To finally get my thoughts about topics out of my heart and on to this site was no easy task. I rustled with thoughts in my mind especially about how it will be perceived and received. Ultimately the topics bubbled up inside of me so much that it took over my doubts and replaced it with confidence.
The actions and steps I took and continue to take each day for patients is my sole purpose in life. This page was created to create awareness and "OPEN WIDE" the minds of patients and hearts of DHCP. If you are a DHCP wanting to learn more about how to keep your patients safe go to the home page and click on the send button to contact RIMA ORIS and get started today on making a change.
The day started off with a rush. Came in, got changed, and looked at the schedule. Although I am the manager, today, I would join my team on the floor for reprocessing. I walked in and checked in with staff. Biologicals were being placed into process challenge devices (PCD) for the first load run with in the sterilizers. I toggled back and forth from the different areas reviewing log books and conversing with the staff. The previous day in the dental department was a high volume day and by numbers on the instrument list today was going to be the same. After logging the efficacy test information for the washers and ultrasonic in decontamination area I went to the sterilization area to unload the sterilizers as the biologicals would need to be placed in the incubator.
The door swings open as assistants were coming in to gather instruments from the storage areas in preparation for the next patient. I continue to unload the sterilizers, place item on the rack, and fill out sterilizer receipt information. “Are there any more handpieces?” said an assistant. “There are but they ae not ready at this time” I responded. The assistant nodded and the door closed. “A few minutes later “how long do you think it will be until they are ready?” the assistant popped in again. “The handpieces are a part of the load ran with the biologicals and they are about to be planted into the incubator.” “I am asking because my provider needs it now and the patient is in the chair” said the assistant. “The handpieces will be ready in 30 minutes” I replied. The door closed and soon after the provider walked in.
“Are these ready?” the provider pointed to the handpieces that were on the rack. “No, they are still cooling down they will be ready in 25 minutes.” “That’s ok I will cool it down chairside” the provider responded. It took a few minutes for me to register what I had just heard. To get a better understanding of what the provider was communicating to me I asked “can you explain to me what cooling it down chairside means?” The providers said “I will just open the package and place it under the running faucet in the operatory to help it cool down faster.” This was the first time I had heard of anything like this.
There were so many risk factors that propose themselves when this practice of cooling down chair side is performed. The possibility of thermal burning, the development of condensation which is a potential source of contamination, and moisture being a pathway for microorganisms to travel. All of which were running through my mind as the providers gaze increased with urgency. “No, you can’t do that” I responded. “when the handpiece is ready, I will let you know.” “My patient is in the chair and has been waiting and you’re telling me I can’t take this?” That is when I realized the provider had no knowledge of the potential risks and implications, this practice, has for the patient. “I am more than willing to have a conversation with the patient regarding all the steps taken to assure their safety” I responded. The provider turned around and walked out.
On this day I was the advocate for the patient and always will be. I called a mandatory meeting and provided my staff with information about chairside cooling. Showed them what ANSI/AAMI ST79:2017 states about cooling and moisture in their comprehensive guide to steam sterilization and sterility assurance in health care settings. It was important for me to share the information with them so that they can effectively advocate for the patient as well when situations pose themselves contrary to what we have learned.
I speak to all dental healthcare providers who participate in this practice. Dental assistant who are afraid to speak up when they see this occur, yes you, you have an obligation to speak up for the patient. It is unethical, unsafe and needs to stop. The patient deserve better and has the right to have critical instrumentation such as the handpiece kept sterile and used only when ready. Instrument sterilization when accomplished properly is a key component to in infection control and prevention.
Dear patients, it high time you start getting the most out of your healthcare visits. Understand without you there would be no need for us. When I say "us" I mean providers, assistants, instrument reprocessor, lab technicians, reception front end staff etc. Changes can be made when you start asking questions.