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Infection Control Dilemma

A situation arose at work this past week and I feel I am between a rock and a hard place. I need advice/support/an ear/anything.

At my workplace, I have been getting more involved in the sterilization room. The autoclaves are maintained well and being tested weekly. The senior dental assistant (Tammy) has been in control of the cold sterile, and I’ve been inquiring recently how that’s been maintained.

Three days ago I walked into sterilization and saw that the Cold Sterile had about half an inch in height of solution. And many instruments were crammed into it, most were sticking out of the solution. I pulled in the other hygienist (Judy) and we both agreed it looked bad. So we put a sticky note on it to not empty it because it needed to be discussed with Tammy. Tammy left early and the discussion didn’t happen. The next day, I went into sterilization and I saw that it had been emptied and all the instruments were sprawled out on the “clean” side and the note was taken off the cold sterile container. The new dental assistant, Ericka, came in and started handling these instruments. I told her to stop because they weren’t properly cleaned. At that point Tammy came in and made a scene and said they were sterilized and just fine. I told her there wasn’t enough solution in it for them to be sterilized correctly. Tammy then answered that they were flipped over and are just fine. Her voice was loud and I know the whole office heard it. I shook my head and walked out, out of the situation. Tammy then began wiping the instruments with a CAVICIDE wipe.

I went home and decided to look up some information. We have no protocol in place for our office for infection control. The cold sterile solution we are using is CAVICIDE, not a proper Cold Sterile solution approved by the FDA. I was horrified. I printed out the report along with the ADA’s guide to infection control about what defines “Critical/Semi Critical/ and non critical instruments. I know for a fact that we are throwing in bloody diamond strips into cold sterile, THAT ISN’T A COLD STERILE! At this point, I felt this was an emergency. I came to work early the next morning and went through the office and pulled all the instruments that had been put through cold sterile and I set them in a plastic container with “DO NOT USE” because they were not sterilized and were contaminated. When Tammy got to work, I explained that CAVICIDE is not a cold sterile solution and every instrument that has been put there isn’t clean. She said it’s been that way for years and things are just fine. I told her to look at the FDA report. She disregarded it and put out all the instruments to be used.

I went to the Dr. to explain the situation. I handed him the paperwork on cold sterile solution and I told him I pulled everything to not be used until we can properly disinfect them. He looked over the paperwork and said we’ll order the correct solution, but in the meantime the situation isn’t ideal but we’ll need to make due. He sided with Tammy in putting out all the instruments to be used.

All day Thursday and all day Friday we used dirty contaminated instruments on people including critical instruments.

I am dreading returning to work Monday.

What do I do?

Do I blow the whistle and report this? Will this ruin my future career if my dentist retaliates and decides to give me a bad report or comes after me?



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4 Answers

I applaud you for how you have handled this so far. You are most correct in that those instruments should not be used on patients!!! And technically patients that these instruments have been used on should be notified of this “breach in infection control.” The fact that you brought this up with the doctor and he isn’t much concerned leads me to believe that this should be turned into OSHA. It is our duty as professionals to report when necessary and this is definitely necessary! There are laws protecting “whistle blowers” and I believe you could report this anonymously. I wish you the best of luck, as this isn’t a fun situation.

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I personally feel that cold sterile is not effective, even if done properly. The things that cannot be autoclaved are typically meant to be disposed of after one use.
I might suggest to your boss that this form of disinfection isn’t cutting it and just stick with heat sterilization. This would solve the issue with all employees and you could feel confident about the cleanliness of the instruments you use on your patients.

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I agree with Kara. However, you need to be prepared that they will assume it’s you since you brought it up. I would be prepared to look for another job because even if there are ‘safe guards’ in place to protect your job it will most likely be uncomfortable. I applaud you for doing their right thing here.

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The other hygienist & I were just talking about how much we hate cold sterile. Good for you for doing the right thing for the patients!! You might be in an uncomfortable situation next week, but don’t let it bring you down.

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