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Urgent Dental Care Practice Setup and Infection Control in Yorkshire and Humber

Reducing the risk of transmission of COVID-19

Version 4.0 Updated 7st May 2020 (Any updates will be highlighted below)

07.05.2020 –

• Updated decontamination section: “Process of Cleaning the Surgery” *major update*

• Legionella section removed and created a new document “summary of managing Legionella in dental practice – COVID” (Available on HEE COVID-19 UDC Education Site)

01.05.2020 – Added new section: How to reduce the risk of Legionella and Legionnaires’ in Dental

Practices during the COVID-19 Pandemic

29.04.2020 – Added under ‘Patient Flow’ section, call patient prior to arrival:

▪ Ask patients to use the bathroom before setting off to reduce the frequency of use of dental surgery toilets and avoid contamination of areas

▪ As they arrive – consider Face to face triage, this can be in large room in practice or outside the dental practice (with appropriate PPE). This helps the dentist ensure the patient does need treatment. Once decided that treatment is required, the patient should return back to car until the treating team are ready (in order to be able to record notes, prepare equipment and to ‘donn’ appropriate PPE).

Contents Preparation of the surgery and dental practice .................................................................................... 2

Why do I need these precautions? ..................................................................................................... 2

How should I set up the practice in preparation for treating urgent dental care patients? .............. 4

1. Environment............................................................................................................................ 4

2. Zoning...................................................................................................................................... 4

3. Patient flow ............................................................................................................................. 5

4. Staffing .................................................................................................................................... 8

5. Staff flow ................................................................................................................................. 8

Infection Control in relation to COVID ................................................................................................ 11

Surgery Set up ................................................................................................................................... 11

How should I set up dental surgery prior to urgent dental treatment? ........................................... 11

How should I take and process intra-oral radiographs? .................................................................. 12

Surgery Cleaning and Equipment ...................................................................................................... 12

How long should I wait prior to cleaning the dental surgery following an AGP? ............................. 12

How should I clean the dental surgery following treatment? .......................................................... 13

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Process of cleaning the surgery ........................................................................................................ 14

Management of equipment and the care environment ................................................................... 17

Equipment ..................................................................................................................................... 18

Communal Areas ........................................................................................................................... 18

Waste ............................................................................................................................................ 18

How to reduce the risk of Legionella and Legionnaires’ in Dental Practices during the COVID-19

Pandemic ................................................................................................. Error! Bookmark not defined.

Example checklists................................................................................................................................ 19

The purpose of this document is to summarise the National SOP for Urgent

Dental Care (UDC) and Public Health England (PHE) guidance in relation to

practice setup and infection control in urgent dental care. Please note that this

summary is based purely on PHE and NHSE & I national guidance which

is regularly updated. Therefore, all members of the dental team must regularly

review the full guidance at:

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-

prevention-and-control

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0282-

covid-19-urgent-dental-care-sop.pdf

Preparation of the surgery and dental practice

Why do I need these precautions?

Standard infection control measures can be insufficient to prevent cross-

contamination of this infection agent (COVID-19). The transmission of COVID-

19 is thought to occur mainly through respiratory droplets generated by

coughing and sneezing, and through contact with contaminated surfaces. The

predominant modes of transmission are assumed to be droplet and contact.

Airborne transmission can occur where aerosol generating procedures (AGPs)

are performed.

Contact Droplet Airborne Prevent and control infection transmission via direct contact or indirectly from the immediate environment (including equipment).

Prevent and control infection transmission over short distances via droplets (>5μm) from the patient to a mucosal surface or the conjunctivae of a dental team member.

Prevent and control infection transmission via aerosols (≤5μm) from the respiratory tract of the patient directly onto a mucosal surface or conjunctivae of one of the

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Precautions now need to be taken for all patient encounters (not just patients

with suspected or confirmed COVID-19) at a time when there is sustained

community transmission of COVID-19, as is currently occurring in the UK, and

the likelihood of any patient having coronavirus infection is raised.

All urgent dental care centres will follow standard infection control precautions and transmission-based precautions (TBPs) to reduce the risk of transmission of coronavirus. In dental settings, there is guidance from HTM01-05 and NICE describing infection prevention and control measures that should be used by all staff, in all settings, always, for all patients. TBPs are additional infection control precautions required when caring for a patient with a known or suspected infectious agent and are classified based on routes of transmission. Robust COVID-19 infection control procedures, are set out in PHE guidance for pandemic coronavirus and key points from this guidance, as they apply in a UDC context, have been summarised in Appendix 3 of the national SOP for urgent dental care published by NHS England & NHS Improvement.

