Taking responsibility for infection control
Without proper education, training and understanding in the area of infection control, the dental team and the public are at risk of potential disease transmission as a result of dental treatment.
A survey undertaken in 2006 of 96 unqualified dental nurses in Ireland revealed that the majority were trained in infection control procedures by a dental nurse employed in the dental surgery. This is an alarming statistic, since Irish law allows untrained, unqualified persons to be employed in dental surgeries as dental nurses. The survey did not indicate whether or not these dental nurses were qualified or unqualified.
The Dental Council of Ireland has a section on its website entitled Dental Nursing Ethics. It states: ‘The dental nurse has a duty to protect his/her patients, other staff and himself/herself from the risk of cross-infection in the dental surgery. The dental nurse shall follow the guidelines on cross-infection control issued by the Dental Council.’
The Dental Council has circulated these infection control guidelines to all dental nurses on the voluntary register. Among the unqualified nurses, who are not eligible for the Dental Council register, this information has not been distributed. This is, in itself, a strong argument for a statutory/mandatory register for dental nurses. A mandatory registration and educational requirement for those calling themselves a dental nurse would aid in safeguarding the public and educating those putting themselves in a potentially harmful working environment.
During a recent conversation, I was discussing how important it is to dispose of endodontic K-files safely after one use. The unqualified, employed dental nurse with whom I was talking assured me that she was aware of infection control and I was not to worry that they were not treating the files as single use items, as she ‘sterilised’ them in liquid right next to the dental burs!
Of the same 96 unqualified employed dental nurses, a large majority have reported that they feel they are left responsible for the infection control procedures in their dental surgeries. My question to dental professionals in Ireland is this – why are we leaving the prevention of disease transmission largely in the hands of an unqualified member of the dental team?
Some may argue that the dentist is ultimately responsible for everything in the dental surgery. I would agree, but are infection control procedures in a surgery constantly monitored? Does your surgery have an infection control policy? In any busy surgery it would be impossible to monitor every move of each member of the dental team.
The majority of unqualified, employed dental nurses that I have spoken to feel they are not equipped with the skills needed to carry out infection control procedures effectively. Dental nurses need to be armed with the skills required to carry out their role in the dental surgery effectively. This education and training is needed to safeguard the public and the dental nurses taking on positions without training.
Where is this all going wrong? Who is monitoring infection control in dental surgeries in Ireland? Is it a lack of available education for dental nurses? A lack of education by employers? A lack of desire for education by dental nurses? A lack of continuing and updating learnt skills?
In my opinion, it is a combination of all of the above-mentioned issues. However, whatever the true reason, the lack of good and acceptable infection control procedures in any dental surgery pose serious risk for dental professionals and the public, and is therefore unacceptable practice.
Dental Council of Ireland. (2005) Code of Practice Relating to Infection Control in Dentistry. http://www.dentalcouncil.ie/files/Infection_Control.pdf [accessed 5 December, 2006]
The Dental Council of Ireland (2006) Dental Nurse Ethic. Available from: http://www.dentalcouncil.ie/g_dentalethics.php [accessed 5 December, 2006]
Mosby (2004) Mosby’s Dental Dictionary. Mosby, Missouri