VA compliance challenges, dental infection control issues, VA dental infection control issues remind dental workers to be vigilent
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Background | Relevant Dental Resources


An apparent breach of standardized practice related to dental instrument reprocessing occurred at the John Cochran Veterans Administration Medical Center (VAMC) in St. Louis, MO. The facility mailed notification letters to 1,812 veterans treated at the dental clinic between February 2009 and March 2010 stating their internal quality inspections determined that some instrument processing steps for dental instruments were not in compliance with their standard policies, creating a low risk of exposure to hepatitis B virus, hepatitis C virus and HIV. In a video interview, Dr. Gina Michael, a spokesperson for the VAMC, said that dental instruments were sterilized but the VA standardized sequence of instrument processing was not followed.

A article on July 1, 2010 reported the VA Under Secretary for Health Dr. Robert Petzel saying that the problem arose because workers prewashing dental equipment failed to use a detergent before the equipment was sterilized allowing for a "phenomenally remote" chance that sterilization might not have been effective. The VA issued a press release on July 1indicating that the lessons learned from the St. Louis VAMC are applied VA-wide.

In a related story at the Dayton VA Medical Center, an employee raised concerns about infection control practices at the dental clinic while an internal VA panel was reviewing clinic operations in late July. The allegations involved improper use of protective gear such as gloves, as well as the inappropriate use of burs. The VA closed the clinic for three weeks to investigate.

These news stories serve as a reminder that proper procedures to prevent infections should be in place, and, importantly, that dental workers be educated to ensure the procedures are understood and followed. OSAP encourages dental professionals to take the time to regularly reinforce best practices for preventing infections and ensuring the safety of patients and the dental team.

OSAP has assembled targeted educational resources for the dental team on instrument processing (see table below). Please let us know if you can suggest additional tools and we will continue to build this resource.

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Dental Resources

CDC Guidelines and FAQ on Sterilization-Cleaning Guidelines for Infection Control in Dental Health-Care Settings, 2003. NOTE: Please see "Sterilization and Disinfection of Patient-Care Items" on pp.20-25 and 42-44 of document.
OSAP Charts
OSAP Online Course Addressing Proper Instrument Processing (note, this is a free resource) Click on link at left or on "Ask Lily" on the OSAP website. Next click on the blue "Advance to Program Access" and then the blue "Run FREE Interactive Guide Program," select language. The "Menu" lists 7 modules. Instrument Processing is addressed in #4. Make Objects Safe for Use.
OSAP Checklist Incorporating CDC Guidelines into your dental practice. OSAP Check-Up: 2003 CDC Guidelines. Is your infection control program up to date?

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