Alexander Roger E, Limes Sharon
Department of Oral & Maxillofacial Surgery, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, TX, USA.
Tex Dent J. 2010 Jan;127(1):15-25.
Recommendations and mandatory guidelines for preventing and managing needlestick incidents and other accidental exposures to bloodborne pathogens in healthcare facilities have been published by the Occupational Safety and Health Administration (OSHA) and the Centers for Disease Control and Prevention (CDC) for more than 2 decades. Over the years, the incidence of official enforcement actions has declined and a complacency about the standards may have evolved in some dental offices. Some practitioners may not have written an occupational exposure incident protocol or made appropriate arrangements for medical laboratory testing and postexposure medical evaluation following an unexpected needlestick or other exposure incident in the office. When an unexpected event occurs, practitioners may become confused regarding the steps to be taken, and may turn to their local dental society or fellow practitioners for guidance. The provided information may or may not be complete, accurate and/or current. Implementation of periodic personnel training to prevent exposure incidents is extremely important and could ultimately save a dental practice thousands of dollars in expenses related to the occurrence of even one exposure incident, as well as save the life and/or career of a dental healthcare provider. This article does not comprehensively detail all infection control and bloodborne pathogen transmission prevention requirements for dental offices. Rather, the article provides suggestions for dental practitioners regarding the step by step management of exposure incidents, and provides resource information for additional steps that can be taken towards prevention, improved office compliance, and improved litigation protection.
职业安全与健康管理局(OSHA)和疾病控制与预防中心(CDC)已经发布关于医疗机构预防和处理针刺伤事件及其他意外接触血源性病原体的建议和强制性指南超过20年了。多年来,官方执法行动的发生率有所下降,一些牙科诊所可能对这些标准产生了自满情绪。一些从业者可能没有编写职业暴露事件预案,也没有针对诊所内意外针刺伤或其他暴露事件后的医学实验室检测和暴露后医学评估做出适当安排。当意外事件发生时,从业者可能会对应采取的步骤感到困惑,并可能向当地牙科协会或同行寻求指导。所提供的信息可能完整、准确且/或最新,也可能并非如此。定期开展人员培训以预防暴露事件极其重要,这最终可能为牙科诊所节省与哪怕一起暴露事件相关的数千美元费用,同时挽救牙科医护人员的生命和/或职业生涯。本文并未全面详细阐述牙科诊所的所有感染控制和血源性病原体传播预防要求。相反,本文为牙科从业者提供了关于暴露事件逐步管理的建议,并提供了可采取的其他预防措施、提高诊所合规性以及增强诉讼保护的资源信息。