Volume 7 • 2020 • Issue 1

35 Issue 1 | 2020 | S upporting Y our P ractice Sterilization has Expanded to MEDICAL DEVICE REPROCESSING The Centers for Disease Control (CDC) Guidelines for Infection Control in Dental Health- care Settings – 2003 document 1 is still one of the primary resources that provincial dental association (PDA) committees use when developing infection prevention and control (IPAC) standards in their jurisdictions. The document quotes the U.S. reprocessing Standards organization 2 and states, “instrument processing requires multiple steps to achieve sterilization or high-level disinfection. Sterilization is a complex process requiring specialized equipment, adequate space, qualified dental health care professionals who are provided with ongoing training, and regular monitoring for quality assurance.” Although reprocessing was recognized as a complex process in 2003, the term ‘sterilizing’ continues to be used among oral health care professionals when reprocessing reusable instruments and devices. The term ‘medical device reprocessing’ or ‘reprocessing’ more accurately reflects all the necessary steps when preparing instruments and devices for safe reuse. Reprocessing involves all of the following 13 steps: 1. Pre-cleaning at point of use 2. Transport to the reprocessing area 3. Preparation and disassembly for cleaning 4. Cleaning, including rinsing 5. Drying 6. Inspecting for cleanliness 7. Checking for functionality 8. Packaging 9. Sterilization 10. Monitoring 11. Documentation (including traceability) 12. Storage 13. Transport for use In Part 1 of this article, we review and raise awareness of the first 7 reprocessing steps. The remaining steps will be reviewed in Part 2 in CDA Essentials in 2020. Resources for Determining Best Practices Provincial IPAC committees continue to use the 2003 CDC guidelines and the updated 2016 CDC Summary and Checklist 3 for guidance when developing their Provincial guidelines. Also used is the Public Health Agency of Canada (PHAC) Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings (2013). 4 The definitive guidance document for reprocessing is the Canadian Standards Association (CSA) Standard Z314-18, Canadian medical device reprocessing. 5 This document, as with all Standards, draws from many other Part 1 Theviewsexpressedarethoseoftheauthorsanddo notnecessarilyreflecttheopinionsorofficialpolicies oftheCanadianDentalAssociation. Infection Prevention and Control at the Dental Office Dr. NitaMazurat recently retired as associate professor in the Department of Restorative Dentistry, College of Dentistry, at the University of Manitoba where she was director for Regulatory Compliance, including infection prevention and control. She is the first Canadian dentist to be amember of the CSA Technical Committee on Sterilization and participated in the development of the 2018 national standard for Canadianmedical device reprocessing, CAN/CSA-Z314-18. Dr. Cecilia Dong recently joined the Division of Prosthodontics at the Schulich School of Medicine and Dentistry, Western University, after working for many years with Dr. Mazurat. Dr. Dong has taught dental students the fundamentals of infection prevention and control and continues to advocate for patient safety and quality of care.