Ensuring effective decontamination of reusable instruments is complex and relies on the integration on having the correct facilities, equipment, a standardised process, and trained staff.
- Facilities: these need to be fit for purpose, well-organised and maintained
- Equipment, Validation, Testing: the correct equipment must be available and be validated and tested to ensure that it is functioning correctly
- Process: a standard decontamination process must be established and followed
- Training: staff need to know their specific roles and be fully trained to carry out their duties effectively
In addition, an effective system for management of the process is necessary to enable the practice to demonstrate, both to its staff and externally, that it meets national standards for decontamination in primary care, can consistently deliver these standards and can identify any improvements required. This involves:
- documenting how the practice sets out to achieve effective decontamination in the form of policy statements and procedures for each part of the process;
- recording and retaining relevant information to show that each part of the process has been effective;
- regular audit and review to monitor whether processes are up to date, are being followed and to implement any changes required.
Policies and procedures are living documents and should be reviewed periodically to
ensure they reflect current best practice and operational activities within the practice. They
should have revision identifiers which should include any code/ revision numbers, revision
dates, who made the changes and a very brief description of what has changed.
The requirements for decontamination management are detailed in the Health Facilities Scotland Management, equipment, and process of the decontamination of dental instruments in a Local Decontamination Unit (LDU) in NHSScotland (SHTM 01-05) Part A and many of these requirements are specified within the NHSScotland Combined Practice Inspection for dental practices.
A suite of template documents entitled Managing Decontamination in Dental Practice (MDDP) has been developed specifically for the needs of dental practices following a review of earlier generic approaches to decontamination management. MDDP aims to help dental practices to create the documentation that underpins a decontamination management system by supplementing the documents that the practice already has.
There is considerable overlap between decontamination management and general health and safety management within a dental practice. Consequently, some of the documentation is common to both of these activities.
MDDP comprises a checklist for reviewing the current status of decontamination documentation and a collection of templates and forms that the practice can adapt for its own use. How to Use the MDDP lists the documents provided and explains how they can be used.
NB: There is no requirement to use the MDDP documents. Instead, they are provided to illustrate what a practice needs to include in its documentation. The majority of the MDDP documents are forms or templates that a practice may adapt to suit its particular situation, if required.
A Framework to Support Staff Development in the Decontamination of Re-usable Medical Devices, which is applicable to staff working in NHS Boards and the independent sector, including general dental practices, has been developed by NHS Education for Scotland and Health Protection Scotland to support those who undertake, manage or are responsible for decontamination activities. (Requires TURAS log in.)