for infectious diseases, such as mumps, measles, rubella, tuberculosis and hepatitis B prior to contact with patients and/or infectious objects or materials in an effort to minimize the risk to patients and dental personnel.

Intent:

All individuals who provide patient care or have contact with patients should follow all standards of risk management thus ensuring a safe and healthy environment.

A. Description

1. Are students encouraged to be immunized against infectious diseases? If so, how?

Students at Lake Superior College are required to be immunized against infectious diseases. The immunization policy is clearly stated in the college admission requirements, College Catalog and the Program Handbook. All dental hygiene program students must have a completed health history on file in the Health Services Office prior to entering the program. Please review a copy of the health history found in Exhibit GGG. There is a complete section required to address immunization against infectious diseases. Dental hygiene students are required to have an annual Mantoux test. Dental hygiene students are also highly encouraged to have the HBV immunization series prior to starting the program.

Students are made aware of the dental hygiene immunization policy when they apply to the program. Students receive verbal and written HBV immunization forms/information and the Dental Hygiene Program Handbook at the orientation/registration session prior to starting the program. If the student does not receive the HBV immunization series, they must sign a waiver prior to starting the program.

B. Supportive Documentation

1. Exhibit CC: Dental Hygiene Program Student Handbook (Separate document)

2. Exhibit GGG: Health history form

3. Exhibit HHH: Tracking forms for student immunization records