Employing universal precautions means taking precautions with everybody. If precautions
are taken with everyone, health care workers do not have to make assumptions about
people's lifestyles and risk of infection. Health care workers should have the right
to be able to protect themselves against infection, whether it is HIV, Hepatitis
or anything else.
The following universal infection control precautions are advised by the World Health
Organization to help protect health care workers from blood- borne infections including
HIV:
- Wash hands with soap and water before and after procedures.
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Use protective barriers such as gloves, gowns aprons, masks, goggles for direct
contact with blood and other body fluids.
- Disinfect instruments and other contaminated equipment.
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Properly handle soiled linen. (Soiled linen should be handled as little as
possible. Gloves and leakproof bags should be used if necessary. Cleaning should
occur outside patient areas, using detergent and hot water.)
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New, single-use disposable injection equipment for all injections is highly recommended.
Sterilizable injection should only be considered if single use equipment is not
available and if the sterility can be documented with time, steam and temperature
indicators.
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Discard contaminated sharps immediately and without recapping in puncture and liquid
proof containers that are closed, sealed and destroyed before completely full.
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Document the quality of the sterilization for all medical equipment used for percutaneous
procedures.
The following measures can drastically minimise the risk of HIV amongst Dental Professionals:
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Infectious organisms can be spread through several routes in the dental office:
direct skin or percutaneous exposure to blood, oral fluids, or other secretions;
indirect contact with contaminated instruments, operatory equipment or environmental
surfaces; and/or contact with airborne contaminants present in either droplet spatter
or aerosols of oral and respiratory fluids. Infection via any of these routes requires
that all of the following conditions be present (commonly referred to as “the chain
of infection”): a susceptible host; a pathogen with sufficient infectivity and numbers
to cause infection; and a portal through which the pathogen may enter the host.
Effective infection control strategies are intended to break one or more of these
“links” in the chain, thereby preventing infection.
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HIV can be transmitted through sharps injuries or direct contact with open wounds
on the skin or mucous membranes. There is no evidence that HIV is transmitted via
the airborne route or insect vectors.
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Because individuals with an infectious disease cannot always be identified through
history review or physical examination, the Centres for Disease Control (CDC) recommends
that Dental Health Care Professionals (DHCP) follow a standard set of precautions
for all patients at all times. The use of these precautions has reduced the chance
that an infection can be transmitted in the dental operatory.
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Standard precaution procedures are widely publicized and describe techniques used
to reduce contact with organisms (breaking the chain at the portal of entry) and
the potential transmission of infectious patient, DHCP should wash their hands and
put on new gloves; after treatment or before leaving the dental operatory, DHCP
should remove and discard gloves, then wash their hands. DHCP always should wash
their hands and reglove between patients.
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Chin length plastic face shields or surgical masks and protective eyewear should
be worn when splashing or spattering of blood or other body fluids is likely, as
is common in dentistry. Masks should be changed between patients or when wet or
soiled.
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Eyewear should be washed with an appropriate cleaning agent and, when visibly soiled,
disinfected between patients.
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Protective clothing (reusable or disposable gowns, laboratory coats, or uniforms)
should be worn when clothing is likely to be soiled with blood or other body fluids.
Reusable protective clothing should be washed, using a normal laundry cycle, according
to the instructions of detergent and machine manufacturers. Protective clothing
should be changed at least daily or as soon as it becomes visibly soiled.
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Impervious-backed paper, aluminum foil, or plastic covers should be used to protect
items and surfaces (e.g., light handles or x-ray unit heads) that may become contaminated
by blood or saliva during use and that are difficult or impossible to clean and
disinfect. These coverings should be discarded and replaced between patients.
These precautions significantly reduce the risk of exposure to HIV when used consistently
and correctly. Unfortunately, humans are not perfect and accidents can happen.
