Surviving COVID-19

Due to COVID-19, we are experiencing a time unlike any other that we have faced before, both personally and professionally. If your dental practice is abiding by recommendations, you are dealing with an abundance of uncertainty for the future. This is a true test of resiliency.

The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. (Martin Luther King, Jr.)

How are you utilizing this time away from patient care? The choices you make now will greatly affect your future. Here are a few tips to help your practice thrive when social distancing ends and patient care resumes.

Utilize online Continuing Education – take advantage of FREE continuing education courses that you and your staff can take from the comfort of your quarantined home. 

Equipment maintenance – there is no better time to do some Spring cleaning at your office and make sure your equipment is in tip top shape. Ensure that your shut down will not lead to equipment malfunction from lack of proper procedure. 

Keep your team engaged – Your team will be depending on leadership to understand what lies ahead. Utilize online platforms like Zoom or ComeToMeeting for staff meetings to keep them engaged and motivated.  

Look for hidden opportunities – How is your community struggling and are there opportunities to rally positive action for those in greater need? Is your hospital running low on PPEs that you, perhaps, have extra to spare? Does your practice have elderly or immunocompromised patients who may be at home with low supplies? There is no shame in promoting your good deeds as it encourages others to do the same. And when employees of that hospital or friends of that immunocompromised patient are looking for a new dental practice in the future, your name will be on their mind. 

Practice self care – Be kind to yourself as well. Pause to reflect where you need assistance and don’t be afraid to ask for help. Reach out to colleagues and other professional services to help guide you through areas where you are struggling. We are all in this together and the help that they provide you may be exactly what they need to stay calm and motivated.

This is uncharted water for us all. How you choose to utilize this down time will help to determine where you land. Custom Dental Solutions will proudly assist your office through this uncertainty to help you build Success Your Way! 

Is Social Media Helping or Hurting Your Employment Opportunities?

By Jill Meyer-Lippert

We live in a world dominated by social media. What we choose to post on social media platforms can help to build or destroy relationships, both personally and professionally. When filling a position within a dental practice, evaluating a candidate’s online profile is a must for employers to help determine how he or she may fit their office culture prior to investing in a new hire.

What are some things employers look for?

Emotional Intelligence

Emotional Intelligence (EQ) is the capacity to be aware of, control, and express one’s emotions, and to handle interpersonal relationships judiciously and empathetically. 

Are posts reactive or driven by emotion? Overly displaying opinions and frustrations is a red flag for potential office drama and conflict. If you are feeling emotionally on edge, take some time to calm down and process your feelings before deciding if expressing them publicly is a wise decision. 

Lifestyle Choices

Posting photos of fun times with our friends is uplifting. It not only preserves precious memories but also helps to show your personal side. After all, we are not robots! But what are your social posts and photos saying about you? Are they possibly portraying an inaccurate view of your life? If you were hiring, would you hire the person you see on your page?

Negative Information Involving Current or Past Places of Employment

It is inevitable to experience some level of conflict in the workplace. Not all dental practices have a strong culture or protocols in place to deal with these issues in a healthy way. In these cases, conflict can quickly create a toxic environment. Even if you plan to leave a job, openly sharing workplace struggles online about an employer, manager, coworker or patient is a red flag, especially in an industry where confidentiality is vital in day-to-day operations. 

Office managers and recruiters face unique challenges finding suitable candidates in times of record low unemployment. Checking public profiles can help to ensure that they hire the right candidate. Each of us has the power to improve our employment opportunities by evaluating how we utilize social media. 

Be Thankful for Your Personality Type

By Corinne Jameson-Kuehl

From time to time I am contacted by someone that states that the completion of Disc and Driving Forces Assessments has created fear and worry due to how they “must look” in the eyes of an employer or manager.  Be assured that there is no reason for anxiety. These are simply informational tools to understand the “how” and the “why” of the one completing the assessment.  Depending on the assessment, it may not take an Emotional Intelligence journey such as Self Awareness into account.  Here are a few things to keep in mind:

1.       Take the time to look through the results, highlight and circle things that you feel are accurate. Likewise, mark statements you don’t agree with or see as inaccurate.  Have a trusted person read results as well.

2.       The intensity of traits is simply different for each person. Look at the % on the graphs to gauge intensity verses stating stereotypical phrases.

