DANB CDIPC cheat sheet

OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) requires a written Exposure Control Plan that is reviewed and updated at least annually.

Hepatitis B vaccination must be offered within 10 working days of initial assignment, at no cost to the employee, unless already vaccinated or medically contraindicated.

Bloodborne pathogens training is required at initial assignment and at least annually thereafter; training records are retained for 3 years.

Employee medical records are retained for the duration of employment plus 30 years.

A sharps injury log records the type and brand of device, the work area, and an explanation of the incident while protecting confidentiality.

Post-exposure evaluation and follow-up are provided at no cost and include confidential medical evaluation and source-individual testing where permitted.

CDC's Guideline for Infection Control in Dental Health-Care Settings (2003) is the standard clinical reference; employers must also meet OSHA and state rules.

The employer holds ultimate legal responsibility for the infection control program; a qualified coordinator may be designated to manage day-to-day operations.

Standard precautions apply to every patient regardless of presumed infectious status or medical history.

Standard precautions treat all blood, saliva, and body fluids as potentially infectious, applying the same safeguards to every patient.

Perform hand hygiene before patient contact, after glove removal, and whenever hands are visibly contaminated.

Select PPE based on anticipated exposure: gloves for all patient contact, plus mask, eye protection, and gown when splash or spatter is likely.

Use single-use needles and never recap by the two-handed method; use a scoop technique or a recapping device if recapping is unavoidable.

Place sharps immediately into puncture-resistant, closable, leakproof, labeled containers located at the point of use.

Respiratory hygiene and cough etiquette measures are implemented for patients with signs of respiratory illness.

Clean and disinfect contaminated clinical contact surfaces, or use impervious barriers that are replaced between patients.

Do not eat, drink, apply cosmetics, or handle contact lenses in areas where blood or body fluids may be present.

For blood spills, absorb visible material, clean, then apply an EPA-registered hospital disinfectant with a tuberculocidal claim or a fresh 1:10 bleach dilution.

Alcohol-based hand rub is preferred for hands that are not visibly soiled; use soap and water when hands are visibly soiled or contaminated with blood or body fluids.

Alcohol-based hand rub is applied for 20-30 seconds; soap-and-water handwashing lasts at least 20 seconds.

Gloves never replace hand hygiene; perform hand hygiene before donning and immediately after removing gloves.

Do not wash, disinfect, or reuse disposable gloves; remove gloves before touching clean surfaces, charts, or equipment.

Change masks between patients or when wet or soiled; surgical masks are not respiratory protection, and N95 respirators require fit testing.

Eye protection must include side shields; reusable eyewear is cleaned and disinfected between patients.

Remove PPE in a sequence that minimizes contamination: gloves first (most contaminated), then eyewear and gown, and mask last, followed by hand hygiene.

Keep natural nails short; artificial nails and fingernail polish are avoided because they harbor microorganisms.

Remove gowns and lab coats before leaving clinical areas and launder them according to facility policy.

Transport contaminated instruments in a covered container to the processing area; keep them moist with a transport gel if cleaning is delayed.

Cleaning must precede sterilization: use manual scrubbing, an ultrasonic cleaner, or a washer-disinfector to remove bioburden.

Ultrasonic cleaner solution is changed at least daily and more often when visibly soiled; instruments are then rinsed and dried.

Critical instruments penetrate soft tissue or bone (e.g., extraction forceps, scalpel blades, surgical burs) and must be sterile after use.

Semicritical instruments contact mucous membranes (e.g., mouth mirrors, amalgam condensers) and require sterilization or high-level disinfection.

Noncritical items contact only intact skin and require cleaning plus low- or intermediate-level disinfection.

Package instruments with an internal chemical indicator when the indicator cannot be seen from outside; place an external process indicator on each package.

Heat-sensitive semicritical items are processed with an EPA-registered high-level disinfectant/chemical sterilant according to label contact time.

Handpieces are cleaned, lubricated per manufacturer instructions, and sterilized between patients; waterlines are flushed before use.

Sterilization destroys all microorganisms including bacterial spores; disinfection reduces or eliminates pathogens but may not kill spores.