PHE have stated that there is insufficient evidence that COVID-19 is spread by

an airborne route, unless an aerosol generating procedure (AGP) is carried out.

However, further research into this area is currently ongoing.

The relevance of this in dental practice is that surgeries should be well

ventilated, keeping doors closed at all times. Appropriate PPE should be worn,

and social distancing should be maintained within the working environment

where possible. Any procedures should be carried out as efficiently as

possible, minimising AGPs, reducing unnecessary clinical interactions and

minimising time spent within 2 metres of both patients and staff.

This is the most common route of infection transmission.

A distance of approximately 1-2 metres around the infected individual is the area of risk for droplet transmission which is why dental teams routinely wear surgical masks and eye protection for treating patients.

dental team without necessarily having close contact.

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How should I set up the practice in preparation for treating urgent dental care patients?

1. Environment

Each practice needs to consider their environment and walk through as if a

patient. There is a need to consider the path of entry in and out, with

minimal touching of surfaces, ideally with a member of staff escorting

them through to allow for this. Points of entry and exit should be limited,

to ensure adherence to protocols clarified below.

There needs to be adequate signage clearly informing patients regarding

entry and exit, social distancing, the need to wait in their vehicles and the

limitations in numbers allowed in at any one time

Any areas which a patient may be seen in, or may pass through, including

waiting rooms, receptions and dental surgeries need to be kept clean and

clutter free. All non-essential items including toys, books and magazines

should be removed from reception and waiting areas. In dental surgeries,

all equipment or items not required for that treatment episode should be

removed to an area outside the treating surgery.

Avoid the use of air conditioning or fans, as these will recirculate the air.

Whilst social distancing measures are in place, waiting rooms and reception

areas of the urgent dental care centres should allow for 2 metre

separation, ideally marked on chairs and flooring.

2. Zoning

The practice layout will need to be assessed, regarding entry and exit points, areas to ‘don’ (apply) and ‘doff’ (remove) PPE, and sufficient surgeries in order to treat further patients to allow time for any aerosol to settle and for cleaning to occur.

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For all patients, physical (eg separate waiting areas and treatment rooms) and temporal (eg appropriately spaced appointments, sessions for specific patient groups) separation measures should be employed.

Consideration should be given to both patient group and the type of treatment being undertaken. Sites, areas and facilities should be demarcated clearly for specific patient groups they have been designated to receive (eg. To separate patients who are shielded or at increased risk.)

Think about surgery layout, having a multi-surgery unit set up will allow for

dedicated donning, doffing areas and accommodate room turnaround

time. Having a dedicated donning and doffing zone that are separate from

treating surgeries will reduce the risk both to staff and patients.

A risk assessment should be carried out in a limited surgery set-up; it may

be that donning can occur in a clean surgery prior to patient arrival, and

doffing in the treatment surgery once the patient has left (with the

exception of eye protection and FFP3 respirators that should be removed

outside the dental surgery, into an appropriate clinical waste bin). Dental

practices will need to think about the ventilation of surgeries, number of

surgeries available, quantities of PPE and staff availability to be able to plan

for the number of patients that can be seen safely.

3. Patient flow

To reduce the risk to patients and staff:

• Only one patient should enter the practice at any given time. Any patients waiting should remain outside, ideally in a vehicle until called. Where this is not possible, patients should maintain social distancing rules.

• If the patient is accompanied, the companion is to be asked to wait outside in a suitable environment such as a car. Where an escort is absolutely necessary (e.g. for consent), one escort should be allowed per patient and this escort should be from the patient’s household to minimise exposure risk. The escort should also be screened regarding COVID-19 risk prior to entry.

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• Consideration should be given to the setup of an external triage area, where patients can be reviewed prior to entering the building, or in a large room within the practice premises.

• Alternatively, a second stage triage can be implemented in each region, allowing for a review of the urgency of treatment and face-to-face assessment where indicated.