3.       Consider background values such a faith-based and faith-driven values.

4.       Acknowledge outside influences that are occurring or previous traumas such as death, divorce and significant illness.

When utilized properly, assessments provide a better understanding of ourselves, therefore creating more peace within both our public and private relationships. The value in having proper training and understanding upon completion is clear, as it avoids unnecessary stress and self judgement. Most importantly, remember that there is no right or wrong, or pass or fail when taking a DISC or Driving Forces assessment. Assessments that are effectively explained simply provide us with tools to be our best selves.

Product Recommendations – One Size Does Not Fill All

by Jill Meyer-Lippert, RDH

At Custom Dental Solutions, we take pride in helping offices to successfully accomplish goals according to their unique needs; Achieving success your way. As practitioners, it’s important to take the same approach with our patients. Just as we would not provide treatment recommendations in a “one size fits all” philosophy, many of the same considerations must be applied to product recommendations.

Your guidance is needed.

One product or line of products will not be the best choice for everyone. Without guidance, our patients will undoubtedly be swayed purely by habit, advertisements or cost, whether it’s an appropriate choice for them or not. Our patients are too often lured into the “fashion over function” trap.

Do no harm.

We owe it to our patients to recognize the unique challenges that they may face. For example, issues such as tooth sensitivity or recurrent apthous ulcers can be aggravated by certain ingredients. Consider medical conditions or medications that result in oral side effects, such a dry mouth. Is this product simply going to mask the issue or provide therapeutic relief while protecting long-term oral health?

Staying consistent.

Will patients receive completely different recommendations in your office depending on which staff member is asked? Are team members doing their homework or are they making recommendations that are swayed by influencers and name recognition? Staying up to date on newly released products, along with changes in names, packaging and formulations is a daunting task.

A team approach is the most practical solution to staying abreast. Designating a few minutes for product and technology updates at each staff meeting provides a valuable opportunity for discussion on studies and new trends. Team members are more likely to invest time and effort into researching new and existing options if value for their input is demonstrated. Inviting product reps for “Lunch And Learns” is also a great way to keep everyone informed and on the same page.

Ransomware: A Frustrating Loss of Your Data or a HIPAA breach?

by Jill Shue, FAADOM

Many practices faced a ransomware attack in September after a security breach within PercSoft, a Wisconsin based dental IT company. Many were left with no data for days or longer, which resulted in a major financial loss as well as the stress of not knowing if patient data remained secure.

One thing many asked was “is this a HIPAA breach?” The Health & Human Services has a clear stance on this concern. Ransomware is a security breach.

Ransomware is essentially blackmail—Hackers encrypt your data and hold it until you pay the requested amount. The amount continues to increase until the hackers delete your data permanently without payment.

Talk with your IT company about what steps they are talking to help you protect your patient data and your practice. Your IT company should be educating you and aiding in your compliance.  Your IT will assist you in:

·        Secure Backup

·        Firewall Installed

·        Antivirus Software Installed

·        Turn on Two factor Authentication

·        Computer and Windows Updates

·        Cyber Liability Insurance

·        Business Associate Agreements with Anyone who Accesses Your Patient Data

In addition to the actions above, schedule your HIPAA compliance training to ensure your team is updated on the latest HIPAA standards and requirements.

Second Opinion: Should Your Practice Be Concerned About the Measles Outbreaks?

By Corinne Jameson-Kuehl, RDH,

Image result for measles outbreak
Source: CNN

The U.S. is experiencing a sharp increase in the number of measles cases in 2019, according to the U.S. Centers for Disease Control and Prevention (CDC). Dental practitioners need to be aware of the signs and symptoms of measles to prevent its spread within the dental office and the community.

Measles is considered an acute respiratory illness. Because it is viral in nature, the common initial signs of possible infection include malaise, slight fever, and a loss of appetite. Patients are considered contagious four days before and four days after the rash appears. The virus is transmitted by airborne droplets when an infected person coughs, sneezes, or even breathes, making it one of the most highly contagious infectious diseases. Simply being in the same room with an infected person (and even up to two hours after they leave the area) means you are at risk for infection.