Gravity-displacement steam autoclave cycle: 121°C (250°F) at 15 psi for 15-20 minutes, or 132°C (270°F) for 4 minutes.

Dry-heat sterilization: 160°C (320°F) for 2 hours or 170°C (340°F) for 1 hour.

Biological monitoring (spore testing) is performed at least weekly; steam and chemical vapor indicators use Geobacillus stearothermophilus, and dry heat uses Bacillus atrophaeus.

Every package receives an external process indicator; internal chemical indicators are placed inside packages that cannot be visualized.

A positive spore test requires removing the sterilizer from service, repeating the test, investigating the cause, and recalling affected loads.

Implants and other items requiring sterility assurance are quarantined until the biological indicator from that load is negative.

Do not overload the sterilizer; allow a drying cycle so packages remain dry and intact after removal.

Clinical contact surfaces (light handles, switches, bracket trays, keyboards) are cleaned and disinfected between patients or covered with impervious barriers that are replaced.

Housekeeping surfaces such as floors and sinks are cleaned at least daily and whenever visibly soiled.

Use a clean-to-contaminated workflow; separate clean and contaminated areas and process instruments in a one-way direction.

Barrier protection is used for surfaces that are difficult or damaging to disinfect, such as electrical switches and computer equipment.

Avoid touching clean surfaces, drawers, or charts with contaminated gloves; remove gloves and perform hand hygiene first.

High-volume evacuation, rubber dams, and proper patient positioning reduce environmental contamination from splash and spatter.

Suction lines and traps are managed according to manufacturer and facility protocols to prevent contamination and backflow.

Use EPA-registered hospital disinfectants with a tuberculocidal claim for surfaces contaminated with blood or other potentially infectious materials.

Follow the manufacturer's contact time; surfaces must remain wet for the full specified time to achieve disinfection.

A 1:10 dilution of 5.25% household bleach (about 5000 ppm available chlorine) is prepared fresh daily for blood spills.

Clean visible organic material before applying disinfectant because soil interferes with chemical disinfection.

Regulated medical waste includes sharps and items saturated with blood or other potentially infectious materials and is placed in red biohazard bags or containers.

Sharps containers are closed and replaced when no more than three-quarters full.

Disinfectant containers must be labeled and used at the labeled dilution; never mix incompatible chemicals such as bleach and ammonia.

State and local regulations may be stricter than federal rules and govern final waste disposal requirements.

CDC recommends that water used for non-surgical dental procedures contain no more than 500 CFU/mL of heterotrophic bacteria.

Surgical procedures require sterile saline or sterile water delivered through sterile tubing, not standard dental unit water.

Flush waterlines for 20-30 seconds between patients and for several minutes at the start of each clinic day, following manufacturer guidance.

Water quality is maintained with independent reservoirs, filters, chemical treatment, or combinations of these methods.

Monitor dental unit waterline quality according to manufacturer instructions and at intervals established by the facility's written program.

Use only sterile, distilled, or otherwise quality-controlled water in independent reservoirs; empty and clean reservoirs per manufacturer instructions.

Antiretraction valves and proper equipment maintenance help prevent backflow of patient material into waterlines.

Handpiece and air/water syringe lines are flushed after use and before the next patient.

High-volume evacuation, rubber dam isolation, and four-handed dentistry reduce aerosol and splatter generation during restorative and hygiene procedures.

A preprocedural mouth rinse with an antimicrobial agent may reduce the microbial load in generated aerosols but does not replace PPE or ventilation.

Use an N95 or higher-level respirator, fit-tested, when aerosol-generating procedures are performed on patients with suspected or confirmed airborne infection.

Patients with known or suspected airborne infectious disease should have elective aerosol-generating care deferred until the infection risk is resolved.

Aerosols and splatter can contaminate nearby surfaces and the operator's PPE; barriers and surface disinfection after treatment are required.

Appropriate room ventilation and air filtration, along with adequate air changes per hour, reduce airborne microbial concentrations.

Dental health-care personnel should maintain recommended immunizations, including hepatitis B, and follow facility respiratory protection programs.

Minimize unnecessary use of ultrasonic scalers and high-speed handpieces when alternatives are appropriate, and always combine them with high-volume evacuation.