Clean walls and blinds only if they are visibly soiled.

Inspect, clean, and disinfect on a regular basis, all bins, pails, cans, and similar receptacles intended for reuse and having the potential for contamination with blood or OPIM. Clean and disinfect these containers immediately or as soon as possible upon visible contamination.

Noninfectious waste refuse containers are not considered infection control hazards. Line them with plastic bags, leave them uncovered, and do not allow them to overflow. Remove hinged doors on cabinet refuse containers and hinged lids on freestanding containers since they present an increased potential for cross-contamination.

Do not pick up broken glassware directly with your hands. Instead, use mechanical means such as a brush and dust pan, vacuum cleaner, tongs, cotton swabs, or forceps.

Laundry

Bed linens, towels, smocks, trousers, and other protective attire are considered ordinary laundry unless they are visibly soiled by blood or OPIM. Ordinary laundry should be sorted wearing gloves and processed following your command’s laundry policy.

Contaminated laundry is any laundry soiled with blood or OPIM, including saliva and will be packed in a red biohazard container or bag, or in a leakproof plastic bag with a biohazard label, before shipment to the laundry. When sorting laundry, you should wear gloves and other appropriate personnel protective attire. Bag contaminated laundry at the location of use. Do not sort or reuse soiled laundry in patient care areas. If your command has on-site laundry service, follow instructions contained in BUMEDINST 6600.10, Dental Infection Control Program.

Regulated Waste Disposal

Infectious waste, now termed “regulated waste” in the DTR is defined as any disposable material with blood or saliva on which, if handled, would release or express blood or saliva. If there is doubt as to the infectiousness of the material in question, contact the ICO or supervisor.

HANDLING. - Regulated waste must be placed in closable, leakproof containers or bags that are labeled as a biohazard (fig. 9-4). The container may be in the DTR or in a central area in the clinic. If a centralized area is used as the regulated waste depository for the clinic, the regulated waste from each DTR must be transported to this central area. If headrest covers from the DTR are used to transport the regulated waste to the depository, they must be closable and identified with a biohazard label.

The ICO should ensure that all DTRs within a clinic and all clinics within a command handle regulated waste in a uniform manner.

RECORDKEEPING. - The ICO should implement a practical system to monitor disposal of infectious waste.

This system includes date, type of waste, amount (weight, volume, or number of containers), and disposition. Further guidance for infectious waste can be found in BUMEDINST 6600.10, Dental Infection Control Program, and BUMEDINST 6280.1, Management of Infectious Waste.

HANDWASHING

Handwashing is one of the most important procedures in preventing the transfer of micro- organisms from one person to another. The purpose of handwashing is to remove these micro-organisms from the folds and grooves of the skin by lifting and rinsing them from the skin surface. Good handwashing techniques and use of gloves are essential before anticipated exposure to patients’ blood or body fluids.

The skin harbors two types of flora, resident and transient. Resident organisms have these charac- teristics:

Can survive and multiply on the skin.

Can be cultured repeatedly from the skin.

Are usually of low virulence and are not easily removed.

Conversely, transient bacteria have these charac- teristics:

Do not survive and multiply on the skin.

Are not firmly attached to the skin.

Are effectively removed by rubbing of the hands together and rinsing them under running water.

HANDWASHING AGENTS

There are many commercial handwashing products available for use in clinics. Because of the variety, we will discuss the two main handwashing