solved

1. Vaccination
The Incident: The child of a working dental assistant was at middle school, and on a Friday afternoon the school’s nurse called the assistant saying the child had developed a fever and had a sore throat, cough, runny nose, and headache. The assistant left work at Dr.Helfer’s office, picked up the child, and drove straight to the physician’s office. The doctor said the child had the flu. Monday was Labor Day, and because the assistant’s mother volunteered to come stay with the child, the assistant went back to work on Tuesday after going to a pharmacy to get flu shot. At work, the assistant helped with eight patients that day; two needed to come back for further treatment on Friday even though the office was normally closed on Fridays. On Wednesday, the assistant called in sick having the same symptoms as the child. On Friday, Dr.Hilfer’s receptionist received phone calls from both patients schedule that day canceling their appointments because they said they had developed colds.
Identify potential opportunities for disease transmission in this scenario. Which preventive measures could have been used?
2. Eye exposure
The Incident: Dr. Chasen was with a patient in operatory 1 was running way behind schedule. So, Dr. C asked the chairside assistant to take the next patient to operatory 2 and conduct a quick oral soft tissue examination. Dr.C told the assistant that patient #2 had called in that morning and complained about some “bumps” on the inside of the lower lip. The assistant put on a protective gown and gloves, set up the operatory with surface barriers, seated the patient, placed the bib, and laid out a packaged mouth mirror and tongue blade for Dr.C. The assistant asked the patient to lean back and open wide. Then a “squirt” of fluid came out of the patient’s mouth and hit the assistant directly in the left eye. The assistant went to the operatory sink, splashed some water on her eyes, dried her face and glives, went back to the patient, and asked the patient not to say anything to Dr.C. The assistant proceeded with the preliminary soft tissue examination and called in the doctor. Dr.C discovered that the patient had aphthous ulcers. A few days later, the assistant did mention the incident to the infection control coordinator who instituted the postexposure management procedures.
Identify potential opportunities for disease transmission in this scenario. Which preventive measures could have been used?
3. Protective Eyewear
The Incident: A third-year dental student was extracting a tooth for the first time. It was a simple removal of #7. Immediately after the tooth was removed., the patient coughed. This caused some spatter of oral fluid to escape. Just as the patient coughed, the student turned and looked at the patient, and, sure enough, those droplets hit the student right in eyes. The student mentioned this to his instructor who asked if the student was wearing glasses. The student showed the instructor the prescription glasses. They were the ” John Lennon” type glasses with lenses about the size of a quarter.
Identify potential opportunities for disease transmission in this scenario. Which preventive measures could have been used?
4. Biological Monitoring
The Incident: Dr. Lawrence was a real stickler about infection prevention in the office, and the office’s infection control coordinator (ICC) worked hard to make sure the patients and staff were safe from unnecessary contamination. When any breach in infection prevention procedures occurred, Dr. Lawrence got upset. The new sterilizing room assistant made every effort to follow procedures. When the new assistant ran the first weekly spore test in the steam sterilizer, it turned out positive (sterilization failure). The assistant informed the ICC who told Dr. Lawrence. Dr. L accused the assistant of messing up and told the ICC to solve the problem immediately. After discussing the packaging and sterilizing procedures with the assistant, the ICC did not discover any procedural errors, so she told the assistant to run two more spore tests. The assistant was pretty upset with all of this and did the spore testing, and the tests came out negative. So, from them on, whenever the assistant had to run a spore test, the exposure time was doubled, and everyone was “happy”.
Identify potential opportunities for disease transmission in this scenario. Which preventive measures could have been used?

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