As dental practitioners, we need to be aware that the first visible signs of the disease are found in the head and neck. An infected patient will have a high fever, cough, runny nose, and conjunctivitis. A rash will form starting at the forehead and spread down to the trunk and feet. Koplik’s spots may occur on the inside of the cheeks. These spots will appear small and whitish with a red background. It can be very dangerous for babies and children to be infected, as the disease can lead to pneumonia, deafness, and even brain damage in some cases.

Vaccinations

If unvaccinated providers believe they have been exposed, the CDC states that they can still receive the MMR (mumps, measles, and rubella) vaccination within 72 hours of exposure, followed up with an immunoglobulin treatment six days after vaccination.“We need to be aware that the first visible signs of the disease are found in the head and neck.”

There are no specific antivirals. However, in severe cases, vitamin A is used in medical settings to help relieve symptoms for children. It is recommended that children receive two doses of the MMR vaccination at 12 months to 15 months and again from ages 4 to 6 years. Infants traveling to another country should have one dose before leaving the U.S.

Your provider-patient medical interview and written medical histories should include the following questions:

  1. Have you been vaccinated against measles?
  2. Have you traveled abroad recently (specifically to Europe, Asia, Pacific Islands, or Africa)?
  3. Have you or a family member been exposed to someone who has traveled abroad?
  4. Are you in a community where you suspect there could be a measles outbreak?

With more and more unvaccinated children and most U.S. cases being reported as being infected by an out-of-country exposure, it is imperative to continue with these questions chairside. If you find your office in the situation in which you believe there has been a measles exposure, the CDC asks that you to immediately report the suspected measles case to your local health department.

Medical Waste Management

By Dr. Katherine Schrubbe, RDH, BS, MEd, PhD, Compliance and OSHA Consultant

Image result for medical waste dental

Rules, regulations and standards of care abound in the dental profession. In order for the dental team to comply, all team members must have a clear understanding of the requirements and mandates. In short, it can be overwhelming.

While the primary goal of the dental practice is to provide the highest quality patient care and the best patient experience – all while ensuring patient and staff safety – team members must be efficient, well-organized and competent in the completion of the tasks and duties related to the requirements and mandates. This creates a culture of standardization and calibration. The instrument processing protocols, how to prepare and turn over operatories, and hand hygiene are all examples of tasks that should happen like clockwork.  What to dispose of – the where and how of waste management – is also one of those tasks.  Dental team members who are unsure of the appropriate steps to take may be making costly errors that hurt the dental practice.

Managing medical waste in the dental setting
Let’s review the types of medical waste produced in the dental setting and the protocols for management and disposal. It should be noted that the Centers for Disease Control and Prevention (CDC) states that dental healthcare facilities should dispose of medical waste regularly to avoid accumulation, and any facility generating regulated medical waste should have a plan for its management that complies with federal, state and local regulations to ensure health and environmental safety. Also, dental team members handling waste should be trained in appropriate methods and informed of the potential hazards.1

Having a clear plan, as well as understanding the risks involved, will streamline processes and productivity related to medical waste disposal. Many times, team members are confused with the terms defining the various types of waste. There are basically two types of waste generated in dental practices: regulated and nonregulated medical waste. General medical waste is defined as any solid waste that is generated in the diagnosis, treatment or immunization of human beings or animals in research pertaining thereto, or the production or testing of biologicals. (The term excludes hazardous and household waste.). Only a small percentage of medical waste is infectious and needs to be regulated.2,3,4 Infectious waste, which is regulated, is a very small subset of medical waste (about 3 percent) that has proven to be capable of transmitting an infectious disease.3

The Bloodborne Pathogens standard uses the term regulated waste to refer to the following categories of waste, which require special handling:

  • Liquid or semi-liquid blood or other potentially infectious material (OPIM).
  • Items contaminated with blood or OPIM, which would release these substances in a liquid or semi-liquid state if compressed.
  • Items that are caked with dried blood or OPIM and are capable of releasing these materials during handling.
  • Contaminated sharps.
  • Pathological and microbiological wastes containing blood or OPIM.5

Most of the regulated waste in dental offices consists of contaminated sharps and extracted teeth. However, other examples of regulated medical waste categories in dentistry, such as those listed above, include liquid blood or saliva; two-by-twos or cotton rolls saturated/caked with blood or saliva; used needles, scalpel blades, ortho wires, broken sharps instruments, burs, biopsy specimens and excised tissue.3

The practice management team must be certain that dental team members are trained and have a clear understanding of how to separate regulated waste from nonregulated waste to ensure a purposeful segregation. The practice incurs a cost from regulated waste because it must be picked up and transported off-site by qualified waste hauler vendors; therefore, only items that are considered infectious should be placed in regulated waste receptacles (commonly known as the red biohazard bags or red biohazard sharps containers).

