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Dental Tribune United Kingdom Edition

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Dental tribune DEC12.indd 1 21/11/2012 11:10 15Infection Control TribuneNov 26 - Dec 3, 2012United Kingdom Edition 15 of participating in the project ‘did not feel that a central supply was feasible given the required turnover of instru- ments’. The podiatry service on the other hand were more amena- ble and ‘…considered daily and weekly checks to be impractical due to lack of staff & time’. The costing involved are quoted in figures from that era and the comments make interesting reading since the initial cost- ing of setting up the centrali- sation was ‘…offset by greater clinic time availability, reduced waiting times and loss of main- tenance costs’. There has been no further work published on this topic since, although this was an option investigated in proposals put forward by an early Glennie report. However, at that time it was considered that the Central Sterile Supply service could not cope with the demand of reprocessing all in- struments from general dental practice. With the passing of time and implications of the capital and revenue costs for upgrading local decontamination units it should be noted that there are some working examples of centralisation of dental instru- ment reprocessing. These have been operational in a number of directly managed dental centres that have had their lo- cal decontamination removed and are being serviced by an off-site sterile supply depart- ment. In one particular exam- ple of an eight-chair dental facility, the instrument turna- round time is 24 hours and the unit has a dedicated storeroom for sterilised instruments and a dedicated room for dirty re- turns. Feedback from the den- tal service indicated that no major issues were identified with turnaround times, pro- cessing loss or damage to in- struments, although the stocks of instruments purchased to accommodate the increased turnaround time were over- estimated by a factor of 3:1. The set-up demanded adop- tion of a more standardised tray set-up with unusual or rarely used items available as supplemental singly packed instruments. Of course centralisation of a directly managed unit does not compare with a general dental practice but perhaps the adop- tion of a different business model whereby a dental prac- tice specifies a tray content (in- cluding handpieces) and rents these from the sterile service department. This of course presupposes that a sterile ser- vice department in the locality has the capacity and facilities to cope with dental trays and handpieces. However, imagine a practice where instrument decontamination is now the re- sponsibility of a Sterile Service manager and the practice can get on with what it does best and treat patients. DT References 1. Rothwell PS, Dinsdale RCW. Cross- infection control in dental practice. Part 1: The practicability of a zone system to reduce cross-infection risks in convention- ally-designed dental surgeries. Br Dent J 1988; 10: 185-187. 2. Worthington LS, Rothwell PS, Banks N. Cross-infection control in dental practice. Part 2: A dental surgery planned with cross-infection control as the design prior- ity. Br Dent J 1988; 165: 226-228. Wilson APR et al JHI 1999; 246-247 About the author Andrew Smith is Professor of Clini- cal Bacteriology and Hon Consult- ant Bacteriologist based at Glasgow University and NHS Glasgow and Clyde where he is the lead con- sultant for Oral Microbiology and Medical Device Decontamination. Professor Smith sits on several local and national committees overview- ing medical device decontamination. Research interests include optimising methods for the decontamination of a wide range of medical devices and in- vestigations into microbial virulence factors. His latest publications rel- evant to vCJD and dentistry include Bioassay studies support the potential for iatrogenic transmission of variant Creutzfeldt Jakob disease through dental procedures and Dental treat- ment and variant Creutzfeldt-Jakob Disease in Great Britain. ‘Imagine a practice where instrument decontamination is now the responsibility of a Sterile Service manager and the practice can get on with what it does best and treat patients’