The recent coronavirus outbreak has had an increasing impact on all of us here in Colorado. I wanted to take the time to update and familiarize our patients and their families about our response to this growing concern, in addition to what we have been practicing as standard procedure for years. The list below includes things that we have worked on since opening, but in recent months this outbreak has been an opportunity for us to re-examine and re-enforce our procedures. This has taken us to a point well above and beyond what are called standard (or universal) precautions as recommended by OSHA and the CDC to minimize the transmission of disease and infections.
- For the past several months we have had daily updates, discussions, and training with our staff regarding COVID-19 (and other “germs”). We have kept our staff up to date with the virus and its course, and we will continue to do so. The staff are crystal clear about how important it is to be held to the very highest standards regarding infection control and hygienic practices for our patients, the community, and for themselves.
- We have a dedicated orthodontic technician who is responsible for OSHA compliance and training. She helps me and my office manager with examining and monitoring our team with continual self-examination and staff education. This is a constant process, and we have found that having a dedicated set of eyes on our team has elevated everyone’s awareness and habits. Our team goal is to go above and beyond standard protocols.
- I use this analogy way too much with our staff, but it is true: Great sports teams reinforce and practice the basics, no matter how simple, that they learned long ago. It may sound repetitive to them, but we review the basics often: Cover coughs and sneezes or excuse yourself to do so. Wash your hands before work, after breaks, after eating, after using the bathroom, after cleaning waste baskets, and after work. Use healthcare grade hand sanitizer every time you remove your gloves. Don’t touch the eyes, nose or mouth, at work. And if you are feeling the slightest bit sick, STAY HOME. I have stressed that cost of materials and supplies is not a concern when it comes to cleanliness, and to use sanitizers and gloves liberally for cleanliness.
- Especially during this period of time, we have made it clear to staff that they will have paid sick leave. This is to ensure they will stay home when not feeling well, without the fear of losing income. I do not want unwell employees working on my patients. This applies to me as well.
- We are posting signs and informing patients to stay home and cancel their appointment if they are having flu-like symptoms or feel unwell. We can always reschedule an appointment! We are also encouraging our patients to reschedule if someone in their shared household has flu-like symptoms. Our staff is being trained to recognize symptoms, and to inform me of noted symptoms.
- We adhere to standard contact and airborne precautions. This includes the use of gloves, eye protection, and face masks. The CDC recommends the use of healthcare grade hand sanitizer before and after patient contact and protective glove removal, and we have this readily available at each workstation, and in every treatment room. We have a total of 12-14 pump bottles on the counters and wall mounted units in each office so that they are always within reach wherever a team member may be.
- Recent changes: While this virus is an issue, we are working on reducing contact such as handshaking and have temporarily shut down the xbox ☹to reduce exposure risks (sorry kids!). Limiting handshaking has been especially hard for me, and when we do, we encourage use of sanitizer.
- We have always been very open to parents and family accompanying the patient to the treatment room for their appointment. This is a part of what has made our practice special, but until this recent concern is reduced, we will be asking our families to help reduce crowds, stay in the waiting room if not being worked on, and to reduce bringing in the entire “gang” if possible. There will be no reduction in the amount of communication patients and parents receive about their treatment though. Please be mindful and help us work together! We of course will understand if young children require parent support and company. When this health concern passes, we will return to the full family atmosphere.
- I don’t think many in the public are aware of the time and effort that our team puts into sterilization and cleaning. We have done this vigorously for years, but again, these times have been a reminder to reinforce the basics. We have an assembly line like progression for all our instruments to be sterilized. It starts with ultrasonic debridement and disinfectant, rinsing, bagging in individualized sterilization bags, date stamping, and steam pressure sterilization to the highest standard that kills bacteria, viruses, fungi, and spores. We use disposable headrest covers and barriers for mouse and overhead light handles. At each workstation there is healthcare grade hand sanitizer and protective eye wear is required. In between patients, the workstation is sprayed with surface disinfectant that again is tuberculocidal, bactericidal, virucidal, and fungicidal. After the spray, all surfaces are wiped, including all non- working surfaces with Clorox.
- We have a designated “floater” technician that oversees wiping and disinfecting surfaces, counter tops, sinks, door handles, pens, etc… at least every ½ hour. They also help to retrieve instruments and supplies for the assistants working on patients so that they reduce the amount of de-gloving or leaving the workstation during appointments.
Sounds like a lot of work, right? We have had many employees that start with us, even after years of working in our profession, and are shocked at how rigorous we are with the above. Most are more than happy to conform and to have higher standards as professionals, but I make it clear that if they cannot meet these standards with a great attitude, they are not a fit for this practice.
Our team of employees are humans, and over the years we have had talks with individuals about incidents that myself or patients have witnessed that need addressing to raise standards. This involves immediate discussions, education, and then re-enforcement and re-assessment. It is a never-ending endeavor! We always welcome our community of patients to comment on any concerns they may have, and I will be sure to address these concerns. Please do not be shy about any questions you may have. We are here to not only provide the best orthodontic care possible, but to provide the safest environment possible for our patients.