• When a patient is booked to attend an urgent dental care centre:

o Consideration needs to be made to reduce processes that would normally take place in reception, in order to reduce transmission. This can include medical history forms, taking payment, signing FP17 forms, booking further appointments etc.

o Call patients prior to arrival:

▪ Re-screen patients regarding COVID-19 risk and urgent dental care need

▪ Where an escort is needed for consent purposes this is allowed, however patients should otherwise attend on their own

▪ Confirm any exemptions and can go over any relevant forms over the phone (including medical history forms). Practices may need to confirm with NHS BSA regarding the need for physical signature on FP17 forms.

▪ Consider options for payment over the phone where possible (alternatives include contactless payments and bringing exact cash in a sealed bag).

▪ Ask patients to use the bathroom before setting off to reduce the frequency of use of dental surgery toilets and avoid contamination of areas

▪ As they arrive – consider Face to face triage, this can be in large room in practice or outside the dental practice (with appropriate PPE). This helps the dentist ensure the patient does need treatment. Once decided that treatment is required, the patient should return back to car until the treating team are ready (in order to be able to record notes, prepare equipment and to ‘donn’ appropriate PPE).

• On entering the building:

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o Patients (and escorts if necessary) should be asked to decontaminate their hands with alcohol-based hand rub

o Respiratory and cough hygiene should be observed by staff and patients/carers. Disposable tissues should be available and used to cover the nose and mouth when sneezing, coughing or wiping and blowing the nose – ‘Catch it, bin it, kill it’.

o Amber or Blue sites - Consideration should be given to the use of a non-contact thermometer for all patients or escorts.

o Red sites – In common waiting areas or during transportation and where tolerable and appropriate in clinical areas, symptomatic patients may wear a surgical face mask. The aim of this is to minimise the dispersal of respiratory secretions and reduce environmental contamination

• The patient flow should be designed that there is one path of entry and exit, minimising the distance travelled and time spent within the practice.

o If practices pathways are designed so that more than one patient is seen at once within the practice, separate entry and exit points or timeslots will be needed to shield and/or protect any patients that are classified under ‘vulnerable’ or shielded’ (Amber sites)

• The path through the practice should be designed such that the patient does not contact or touch any surfaces unnecessarily, eg. Door handles, hand rails etc. There should be relevant signage to identify this.

A designated member of staff should therefore escort patients through the practice, with appropriate PPE as they will likely come within 2 metres of the patient.

• A treating surgery will ideally be located in close proximity to the main entrance / exit as well as designated patient toilet facilities.

• Any areas of the practice that are not determined as necessary for patient thoroughfare, should be zoned off to reduce this chance.

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4. Staffing

Staffing should be minimised in order to allow for adequate social distancing where appropriate. As few staff as possible should be allocated to see patients, particularly those shielded, to minimise contacts without compromising the safe delivery of care.

However, there will need to be sufficient numbers to allow for safe

donning, doffing, infection control and patient flow.

Example staffing levels include:

Each session will be comprised of 4 staff members, each with a specific designated role

1. The treating dentist

2. The ‘assisting’ nurse in surgery providing patient care with the dentist

3. The ‘runner’ nurse outside the surgery, to assist with passing required instruments and materials into the surgery and assist donning and doffing

4. A third ‘escorting’ nurse outside of the surgery, to develop radiographs and retrieve emergency drugs if necessary, assist with retrieving any equipment or materials outside of the surgery and escorting patients into and out of the practice.

5. Where larger practices can allow for more than one patient to be seen at a time, then 6 staff members can be utilised. This includes 2 dentists, 2 ‘assisting’ dental nurses and 2 ‘runner’ dental nurses to fulfil the roles outside the dental surgery. It is important that the two dental surgeries are located in different areas of the practice, where possible.

5. Staff flow

Ideal staff flow are as follows:

• Hand hygiene, washing thoroughly with soap and water, is essential to reduce the transmission of infection. All dental staff should decontaminate their hands with alcohol-based hand rub when entering and leaving urgent dental care services

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• Designated rooms and areas ideally should be identified as ‘donning’ (putting on PPE) and ‘doffing’ (Removal of PPE) areas and these remain fixed.