Non-sharp regulated waste items, such as those listed above, must be disposed of in red biohazard bags. Contaminated sharps, however, must be disposed of in red biohazard sharps containers. OSHA points out that contaminated sharps shall be discarded immediately or as soon as feasible in containers that are closable, puncture resistant, leakproof on the sides and bottom and labeled or color-coded. OSHA also states that, during use, containers for contaminated sharps shall be easily accessible to personnel and located as close as is feasible to the immediate area where sharps are used or can be reasonably anticipated to be found, maintained upright throughout use, replaced routinely and not allowed to overfill. Lastly, when moving containers of contaminated sharps from the area of use, OSHA states that containers shall be closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport or shipping, and placed in a secondary container if leakage is possible. The second container shall be closable; constructed to contain all contents and prevent leakage during handling, storage, transport or shipping; and labeled or color-coded according to this standard. Reusable containers shall not be opened, emptied or cleaned manually or in any other manner that would expose employees to the risk of percutaneous injury.6   

The CDC recommends that sharps containers be located as close as possible to the work area.1Accordingly, every operatory should have a red biohazard sharps container, which should be stored in a place inaccessible to small children who could mistake a red container for a toy or surprise box.

Once procedures are complete, staff members should dispose of any disposable sharps in the operatory sharps containers. All other used items from patient care that have not been disposed of in red biohazard bags or sharps containers may be safely thrown out in the regular trash. Items such as barriers, gloves, masks, bibs, lightly soiled gauze and cotton rolls are not considered infectious or dangerous to the environment.3

Medical waste is primarily regulated by state environmental and health departments. The Environmental Protection Agency (EPA) has not had the authority to oversee the handling of medical waste since the Medical Waste Tracking Act (MWTA) of 1988 expired in 1991. It is important for the dental team to contact their state environmental program before they dispose of medical waste. They should contact their state environmental protection agency at www.epa.gov, as well as their state health agency, for more information regarding their state’s regulations on medical waste.2

It should be noted that the dental practice remains responsible for the regulated waste it generates until it is destroyed or rendered non-hazardous. This concept, which is called cradle-to-grave liability, means that even after waste leaves the practice, any cleanup for any damage it may cause is the responsibility of the generator (the practice); so, the practice should carefully select a licensed waste hauler.3,4

Recordkeeping for the disposal of waste must meet state regulations. The most critical record is the waste manifest – a tracking document that comprises the name of the generator (dental practice), transporter, disposer and the waste itself. It also may include the description and quantity of waste, date, type of container and the type of final disposal.4   All manifest records must be kept for three years.4

The management of medical waste in a dental practice is a critical component of compliance to federal, state and local agency standards. Regardless of the practice size, all dental team members must be aware of what to dispose of, and how and where to dispose of it. Otherwise they risk taking a haphazard approach to the disposal of hazardous materials, causing potential risk to patients and staff, as well as the environment.

References

  1. Centers for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings — 2003. MMWR 2003;52(No. RR-17). Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm. Accessed November 18, 2018.
  2. U.S. Environmental Protection Agency. Medical Waste. Available at https://www.epa.gov/rcra/medical-waste#who%20regulates%20medical%20waste. Accessed November 18, 2018.
  3. Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team. 5th ed. St. Louis: Mosby Elsevier; 2013;192-196.
  4. OSAP Interact Training System Workbook. OSHA and CDC Guidelines; Combining Safety with Infection Control and Prevention. 5th Edition; 2017.
  5. U.S. Department of Labor. Occupational Safety and Health Administration. Bloodborne Pathogens Standard; 1910:1030. Most frequently asked questions concerning the bloodborne pathogens standard. Available at https://www.osha.gov/laws-regs/standardinterpretations/1993-02-01-0#waste. Accessed November 18, 2018.
  6. U.S. Department of Labor. Occupational Safety and Health Administration. Bloodborne Pathogens Standard; 1910:1030. Available at https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030. Accessed November 18, 2018.