Infection Control, Public Health, and Safety Obligations
Standard precautions, not risk assessment
The operative principle is that every patient is potentially infectious. Practices must maintain a written exposure control plan, offer hepatitis B vaccination, provide appropriate PPE at no cost to staff, enforce hand hygiene, and follow safer sharps handling with engineered devices where required. Gloves supplement but never replace hand hygiene, and PPE must be removed before leaving the treatment area.
Instrument processing chain
Know the sequence and what each step proves: transport in a labeled container, cleaning (ideally ultrasonic or washer-disinfector), inspection and packaging, sterilization, and monitoring. Chemical indicator tape shows only that the load was processed; biological spore testing is what verifies sterilization efficacy and is performed on a routine scheduled basis with logged results. Environmental surfaces are cleaned and disinfected - they are not sterilized - with barriers used on high-touch items. Dental unit waterlines require documented quality management, and amalgam waste and sharps require compliant disposal streams.
Radiology and post-exposure
ALARA governs radiography: justified orders, collimation, lead apron and thyroid shield, and retakes only for diagnostic necessity. After a needlestick or splash, wash, report immediately, and follow the written post-exposure evaluation and follow-up protocol; source-patient testing requires consent or the process the law allows.
Traps
Confusing disinfection with sterilization, treating autoclave tape as proof of sterility, assuming gloves replace hand hygiene, and overlooking written-plan and documentation requirements - surveyors and examiners test documents, not intentions.
Rule of thumb
Document the chain: cleaned, packaged, sterilized, monitored, logged. If the log is missing, the process is not defensible.