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.

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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.

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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.

ICCS Infection Prevention & Control Newsletter: June 2023

This issue covers some of the most significant news from June. Topics include MRSA, nursing homes, Candida auris, malaria, hand hygiene and flexible endoscopes.

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Updated Guidance Shows How Hospitals Should Protect Patients from Resistant Infections — Five medical organizations led by the Society for Healthcare Epidemiology of America (SHEA) issued updated recommendations for preventing MRSA.
 
Decolonization Protocol Tied to Dramatically Reduced MRSA in Critically Ill Infants — Research showed a decolonization protocol normally used in older patients was associated with a sharp reduction in MRSA infections in critically ill infants.
 
APIC Calls for Dedicated Infection Prevention Staff at All Long-Term Care Facilities to Prevent Deaths of Seniors — APIC called on the federal government to require full-time infection control specialists at nursing homes.
 
US Hospital Data Show High Death Rate With Candida Auris Infections — An analysis of US hospitalizations linked to Candida auris found an estimated mortality rate of about one-third.
 
Better Tests Needed to Identify Candida auris Susceptibility — The American Society for Microbiology called for the development of antifungal susceptibility testing for Candida auris.
 
IDSA 2023 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections — IDSA released updated guidance on the treatment of antimicrobial-resistant gram-negative infections.
 
Locally Acquired Malaria Cases Identified in the United States — CDC issued an alert following reports of locally acquired malaria infections in Florida and Texas.
 
Gentle Cleansers and Harsh Soaps Equally Effective at Killing Deadly Viruses, Study Finds — Research found that gentle cleansers are just as effective as harsh soaps at killing certain viral pathogens that are common targets in healthcare facility infection control.
 
Best Practices for Flexible Endoscopes Storage — An Infection Control Today column shared recommendations for storing endoscopes clean, safe and intact.
 
WHO Lays Out Research Priorities for Antimicrobial Resistance — The World Health Organization published its first global research agenda for combatting antimicrobial resistance.
 
CDC Advisors Recommend RSV Vaccine Approval. What It Means for Older Adults — A respiratory syncytial virus (RSV) vaccine for older adults could soon be available after a CDC advisory committee voted to recommend them.

ICCS Infection Prevention & Control Newsletter: May 2023

This issue covers some of the most significant news from May. Topics include SSI prevention guidelines, assisted living guidance, eyedrops, outpatient dialysis and RSV.

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Strategies To Prevent Surgical Site Infections in Acute-Care Hospitals: 2022 Update — Five medical organizations led by the Society for Healthcare Epidemiology of America (SHEA) issued updated recommendations for preventing SSIs. This SHEA news release summarizes the key recommendations.
 
New Guidance: Antibiotics Should be Halted Upon Closure of Incisions — Included in the updated SSI recommendations: discontinue antibiotics administered before and during surgery immediately after a patient's incision is closed.
 
Assisted Living Infection Prevention Guidance Updated by CDC With PHE Expiration — CDC issued updated infection prevention guidance for assisted living, group homes and other residential care settings (not including nursing homes).
 
Ending of the COVID-19 Public Health Emergency & Other Policy Changes: What Clinicians Need to Know — IDSA published an infographic on policy changes related to the expiration of the COVID-19 public health emergency and certain federal legislation/funding.
 
Tainted Eye Drops Tied to 81 Cases of Highly Resistant Pseudomonas, 4 Deaths — CDC issued an update on the eye drops linked to an outbreak of drug-resistant bacteria responsible for multiple deaths and more than a dozen people experiencing vision loss.
 
Study Shows Hospital Policy Allowing Nurses to Initiate C. Difficile Testing Could Reduce Infection Spread and Associated Morbidity — The results of a study found that allowing bedside nurses to independently order testing for C. diff significantly decreased the amount of time to receive test results as compared to requiring physician approval.
 
5 Unsafe Injection Practices That Can Harm Dialysis Patients — An article from the American Medical Association discussed unsafe injection practices in outpatient dialysis.
 
Building a Culture of Safety in Health Care — The American Hospital Association issued a report highlighting key takeaways from a series of AHA-hosted listening sessions on the state of infection prevention and control.
 
Why Is RSV Different Now Than in Past Years? — An article from the Cleveland Clinic explored how the respiratory syncytial virus is changing.