Dental Tribune United Kingdom Edition

B y now, all dental practic- es must comply with the essential requirements of Health Technical Memorandum 01-05 Decontamination in Den- tal Practice (aka HTM 01-05). If they do not, they are in breach of CQC Regulation 12, Outcome 8. HTM 01-05 was produced (in the words of the Depart- ment of Health) “in response to emerging evidence around the effectiveness of decontami- nation in primary care dental practices and the possibility of prion transmission through protein contamination of dental instruments.” In brief, the essential require- ments of HTM 01-05 are that: • Regardless of the technology used, the cleaned instruments, prior to sterilisation, should be free of visible contaminants when inspected with a mag- nification device. Instruments should be reprocessed using a validated decontamination cycle including: cleaning/ washing (in terms of manual cleaning, this includes having a written protocol, a validated steam steriliser, and at the end of the reprocessing cycle they should be in a sterilised state). • Reprocessed dental instru- ments should be stored in such a way as to ensure restraint of microbiological re-colonisa- tion. These measures should be backed by careful controls on the storage times to which instruments that are less fre- quently used are subject. • Practices should audit their decontamination processes quarterly using an audit tool (the use of the Infection Pre- vention Society/DH audit tool that accompanied the docu- ment was strongly recom- mended). • Practices should have in place a detailed action plan on how the provision of decon- tamination services will move towards best practice. Continue raising clinical governance awareness Considering that last bul- let point in more detail, it is implicit in the guidance that merely meeting the essential requirements of HTM 01-05 is not an end in itself. Instead, practices should continue moving forward with decon- tamination and aim towards best practice – effectively shooting at ever narrowing goalposts. By definition, I cannot tell you in detail what best practice is. It will continue to evolve over time as more effective processes are discovered and as better decontamination equipment is produced. Also, you may be close to achieving best practice now or you could be a long way off it. In moving towards best practice, you may wish to con- sider some or all of the follow- ing upgrades to your practice: • The use of an automat- ed (HTM 01-05) washer- disinfector • Separate facilities for decon- tamination clearly separated from the clinical treatment area. This implies the use of a separate room or rooms which should be used for the purpose of decontamination only and to which access should be re- stricted to those staff perform- Beyond HTM 01-05 Amanda Atkin explains on-going clinical governance June 4-10, 201214 Infection Control Tribune United Kingdom Edition