Thursday Troubleshooter: Dental professional horrified at lack of infection control practices

This dental hygienist was so stressed with the lack of infection control in the practice that she had to quit the position. Can she report the office, and if so, who should she go to?

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QUESTION: I believe that with my oath to become a dental professional I agreed to protect the safety of my patients and community. My former employer’s infection control practices violated my ethical code, and to my knowledge, OSHA and IC regulations also.

The anxiety and stress I experienced while working there, in addition to the many ethical dilemmas I encountered, resulted in me quitting the position. Even though I no longer work there, I still feel I should report some things.

• With dirty gloves on, the dentist touched patient folders, used light switches, and walked up and down the halls and in and out of the sterilization room. He also touched x-rays with contaminated gloves, which the receptionist and I then unknowingly touched barehanded.
• They cold sterilized air water syringe tips and reused single-use high volume evacuators and saliva ejectors.
• They reused sterilization bags for RINNs, cavitron tips, and surgical instruments, and sterilized loose instruments in bags when the indicator strip had already changed. Instruments were often found sitting in sterilization in an open package or unpackaged.
• The setup for drip developing x-rays was never wiped down, and the conditions inside the box did not look sanitary, almost as if mold was growing.
• The dentist’s “clinical jacket” was a t-shirt, which exposed his arms between the wrist and elbow.

I fear for the safety of patients in this practice and I take my licensure and profession seriously. I would like to know if I have a case to report, who I would report it to, and if I can remain anonymous?

ANSWER FROM KAREN DAW, The OSHA Lady, authorized OSHA trainer and infection control specialist:
Thank you, thank you, thank you
for speaking up about unsafe and unsanitary work conditions in this dental practice. We all deserve a job to look forward to, not one that causes anxiety and stress. Per the Occupational Safety and Health Administration (OSHA), you have the right to a safe work environment. In addition, the Centers for Disease Control and Prevention (CDC) have enforceable guidelines in many states to protect you and your patients.

Everything you described is reportable. While you can opt to remain anonymous to the former employer, the inspectors will need your contact information. Here are three possible action steps for you:

1. Items related to employee safety go to the local OSHA office. Complete the OSHA Online Compliant Form. You can click the box to "not reveal" your identity to the employer. Since you are no longer employed there, it will be treated as an informal complaint, however, even an informal complaint will have the desired outcome. The doctor will know he must correct these conditions. You can also encourage a current employee or the state dental governing body to notify OSHA as that will make it a formal complaint. Know that OSHA protects employees from employer repercussions for contacting them.

2. Infection control breaches and patient safety concerns should be reported to your local dental board, dental commission, and department of health. In some states you can do this online and inform the investigator you choose to remain anonymous. The inspector told me you can expect to hear back within a few weeks of submitting the compliant.

3. Finally, I hope you’ll read and post this relevant RDH magazine article, Talk or Walk: What to do about subpar infection control in the practice, on social media and dental hygiene boards. It will benefit others who may be in your same situation. Let’s get everyone talking about employee and patient safety and how to initiate that difficult conversation in the workplace.

Best of luck!

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