• The ‘DON’ area is for dressing in appropriate Personal Protective Equipment (PPE). The ‘DOFF’ area is to remove PPE.

o Please see Yorkshire and Humber Urgent Dental Care PPE document and PHE Guidance and videos on donning and doffing (links below)

• Ideally plans should include use of multiple treatment rooms, in order to allow any aerosol to settle between patients, and alternating rooms between patients

o A minimum of two dental surgeries is required, however in the case of an AGP being performed then a minimum of three dental surgeries may be ideal, to give adequate time for cleaning to occur.

o In the case where more than one patient is being treated at once within the dental practice, a minimum of four or six dental surgeries required (as per above), with consideration for separate entry and exit pathways where possible.

• During dental treatment, the door must remain shut where possible and windows should be kept open, to aid ventilation and reduction of ≤5μm particles remaining within the air of the dental surgery. Windows should be kept open for at least an hour following treatment.

o Any procedures should be carried out with a single patient and only staff who are needed to undertake the procedure present in the room with the doors shut

• The team travels from a treatment room (after treating a patient) to the designated DOFF room in order to remove PPE*

• From this room, the team travels to the designated DON room in order to put on PPE.

• The team then travels to the next treatment room

• Prior to re-entering the used surgery, staff need to wait for adequate time for the aerosol to settle. In a primary care dental practice, with limited air changes, this may be up to 1 hour (see section below for clarification).

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However as mentioned previously, a risk assessment should be carried out where this is not possible. Alternatives may include utilising a clean surgery to don PPE prior to a patient entering. Once the treatment is completed, doffing PPE should ideally be carried out outside the dental surgery, and disposable PPE placed straight into clinical waste bags. However, where that is not possible, it could be carried out in surgery, ensuring eye protection and FFP3 respirators are kept in place until out of the surgery and removed at a designated station. The key aspect of any plan is that FFP3 respirators must always be removed once outside the surgery. * Gloves and disposable aprons should always be removed after each patient contact. However, dependent on local risk assessment, some items of PPE may be left on for sessional use and only removed after the last patient of that session has been seen.

Staff uniform

The appropriate use of personal protective equipment (PPE) will protect staff uniform from contamination in most circumstances. Healthcare facilities should provide changing rooms/areas where staff can change into uniforms on arrival at work.

Where practices do not launder staff uniforms, then uniforms should be transported home safely. This could be a disposable plastic bag, which should then be disposed of into the household waste stream. An alternative could be the use of a pillowcase, as this can be put straight into the washing machine, and reduces the risk of contaminating the home environment. The BDA advice leaflet “staying safe” provides useful information on this (linked below).

Uniforms should be laundered:

• separately from other household linen

• in a load not more than half the machine capacity

• at the maximum temperature the fabric can tolerate, then ironed or tumbled-dried

Note: It is best practice to change into and out of uniforms at work and not wear them when travelling

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Links for Further Reading:

https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-

aerosol-generating-procedures

https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-

non-aerosol-generating-procedures

https://bda.org/advice/Coronavirus/Documents/Staying%20safe%20poster.pdf

Infection Control in relation to COVID

Surgery Set up

How should I set up dental surgery prior to urgent dental treatment?

Due to the risk of droplet transmission and airborne transmission (during AGPs), opening a drawer in a dental surgery mid-treatment can risk contamination of the contents of that drawer.

Dental surgeries should therefore consider emptying drawers of materials and equipment and consider alternative means of accessing equipment for treatment.

Examples include:

• Setting up for the planned procedure, based upon robust triage, prior to patient attendance, with set instruments and materials pre-planned according to the procedure

• Keeping all extra equipment and materials outside the dental surgery, passed in through the door by a ‘runner’ nurse as requested (at no stage should the ‘runner’ nurse enter the surgery)

• Keeping a number of sealed boxes filled with a single procedure worth of equipment outside the surgery, ready to be passed in once required.

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How should I take and process intra-oral radiographs?

Where intra-oral radiographs need to be taken:- For wet film and phosphor plate radiographic films:

• ‘Assisting’ nurse cleans/disinfects radiographic film, as per the normal disinfection protocol.

• ‘Runner’ nurse opens surgery door, and film can either be placed into a sealed box, held by the ‘runner’ nurse, or radiograph passed onto a trolley from outside the surgery

• This box or trolley can be taken to develop radiograph outside the surgery, ensuring the box, trolley and radiograph are cleaned and disinfected appropriately

For CCD radiograph imaging sensors proceed as usual with barrier protection and consider disinfection once barrier cover removed.

