Reuse of Single-Use Devices: Why Dental Practices Are Coming Up Short

Infection Control Consulting Services (ICCS) continues to provide a range of services to dental practices, including assistance with remediating deficiencies related to non-compliant practices which violate nationally recognized guidelines and standards.

An ICCS client was recently reported to the state department of health (DOH) and dental board by an employee who was concerned about the reuse of a single use item labeled as disposable. Depending on the type of item being reused, the state DOH will discipline the practice based on the level of risk to patients. The consequences of a visit from authorities include a spectrum of penalties from fines to the dentist(s) losing their license to the worst-case scenario of dental practices being required to notify patients that they may have been exposed to a bloodborne pathogen.

Reuse of single use devices remains a significant issue in the dental community. According to observations conducted onsite and via staff interviews, ICCS consultants report the following as the reasons dental practices fail to adhere to the standards:

• Cost savings

• Lack of recognizing international symbols (e.g., single-use symbol of a 2 with a slash through it)

• Misunderstanding product labels (disposable items are also considered one-time use)

• Unaware of the importance of a manufacturer’s instructions for use (IFU)

• Overall lack of general infection prevention and control education

ICCS reminds the dental community that the Centers for Disease Control and Prevention (CDC) released Guidelines for Infection Control in Dental Health-Care Settings in 2003 and updated in 2016, with an extensive checklist for offices to follow. The American Dental Association references the CDC guidance and encourages all dental practices to strictly adhere to them. Educating and reeducating staff on the importance of following nationally recognized guidance, following manufacturer's IFUs and considering items as single use if IFUs are absent are vital to patient safety.

ICCS Infection Prevention & Control Newsletter: August 2023

This issue covers some of the most significant news from August. Topics include CAUTI, sepsis, proton-pump inhibitors, eye drops, TB, vaccines and nose picking.

* * *

Alternatives to Indwelling Urinary Catheters Help Patients Avoid Infections and Urethral Trauma — Five medical organizations led by the Society for Healthcare Epidemiology of America issued new recommendations for the prevention of catheter-associated urinary tract infections (CAUTI).
 
Hospital Sepsis Program Core Elements — CDC released its first-ever "Hospital Sepsis Program Core Elements." The agency stated that these elements are designed to help all hospitals implement, monitor and optimize sepsis programs and improve survival rates.
 
PPIs Linked to Long-Term Infection in Kids — New study results were published that should serve as a good reminder to only use proton-pump inhibitors (PPIs) when needed and limit their use once started.
 
Report Highlights Hospital Sinks as Source of Highly Resistant Pathogen — A report highlighted the role of the hospital water environment in the transmission of highly resistant, difficult-to-treat pathogens.
 
FDA Warns Consumers Not to Purchase or Use Certain Methylsulfonylmethane (MSM) Eye Drops Due to Contamination — FDA issued a new eyedrops warning due to concerns about bacterial and/or fungal contamination.
 
WHO Operational Handbook on Tuberculosis — The World Health Organization released a new operational handbook on tuberculosis infection prevention and control. It includes TB best practices and provides checklists and job aids.
 
FDA Approves First RSV Vaccine To Prevent Infections in Infants — FDA approved the first vaccine meant to prevent respiratory syncytial virus in infants. It is designed to be administered to pregnant mothers in their third trimester.
 
Sporicidal Disinfectants Shown More Effective Against Candida Auris — New research was published on the effectiveness of disinfectants against Candida auris. A big takeaway: Quaternary-ammonium disinfectants, which are widely used in U.S. healthcare facilities, were largely ineffective.
 
COVID Boosters Show Value for Those Pregnant or Trying To Conceive — Research showed the benefits of the COVID-19 vaccination with a booster for pregnant individuals.
 
From Blueprints to Ribbon Cutting: Infection Preventionists' Role in Construction — An Infection Control Today column discussed the importance of incorporating infection prevention and control measures throughout the entire construction process.
 
CDC Recommends Update to Hepatitis C Virus Screening — CDC issued new guidance recommending healthcare facilities and labs use only single-visit approaches to hepatitis C testing in the hopes of reducing incomplete testing and missed HCV diagnoses.
 
New Standard on Cutting Risk of Infectious Aerosol Spread Sets High Bar for Building Ventilation but Is Work in Progress — A CIDRAP column looked into the new ASHRAE standard intended to reduce the risk of infectious aerosol transmission in buildings.
 
Nose Picking Linked To Higher Risk of COVID, Study Shows — There are many good reasons not to pick your nose. You can add an elevated risk of contracting the coronavirus to the list.

ICCS Infection Prevention & Control Newsletter: July 2023

This issue covers some of the most significant news from July. Topics include acute-care recommendations, dirty devices, TB, mold and the flu vaccine.

* * *

Implementing Strategies To Prevent Infections in Acute-Care Settings — Five medical organizations led by the Society for Healthcare Epidemiology of America issued updated recommendations for infection prevention in acute-care settings.
 
Doctor Gets 25 Years in Federal Prison for Fraud, Using Dirty Surgical Devices — It remains critical that facilities follow manufacturers' instructions for use (IFUs) and/or nationally recognized guidelines and standards, including adhering to the forbiddance of reusing single-use items, regardless of the type and cost. ICCS frequently reminds clients of the necessity to understand the instructions and the symbols for single use, including the number 2 (two) circled with a strikethrough.
 
CMS Still Dropping the Ball on Infection Prevention in Nursing Homes: GAO — The Government Accountability Office (GAO) called out CMS for its inactivity concerning the development of new infection prevention and control standards for nursing homes.
 
More TB Transmitted via Bone Grafting — Contaminated bone graft materials were linked to more patients testing positive for tuberculosis.
 
Innovative Infection Prevention Program Reduces Surgical Site Infections, Results in Hospital Days Reduced and $500,000 Savings — New research revealed the potential benefits associated with an anesthesiologist-led infection prevention program, including reduced SSIs and lengths of stay.
 
Minimizing Health Risks: Controlling Mold in Health Care Settings — An Infection Control Today column took a close look at mold growth prevention.
 
Study Finds Prevention Bundle May Reduce Some Surgical-Site Infections — A quality improvement study found implementation of a surgical-site infection (SSI) prevention bundle with facility-level discretion on its components may be associated with reduction of certain SSIs.
 
For Those Taking Flu Shots, There Is Less Need for Antibiotics, Study Finds — A study showed that flu shots are linked to reduced use of antibiotics.
 
'Alarming' COVID-19 Treatment Rates in Nursing Homes Discovered — Research revealed that just 18% of COVID-19 cases in nursing homes were treated with antiviral medications, and the rate increased only slightly after oral treatments were approved
 
GAO's New COVID-19 Report Highlights Recommendations Critical to Preparing for Future Public Health Emergencies — GAO released a report sharing its most significant COVID-19 findings along with recommendations intended to help federal agencies better prepare for future public health emergencies.