Hygiene und Infektionsprävention in Zahnarztpraxen

Abstract

Recommendations for prevention of infection in dentistry have been published in many countries and in Germany as well. In a pilot project in collaboration with the Public Health Service of the City of Frankfurt and the chamber of dentists in Hesse, compliance with these recommendations was studied in dental practices in Frankfurt/M in 2005. After being informed about the recommendations, more than 50% of the 560 Frankfurt dentists agreed to participate in this project, and 127 of these practitioners were visited by experts of the dentist chamber. Hygienic standards in the practices were examined using a checklist. A proper hygiene schedule was observed in 84% of the practices. Facilities for hand hygiene such as dispensers for soap, disinfectant and towels were available in 98, 93 and 92% of the practices, and personal protective equipment such as gloves, masks, eye wear and gowns was found in 98, 100, 98 and 88% of the practices, respectively. Reprocessing of dental instruments was done either manually (52%), manually in combination with ultrasonic cleaning (48%) or by using special reprocessing machines (32%). Steam sterilization was used in all practices; in some practices gravity displacement sterilizers were used (14%), whereas in most of the practices (61%) a high-speed prevacuum sterilizer was available -- especially in dental surgeon practices (77%). Monitoring and documentation of the sterilization process was done automatically (33%) or by hand (55%). In 80% of the practices, pressure, temperature, time and person responsible were documented. Documents of routine maintenance and regular biological testing of the sterilizers could be shown in 93 and 84% of the practices. The Frankfurt pilot project based on information and advice in combination with control has proven to be successful in the majority of practices enrolled. Encouraged by this experience, the chamber of dentists wants to implement this project all over the state of Hesse. The intention is to inform and to visit all 4,500 dental practices in agreement with the local public health services, which in turn could reduce their own control visits in dental practices. Thus, hygiene control visits of the public health services could focus on other practices such as ambulatory surgery or endoscopy.

Principles of infection prevention and reprocessing in ENT endoscopy

“…This fact corresponds to data in the literatures: a survey of private practices performing outpatient surgeries (including ENT practices) made by the health authorities of Frankfurt/Main, Germany, showed that the reprocessing of instruments was carried out manually in 93% [ 43 ]. In dental practices the situation in 2005 with manual reprocessing was slightly better [ 44 ]. A report published 2008 by the Federal Ministry of Health also drew the conclusion that cleaning and disinfection in private practices is nearly always performed manually.…”

Hygiene und Infektionsprävention in medizinischen Einrichtungen und in Kindergemeinschaftseinrichtungen – Gesetzliche Grundlagen, Überwachungspraxis und Erfahrungen der Gesundheitsämter

“…Auch Einrichtungen für ambulantes Operieren werden von den meisten Gesundheitsämtern, endoskopierende Praxen sowie Arzt-und Zahnarztpraxen bzw. Praxen von Heilpraktikern von einigen Gesundheitsämtern begangen [5,7,[13][14][15][16][17][18][19][20][21][22][23]. Empfehlungen zur Durchführung von Krankenhausbegehungen [24][25][26][27] und von Arztpraxen [27][28][29][30] sowie zur Priorisierung der infektionshygienischen Begehungen wurden publiziert [27].…”