Surgery Cleaning and Equipment

How long should I wait prior to cleaning the dental surgery following an AGP?

Guidance from NHS England & NHS Improvement in the national SOP for urgent dental care recommends that when an AGP has been carried out the dental surgery is left vacant one hour in a neutral pressure room before performing a terminal clean. Windows to the outside in neutral pressure rooms can be opened.

A dental surgery can have varying number of air changes per hour, depending on ventilation, and opening of doors and windows. Therefore, in order to be safe, it is recommended to open all windows, leave the room following the completion of treatment and close the door. Wait one hour prior to entering the room again. Guidance on the PHE site (as linked below) states that a minimum of 20 minutes is adequate for hospital settings, however the number of air changes in hospital facilities is quite often higher than in a primary care dental practice.

Clarification on air changes and primary care dental practice

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The rate of clearance of aerosols in an enclosed space is dependent on the extent of any mechanical or natural ventilation – the greater the number of air changes per hour (ventilation rate), the sooner any aerosol will be cleared.

The time required for clearance of aerosols, and thus the time after which the room can be entered without a filtering face piece (class 3) (FFP3) respirator, can be determined by the number of air changes per hour (ACH)

It has been found that in a dental practice, the ACH can vary between 2 and 10 changes per hour, depending on ventilation, opening of doors and windows and movement of people in and out of the room.

Clearance of aerosols is dependent on the ventilation and air change within the room. Once an end to dispersion can be defined (such as the patient leaving the room), a single air change is estimated to remove 63% of airborne contaminants and similarly with each subsequent air change. After 5 air changes, less than 1% of the original airborne contamination is thought to remain.

Links for Further Reading:

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0282-covid-19-

urgent-dental-care-sop.pdf

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-

control/reducing-the-risk-of-transmission-of-covid-19-in-the-hospital-setting

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-

control/transmission-characteristics-and-principles-of-infection-prevention-and-control

How should I clean the dental surgery following treatment?

Decontamination following treatment should follow HTM01 05.

Dental care professionals working in urgent care settings should be trained in all aspects of infection prevention and control (IPC) and fully familiar with HTM01 05 for decontamination. Cleaning staff should also be trained in IPC measures. In addition to this, decontamination should be carried out by staff trained in the appropriate PPE. In some instances, this may need to be trained clinical staff rather than domestic staff, in which case, clinical staff may require additional training on standards and order of cleaning.

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Process of cleaning the surgery

Please refer to:

Appendix 3 of the National SOP

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0282-

covid-19-urgent-dental-care-sop.pdf

Section 4.9.2 of PHE COVID-19: infection prevention and control guidance

which updates the SOP

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_

data/file/881489/COVID-19_Infection_prevention_and_control_guidance_complete.pdf

Decontamination following treatment should follow HTM01 05

In addition, when an AGP has been used, it is recommended that the room is left vacant with the door closed for one hour before performing a terminal clean following HTM01 05. Windows to the outside in the room can be opened to aid air circulation. Please see HTM01 05 Sections 6.37-6.74

The Infection prevention and control guidance states (page 20) that only if the room needs to be put back into use urgently, then it is recommended that the room is cleaned as in Section 4.9.1 (page 19) as though the patient is still in the same room and that this decontamination should take the form of - After cleaning with neutral detergent, a chlorine-based disinfectant should be used, in the form of a solution at a minimum strength of 1,000ppm available chlorine. If an alternative disinfectant is used within the organisation, the local infection prevention and control team (IPCT) should be consulted on this to ensure that this is effective against enveloped viruses.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881489/COVID-19_Infection_prevention_and_control_guidance_complete.pdf

Additional considerations for decontamination following an AGP

If possible, only one person should undertake the room decontamination and the responsible person should be trained and familiar with the relevant processes and procedures:

Before entering the room

• Perform hand hygiene then put on a disposable plastic apron and gloves,

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a fluid resistant surgical mask, and eye protection.

• Collect all cleaning equipment and clinical waste bags before entering the room

On entering the room

• Keep the door closed with windows open to improve airflow and ventilation whilst using detergent and disinfection products.

• Bag all disposable items that have been used for the care of the patient as clinical waste.

