Sterilization processes are always important in dental practices to protect your staff and your customers. During the Coronavirus pandemic, everyone is especially concerned about proper procedure. You have to follow Instructions for Use (IFUs) and properly sanitize and sterilize your instruments. In this episode of Talking with the Toothcop, Stephen Kovach—whom I am now referring to as the “Godfather of Infection Control”—joins Andrea and myself to chat about the importance of sterilization processes.
Stephen Kovach is Educator Emeritus at Healthmark Industries and has been in the medical field since 1975—now celebrating his 45th year in Healthcare. He is a member of IAHCSMM orthopedic council for loaner instrumentation and a voting member on various AAMI committees. He’s published numerous articles varying in subject matter from perfusion to the importance of cleaning surgical instruments.
Outline of This Episode
- [0:22] Stephen Kovach joins Andrea and I
- [2:14] Stephen’s tremendous wealth of experience
- [4:05] Instrument sterilization and cleaning
- [10:13] The importance of IFUs
- [19:03] Stephen’s thoughts on hinged instruments
- [26:55] The legal precedent for following IFUs
- [34:45] Get rid of rusty instruments
- [37:25] What to monitor with water quality
- [50:31] Why you need 2 full-sized sterilizers
- [52:20] Coronavirus and infection control
The importance of proper sterilization and cleaning
According to my research—which I will publish at some point here—9/10 offices aren’t doing a good enough job cleaning their instruments. When I recently heard Stephen speak, he pointed out that “When you sterilize dirty instruments the end result issterile dirt”. Every dental office NEEDS to have a quality management system in place—and most don’t.
Stephen points out that dentists need to be referencing the AAMI ST79—The “Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities”. But most aren’t. Why? Stephen and I agree it’s because the high price ($400) is a barrier to entry. While their information is proprietary, it would be wise to have this information widely disseminated for the safety of our patients.
What you may not know about Instructions for Use (IFUs)
I’ve talked about IFUs before and have emphasized the importance of acquiring and referencing them for proper instrument sterilization. They outline the exact cleaning and sterilization process step-by-step to ensure proper cleaning of the tools. What you may not know is that device manufacturers have tested this repeatedly, and to get their products to market the FDA HAS to approve the IFUs they’ve submitted. They don’t just slap instructions together willy-nilly. It is a well-researched process that you need to follow.
I’ve been surprised how many dental professionals have no idea what I’m talking about when I ask them if they’re using their IFUs. Turns out, IFUs can be hard to obtain. I’ve even asked a device rep for an IFU and was told point-blank it was only provided to clients. Some can be found online—but not all are readily available.
Stephen and I agree you must seek out and obtain IFUs for any tool or instrument you use. Follow at the very least the minimum requirements for sterilization and go above and beyond when possible. Keep listening for our discussion on cleaning hinged instruments.
Document your procedures to protect your practice
Stephen has been a part of many depositions where professionals are asked how they documented their process and how they followed their IFUs. If they stray from the directions on the IFUs they must state why they think their cleaning procedure was superior to that of the manufacturer.
If you stray from the proper sterilization procedures and a patient's illness or even death is traced back to you—you’re in serious trouble. You must be able to prove in a court of law that you followed the instructions properly and show documentation.
Some professionals claim they were told something different by the manufacturer—but have no concrete proof. Stephen recommends that if you contact the device manufacturer and they verbally tell you a process that contradicts the IFU—get it in writing. Ask them to outline the company letterhead and mail it to you for records. But if all else fails, following the IFU is the ultimate protection.
Why following instructions are SO important during the Coronavirus Pandemic
Stephen was quick to point out that he sees some of the best pre-infection control in dental offices. His personal dentist washes his hands in front of him, uses hand-sanitizer, puts on a mask and safety shield, and protective eyewear. Continue to practice these basic means of infection control—but do it correctly.
Stephen has noticed that most people don’t even know how to properly use Clorox wipes. The contact time of the solution on the surface is of the utmost importance. Most people quickly wipe down surfaces with a wipe and call it good. But if you read the instructions (which vary) it states that the surface must remain visibly wet for up to 4 minutes to properly sanitize. Read the instructions people!
Contact time is also important for hand-washing. The longer you wash your hands (experts say you can sing the “Happy Birthday” song in your head) the more effective you are removing bacteria, viruses, etc.
Proper sterilization techniques are more important than ever during the pandemic—not because it was less important before—but because it brings you and your patients peace of mind in a time of chaos. Listen to the whole episode for our discussion on critical water, proper training, and how many sterilizers are necessary.
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