By Lisa Hannah, RN, CIC, AL-CIP, CDIPC

Infection control and prevention practices in healthcare facilities are standard for the most part, but some practices change and evolve. The goal of the Washington State Healthcare Associated Infections Prevention Team is to work with healthcare facilities to create the safest healthcare environment possible by identifying gaps and using best practices to help prevent the spread of infection.  We make sure healthcare facilities are set up for success to handle both the daily and unforeseen infection control challenges that may arise.

The Healthcare-Associated Infections and Antimicrobial Resistance Program (HAI & AR) in Washington began in 2007. This program has evolved over the years. From 2015-2019, Ebola funding allowed for infection prevention expertise at the State Department of Health and 2 local health jurisdictions. This expanded the program from acute care settings and high-profile investigations to ambulatory settings. In 2017, the infection prevention program began offering Infection Control Assessment and Response (ICAR) assessments, a non-regulatory, free, consultative service to dental clinics.

In 2021, the Dental Quality Assurance Commission (DQAC) amended Washington Administrative Code (WAC) 246-817-601 through 246-817-660 to “establish requirements for infection control where dentistry is provided.” Following the January 23, 2021, effective date, dental facilities need current and evidence-based infection prevention recommendations to meet the requirements of the revised WAC. The HAI program recognized that when DQAC amended infection control rules to align with CDC recommendations, it increased focus on education, including requirements for water-line testing and sterilization practices in dental settings, could be beneficial for preventing disease transmission. To respond to this potential need, the HAI program developed a Dental Infection Prevention Training Program to educate our infection preventionists in the specialized field of Dental Infection Prevention. Since 2021, two cohorts of infection preventionists have completed the training. This has increased the knowledge of infection prevention of public health staff at the local and state level. We have also partnered with dental assistant programs across the state to emphasize the importance of education in this area for dental practitioners to prevent disease transmission in their patients and staff. These presentations have allowed us to share common findings and discuss the “why” behind the recommendations or regulations. Infection preventionists with the HAI program have additional training in infection prevention, including the Certified in Dental Infection Prevention and Control exam (CDIPC) through the Dental Assistant National Board (DANB).

The HAI program works with local partners and oral healthcare settings to make sure evidence-based practices are shared and can be implemented.  The visits are designed to assess infection prevention strengths and potential areas for improvement in a supportive process.

The 2-hour consultation, designed to not disrupt clinical activities, consists of the following:

• A 30 to 40-minute conversation to learn about the clinic and the services provided
• Review of current dental infection prevention policies and procedures
• Review and observation of oral healthcare provider practices including:
• Hand hygiene
• Injection safety
• Personal protective equipment (PPE)
• Sterile processing, high Level disinfection, and storage of sterile instruments
• Environmental cleaning and disinfection practices
• Waterline testing, program management and educational resources

We are also available to provide free education to dental providers in accordance with WAC 246-817-615. Please reach out to our program if you would like more information on our ICAR program at HAI-FieldTeam@doh.wa.gov.