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PRACTICE OF INFECTION

CONTROL

BEFORE:
- Hepa B vaccination and
screening
- Hand washing / Hand
hygiene

DURING:

AFTER:

-Gloves and gloves use

- Handwashing

-Clinical contact surfaces

- Sterilization and
Disinfection

-Use of gloves

- Instruments

- Sterilization and
Disinfection

-Aseptic maintenance

- Instruments
- Aseptic maintenance
surfaces

QUESTIONNAIRE
For Clinicians
BEFORE:
HEPA-B VACCINE AND SCREENING:
1. Have you completed your Hepa-B vaccination series? (3 doses- 1 dose for 3 consecutive months)
YES
NO
2. Do you screen your patients for Hepa-B virus?
YES
NO
3. If patients is positive for Hepa-B virus, do you still render treatment?
YES
NO
HAND WASHING:
1. Do you do hand washing before donning gloves?
YES
NO, because I will wear gloves anyway
2. Do you do hand washing before and after treating each patient?
YES
NO
3. For oral surgery procedures, do you do surgical hand washing?
YES
NO
4. Do you have soap for hand washing?
YES
NO

GLOVES AND GLOVES USE:


1. Do you keep your nails short?
YES
NO
2. Do you use a new pair of gloves before each patient?
YES
NO
3. Do you remove or replace gloves that are torn, cut or punctured as soon as possible?
YES
NO
4. Do you use appropriate glove according to your size?
YES
NO
STERILIZATION AND DISINFECTION OF INSTRUMENTS:
1. Do you sterilize critical and semi-critical instruments before use?
YES
NO
2. Do you use container system or wrapping compatible with the type of sterilization process?
YES, if yes what type of container system:
__ sterilizing pouch
__ paper
NO
3. Do you use an indicator in each package?
YES
NO
4. Do you wash and disinfect your other instruments like bite blocks and cheek retractor?
YES
NO
CLINICAL CONTACT SURFACES:
1. Do you use surface barriers to protect clinical surface contact?
YES
NO
2. Which area in the dental chair do you place these surface barriers?
__ dental light handle only
__ dental tray handle only
__ the whole tray and its handle
__ arm rest of patient only
__ dental light handle, tray handle and arm rest

3. Do you remove and replace it every after each patient? During or after treatment?
YES
NO
DURING:
GLOVES AND GLOVES USE:
1. Do you remove and replace your gloves that are torn, cut or punctured as soon as possible?
YES
NO
2. Do you wash your hands after your gloves have been torn, cut or punctured?
YES
NO
3. Do you use different gloves for clinical examination and procedures?
YES
NO
4. Do you use over gloves?
YES
NO
CLINICAL CONTACT SURFACES:
1. During clinical procedures, do you only touch the parts of the dental chair that are covered with surface
barriers?
YES
NO
AFTER:
HANDWASHING:
1. Do you wash your hand after removing gloves?
YES
NO
GLOVES AND GLOVES USE:
1. Do you use puncture and chemical resistant utility gloves?
YES
NO
STERILIZATION AND DISINFECTION OF INSTRUMENTS:
1. Do you use sponge in cleaning instruments?
YES
NO
2. What kind of soap do you use in cleaning instruments?
__ powder detergent
__ dishwashing liquid
__ Zymex, from Sultan
__ Enzymax Spray Gel from Hu-Friedy

3. Do you clean and dry your instruments before packing?


YES, how ___________
NO, I just packed it right away
4. Do you put indicator for that sterilization?
YES
NO
CLINICAL CONTACT SURFACES:
1. Do you remove your surface barriers after procedure?
YES
NO
2. Do you clean your dental chair after procedure?
YES, what type of disinfection ___________________
NO, I already use surface barriers
For Clinician on Duty: Regarding environmental surfaces
For Clinical Instructors: Regarding "during clinical procedure"

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