• Close any sharps containers wiping the surfaces with the appropriate agent

Cleaning process

• Use disposable cloths or paper roll or disposable mop heads, to systematically clean and disinfect all hard surfaces or floor or chairs or door handles and reusable non-invasive care equipment in the room.

• Ensure that any products used are in line with HTM01 05. If consideration is given to use of non-chlorine-based products or they are incompatible with equipment manufacturers guidance, you should ensure that any detergent and disinfection products used are effective against envelope viruses

• Where your usual products are not effective against enveloped viruses, use either:

a combined detergent disinfectant solution at a dilution of 1000 parts per million (ppm) available chlorine (av.cl.) OR, a neutral purpose detergent followed by disinfection (1000 ppm av.cl.) Advice and support in terms of appropriate cleaning solutions can be sought from your local Infection Control team.

• Follow manufacturer’s instructions for dilution, application and contact times for all detergents and disinfectants.

• For any reusable non-invasive equipment that needs decontamination, follow the guidance here (Also see diagram below)

On leaving the room

• Discard detergent or disinfectant solutions safely at disposal point.

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• Any cloths and mop heads used must be disposed of as single use items.

• Clean, dry and store re-usable parts of cleaning equipment, such as mop handles and buckets after decontamination

• Remove and discard PPE as clinical waste.

• Perform hand hygiene.

Cleaning of communal areas

• Particular attention should be paid to regular and thorough cleaning of communal areas, including door handles.

• If a suspected case spent time in a communal area, for example, a waiting area or toilet facilities then these areas should be cleaned with detergent and disinfectant (as above) as soon as practicably possible, unless there has been a blood or body fluid spill which should be dealt with immediately. Once cleaning and disinfection have been completed, the area can be put back in use.

Summary

Decontamination Additional comments

Non-AGP Follow routine HTM01-05 - ensure

products are active against

enveloped viruses

Locally agreed suggestion that

20 mins is left between

patients to permit

decontamination and ensure

social distancing between

patients

AGP

• One hour settle time after

patient leaves

• Follow routine HTM01-05

• ensure products are active

against enveloped viruses

AGP

(1 hour settle time

not possible)

Not recommended

• Surgery needed urgently - one

hour settle time after patient

leaves not possible

• Surgery should be cleaned

following the guidance set out

in Section 9.4.1 of infection

prevention and control

guidance

Surgery decontamination

follows the guidance as

though the patient is still in

the room, including wearing

PPE suitable for AGP.

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Management of equipment and the care environment

Protocol for decontamination of reusable non-invasive patient care equipment

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877533/Routine_decontamination_of_reusable_noninvasive_equipment.pdf

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Only cleaning (detergent) and disinfectant products supplied by employers are to be used. Products must be prepared and used according to the manufacturers’ instructions and recommended product ‘contact times’ must be followed. If alternative cleaning agents/disinfectants are to be used, they should only on the advice of the IPCT and conform to EN standard 14476 for virucidal activity.

Equipment

Patient care equipment should be single-use items if possible. Reusable (communal) non-invasive equipment should as far as possible be allocated to the individual patient or cohort of patients.

Reusable (communal) non-invasive equipment must be decontaminated:

• between each patient and after patient use

• after blood and body fluid contamination

• at regular intervals as part of equipment cleaning

Communal Areas

Care should be taken such that patients do not touch any surfaces, door

handles or items unless necessary. Where patients have touched handles or

sat down on chairs in communal areas, these should be cleaned appropriately

as per the guidance in HTM01-05.

Waste

Dispose of all waste as clinical waste.

Waste from a possible or a confirmed case must be disposed of as Category B waste.

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Example checklists

These checklists can be utilised to help prepare a practice for providing urgent

dental care during the COVID-19 outbreak.

Source: ExampleCQC.com

COVID Risk

Mitigation_Isolation Rooms.pdf

COVID Risk

Mitigation_Protect Clinicians.pdf

COVID Risk

Mitigation_Suspected COVID Case.pdf

COVID Risk

Mitigation_Protect Your Colleagues.pdf

COVID Risk

MitigationProtect Patients.pdf

COVID Risk

MitigationProtect Patients.pdf

COVID Risk

Mitigation_Enhanced Infection Control.pdf

COVID Risk

Mitigation_Employer Protection.pdf

COVID Risk

Mitigation Poster_everythingCQC.pdf