We consider the environment of the decontamination room or area when we review if the practice is safe. This relates to regulation 15 (premises and equipment) and regulation 12 (safe care and treatment).
Many dental practices now have a separate decontamination room or rooms to carry out the cleaning, inspection, sterilisation and storage of dental instruments and equipment. However, due to the constraints of the building such as lack of space or listed building regulations, this may not be possible. In these situations, reprocessing dental instruments will need to take place in the dental treatment room unless other arrangements are made such as using an external central decontamination facility.
Professional guidelines: HTM 01-05: Decontamination in primary care dental practices
Mandatory requirements
Where instruments are reprocessed in the dental treatment room we would expect to see that reasonable steps are taken to reduce the risks to patients. These include:
- having the reprocessing area as far from the dental chair as possible.
- reducing the risk of exposure to bacterial aerosol by not manually washing or using ultrasonic cleaners without a lid when the patient is in the dental treatment room.
To ensure patient comfort, reduce extraneous noise in the treatment room as much as possible. Do not operate ultrasonic cleaning baths and autoclaves whilst patients are undergoing consultations or treatment.
Recommended practice
The decontamination area in the dental treatment room should, preferably, be a single run of sealed, easily cleaned worktops and include:
- a setting down area for dirty instruments
- washing and rinsing sinks (or a single washing sink with a removable bowl for rinsing)
- an area for inspection of cleaned instruments prior to sterilisation
- a suitable and appropriate space to house an autoclave
- an area for packaging of the processed instruments
- a separate hand washing sink.
Maintain a dirty to clean workflow throughout the decontamination process to minimise the possibility of used instruments coming into contact with sterilised instruments.
If decontamination is being deferred until the end of a clinical session, inspectors would expect to see that practices carry sufficient stock of instruments and dental handpieces to cover the number of patients for a morning or afternoon session.