Return to Work Policies and Procedures | US Oral Surgery Management

Time to head back to work in our “new normal”. But what does that return to work look like?

NOVEL CORONAVIRUS/COVID-19 PANDEMIC: MANAGEMENT OF PATIENT FLOW, SOCIAL DISTANCING AND INFECTION CONTROL

April 17, 2020

Have you or an immediate family member been sick or had a fever within the last 14 days? If you, anyone in your family, or anyone you have been in contact with is experiencing fever, respiratory symptoms or shortness of breath or has tested positive for the novel coronavirus, please notify us before coming to the office.
Have you or a member of your household traveled outside the US within the last 14 days? If you, or anyone with you, have traveled internationally please notify us before coming to the office.
Please go online and complete all registration forms so we can avoid giving you paper documents.
When you arrive, please call our office to let us know you are here (give them ph. #)
Upon arrival, please wear a mask or one will be provided for you.
We will be taking temperatures of both patient and accompanying family member before entering the building.
We will have you wait in the car while completing paperwork, during your loved one’s surgery or if there is a back-up in the lobby.
We will be adhering to social distancing in all areas of the office.

Review the number of treatment/consult rooms you have and discuss with your surgeon, how frequently patients will be scheduled to ensure patients are always separated from other patients by at least 6 ft.
Work with staff members to stagger lunches.
Work with surgeons and patients to do online/telephone consults as much as possible. (will help with surgery spacing and social distancing).
BEST DEMONSTRATED PRACTICE: Surgeon looks at the consults for the week and when s(he) has availability, calls the patient to assess the problem over the phone and determine if an in person consult is necessary. If it is, then doctor asks pt to come prepared for surgery.

If Surgery:

Meet pt at the front door and check and record each person’s temperature (wear gloves and mask). If 100.4° or above, notify Doctor immediately. If temperature is below 100.4° proceed to the front desk where pt will complete paperwork, update consent, make payment, etc.
Provide pt with mask if not already wearing one.
Ask patient to wash or sanitize hands.
Patient to rinse with .1% Hydrogen Peroxide for one (1) minute prior to starting clinical care.
Patient will be taken back to operatory and the family member will be asked to wait in car. Escort will be called when it is time to drive around and come to recovery area to get instructions and speak with doctor before discharge.
Provide escort with mask if not already wearing one.
Patients will be separated from other patients in the office by at least 6 ft.
When possible, rotate rooms to allow more time between patient’s encounters with cleaned surfaces.

If Consult:

Meet them at the front door and check and record temperature (both patient and parent/guardian), wearing gloves and mask. If temperature is above 100.4,° notify Doctor immediately.
Ask questions on the “Commitment to Safety” sheet (ie travel outside county? Fever? Attended high attendance event?). If pt answers “yes” to any of the questions, please reschedule in 2 weeks or more. If all answers are “no,” provide clipboard with paperwork and have the patient/family member return to their car and call the office when they have it completed.
At that time, we will direct pt to come into building with paperwork completed and we will escort the patient (or minor patient with parent/guardian directly into an exam room.
Provide pt and escort with mask.
Ask pt to wash hands prior to sitting in dental chair.

Attire:

Clinical employees will wear N95/ KN95 masks, gloves, full face shields and gowns.
Disposable gowns should be discarded in a dedicated waste container after use; cloth isolation gowns should be laundered after each use.
Non-clinical employees will wear Level 1 masks and gloves.
Gloves and gowns will be disposed of after each patient.
Wear Level 1, 2, or 3 mask over the K95 or N95 masks and change between each patient.
N95/KN95 masks needs to be changed after 40 clinical hours and can be kept in a brown
Protective clothing i.e.: scrubs, scrubs jackets, lab coats, are not be worn to and from the office. They must be laundered in the office laundry. If laundry at the office in not available, utilize services for laundering of scrubs.

Infection Control Procedures:

Daily health screening: take staff temperature before workday begins.
Doctor and support team to ensure washing hands prior to and after all care
Make sure to remove gloves immediately after care and not to touch any surfaces with gloves
Recommended to apply a rubber dam during all procedures that are applicable to decrease aerosol
Make sure to utilize high volume suction throughout procedure to decrease aerosol during use of high speed and slow speed handpieces
All instruments will be disposed of or sterilized in the autoclave and will be individually wrapped for each patient.
Dental chairs, capes, and facial shields will be cleaned and sanitized after each patient.
Dental office will continue to follow the protocols provided by the American Dental Association for handling stock.
Staff will be required to adhere to guidelines established by the American Dental Association and state Dental Association.
Minimize the amount of paper exchanged between staff and patients by encouraging online registration or taking digital impression of the document (ie via phone or Ipad).
Minimize cash payments if possible due to difficulty to disinfect:
- Have patient use CC machine themselves. Take a verbal authorization.
- Have patients use their own pens to sign documents or have them keep the pen.
Remove items from waiting area such as magazines, coffee/tea stations, etc.

Cleaning Between Patients

Clean [PPE] with soap and water, or if visibly soiled, clean and disinfect reusable facial protective equipment (e.g., clinician and patient protective eyewear or face shields) between patients.
Non-dedicated and non-disposable equipment (e.g., handpieces, dental x-ray equipment, dental chair and light) should be disinfected according to manufacturer’s instructions. Handpieces should be cleaned to remove debris, followed by heat-sterilization after each patient.
Routine cleaning and disinfection procedures (e.g., using cleaners and water to pre-clean surfaces prior to applying an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on the product’s label) are appropriate for SARS-CoV-2 in healthcare settings, including those patient-care areas in which aerosol-generating procedures are performed.
Surfaces such as door handles, chairs, desks, elevators, and bathrooms should be cleaned and disinfected frequently

Front Office Cleaning

Sanitize administrative area morning, noon, and evening. Include phones, screens, and patient windows.
If utilizing waiting room, disinfect between patients.
Disinfect office bathrooms and other communal spaces (ie breakroom) often.
If patient touches credit card machine, sanitize.