Thursday Troubleshooter: Dental team tired of treating people when they're sick
This dental team member is tired of having to treat patients when they're sick, and feels that the risk of spreading germs is unfair to the dental staff and other patients. Unfortunately, the front office team disagrees.
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QUESTION: In the office where I’m presently working, the office manager thinks it's acceptable for us to see patients who are sick. We even see people who come in with a fever. The office manager says, “The patients say they feel up to coming to their appointment, so you all just need to wear the proper masks and gloves.” The doctor doesn't object to this, but the hygienists and assistants are tired of having to treat sick people. Is there some CDC or OSHA recommendation that states a dental office shouldn't see sick people? I feel like we’re putting not only ourselves at risk, but other patients also.
ANSWER FROM LINDA DREVENSTEDT, Drevenstedt Consulting, LLC:
It’s tough to follow rules you don’t agree with that are set by someone else. For this answer I collaborated with my colleague, Jackie Dorst, who is an OSHA, safety, and infection prevention consultant.
First, when you set out to discuss your concerns with the team, you must be careful before you say other people are wrong. Often, even when you’re right, the backlash can be noticeable because no one likes to be told they’re wrong. Your office manager may be just following the instructions of the boss.
I am including a reference to the current CDC guidelines, Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care.This downloadable guide is a good place to start. I recommend that you have the whole team, including the front office, read this summary and discuss how best to implement these guidelines into the practice. In the process of bringing your office up to the highest standard, your practice will need an appointed infection prevention coordinator.
No one wants to be exposed to sick people and their germs unnecessarily, particularly during cold and flu season. Here is a helpful idea from Ms. Dorst: “Create a sign like the one below and place a box of tissue and alcohol-based handrub (ABHR for health-care settings) next to this sign. Place a trash can close to the box of tissues. This way patients or parents can easily dispose of soiled tissues and not hand them to the front office team.”
The CDC recommends rescheduling patients for non-emergency appointments when they are infectious, which is normally a temperature of 100 degrees or above. The practice can purchase disposable paper thermometers to verify a temperature.
The clinical team needs to know how to adhere to a system within the CDC guidelines. Unlike a pediatrician’s office, where there is a “sick child” waiting area, most dental offices require everyone to sit together in one reception area. Known sick patients should immediately be seated in an operatory to prevent transmission to others in the reception room. In general, the guideline suggests caring for sick patients in an emergency only, and to reappoint when someone is well for lengthy or regular treatment.
After reviewing the CDC guidelines, it is important for the practice to establish systems for everyone on the team to follow. Since the front office team members are the first to encounter patients, they must be informed about the guidelines and follow the practice infection prevention protocols. The practice protocols cannot be arbitrary. They must follow the basics of the CDC guidelines.
Remember, the smart thing is for employees to stay home when they’re sick, especially when they have a temperature. It is best to ask patients to reschedule their routine dental treatments when they’re sick. Infection prevention is the job of every team member. The dentist and team need to know the CDC guidelines, and they need to put practice systems in place for everyone to follow to keep team members and patients safe from unnecessary infection exposure.
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