Dental clinic safety Exam

HIPAA deals with the information provided by the patient

Both the ADA and HHS educate the clinician in HIPAA

You cannot use a patient's picture in advertising you clinic without that patient's consent

The goal of HIPAA is to protect Employee Information

Dentists are Covered Entities

You need another HIPAA consent to refer a patient to an endodontist

You need another HIPAA consent to refer a patient to an oral surgeon

You need another HIPAA consent to refer a patient to a periodontist

Collection Agencies and Law firms are not Business Associates

A Covered Entity is one that is directly involved in patient care activities

A Business Associate does not provide any treatment to a patient

If a patient's health information is being used for research purposes, you need to inform the patient and get another consent for that purpose

You can talk to anyone in your clinic about a patient

You don't need additional HIPAA consent to refer a patient, share the information with the patient's insurance company or send a prescription to a pharmacy

Only orthodontists and pediatric dentists can put a picture of their patient in an advertisement without the patient's consent

It is alright to use a kid's picture in an advertisement without further consent

Security rule does not adequately protect the patint'ss PHI even if implemented in the clinic

A key opinion leader is always correct on HIPAA rules as he/she has a huge dental following and knows more about dentistry than HHS

HIPAA did not consider dentists as stake holders when he act was written

Dental offices are small, the ADA and AGD can protect dentistry against HHS

CEs must have a BA agreement if using a BA to handle EPHI

HIPAA applies in small entities such as dental clinics

HIPAA applies only to large entities such as Hospitals

HIPAA is scale able

You can alter the patient's information in the EHR without the patient's consent as your clinic owns it

Alteration or changes of patient's information needs to be document in the electronic health record

Not documenting any changes if changes are made is simply wrong according to HIPAA

Tampering is similar to altering as in a patient record

Dental Safety Comprises Patent Safety and Employee Safety

PHI stands for Protected Health Information

In the 1960s dentists spread Hepatitis B virus to patients

You should always do your best in protecting patient information

Hepatitis infection was commonly associated with social stigma in the 1960s

Pediatric dental patients can access the clinic's WiFi system as they are harmless

The 1993 IC recommendations by the CDC stated that the highspeed handpieces could be disinfected

A clinic should offer a separate WiFi system a patient could use

Fomites show the highest risk in routes of disease transmission

If a neighboring clinic which is friendly with you on Face Book or Instagram share their Business Associate agreement, you should use it

Contact is high risk

Shared agreement between clinics is a good idea as it is cheap

There are more steps while following Transmission Based Precautions

Free HIPAA courses are not really free as someone pays for it and there could be an ulterior motive

You should first Disinfect or Sterilize before sanitization

Looking into a patient's financed account and then raising the statement of work is not fraudulent

Sanitization is to remove most bioload and bioburden

Looking into a care-credit account to determine the money available is not a crime

Sterilization is the highest level of Decontamination

Only spoken method of patient information sharing is allowed by HIPAA.

Spaulding's classification has 3 classes

Name, address, social security number, phone number and credit card number are not protected information

Items used in implant surgery can only be disinfected

Patient information in the electronic dental record belongs to the patient. One cannot alter or share this information even if a Key Opinion Leader says one can on social media

One should no of the risks of many respiratory and also sexually transmitted disease as we frequently encounter them in dentistry

HIPAA Consent is similar to Informed consent

We must be concerned about HIV and COVID-19 in disease transmission

If greater than 500 patients are affected, the breach is small

Children do not transmit infectious diseases

If a patient asks for a copy of their record, include the picture of their radiograph as it can be opened by most devices

TB made a resurgence in the 1980s

"A patient has access to their info and the clinic may charge a nominal fee of about $25 to the patient"

HAV and HEV are transmitted mainly by blood

Giving the patient their information varies from federal to states like Texas. Federal requirement is a maximum of 30 days as opposed to 15 days in Texas

HBV is transmitted mainly by Blood

Federal rules over rule commonly over rule state rules

HCV, HDV, and HGV are all piggy-back viruses

The clinics should have electronic or digital access controls

HBV is a virus with a long incubation period of about 45-160 days

Some states treat normally considered BAs similar to CEs (as in Texas)

HAV has a long incubation period and is called chronic Hepatitis

Clinic must upgrade their equipment and software periodically to conform with HIPAA

1% if HBV infected become chronic carriers

End-point security is not need in dental clinics

An employee can only use their smartphone to take the PHI out of the clinic. They cannot use a thumb drive, tablet or laptop or email it out

Post testing for HBV titers in mandatory for all employees

Unpaid gmail cannot be used to transmit patient PHI as they are not encrypted

HAV and HBV vaccines are now available as combined vaccines

Dentistry does not digitally share images

HCV is a silent killer

Dental employee who do not follow HIPAA can be penalized by the clinic

HEV is seen more commonly during pregnancy

You don't need to follow up with shared information if the recipient is with the insurance network

Vulnerability, Threat and Risk are very important in Risk Analysis and Risk Management

HIV was identified in the 1980s

You should do an audit of your clinic's risks to data at least annually

HIV had a social stigma

Since you completed this HIPAA training, you don't need to do an audit of your clinic

David Acer was proven to infect 9 patients with HIV

You should hire a lawyer or a seasoned expert I HIPAA to help you with an audit

According to data from the CDC, HIV spread rapidly in the US

If you get a patient's credit card information, you can write it on a sticky not and stick it to the bottom of your computer screen and enter it the next day

It is necessary to enter an HIV patient's CD4 counts and viral load in a dental chart

If CD4 counts are below 200 and viral load is High it is good

Post exposure prophylaxis to the expose individual should be started as soon as possible (in hours)

MDR TB is more common in uncontrolled HIV patient

Today HIV can be seen only in Homosexual Males

HIV can proceed into PGL phase and AIDS stage

Oral Hairy Leukoplakia of the tongue and oral candidiasis are seen commonly today in HIV patients

The risk of occupationally getting HIV in dentistry is very low (

You should open an occupational health record in the clinic for each employee

TB spread is mainly through droplets and it is not a concern for dentistry

TB spread is mainly through droplets and it is not a concern for dentistry

About 1 million people die worldwide so it is not of concern

Clinically identifying TB is night sweats, malaise, recent weight loss, fever, fatigue, chest pain, coughing with expectoration that may possibly be tinged with blood, cough and above symptoms for more than 3 weeks. These questions may be incorporated int

Annual TB tests are not needed for dental employees as the risk is low

Some of the emerging disease of concern are SARS, Flu, Avian Flu, Swine Flu, West Nile Virus, Chikungunya, Dengue, Malaria, Japanese Encephalitis, Yellow Fever

Sars and COVID-19 behave very differently and do not have similar signs and symptoms

Lice or pediculosis is quite common even is good counties

Follow strict universal precautions and you fall under to guidance of an expert panel as in H I V and hepatitis C

Measle, Mumps and Rubella are childhood diseases of concern in dentistry

You should only follow the national statistics and implement only the federal guidelines during a pandemic

The symptoms of COVID can be fever, myalgia, and temperature of 104 Fahrenheit

Airborne aerosols will have droplets suspended for long periods of time

Aerosols are heavier than droplets

Most state board of dental examiners and OSHA rely on the CDC for disease information

Dentistry is at high risk for airborne diseases

Airlifters that are portable and have a UV light is not commonly used in a dental clinic now

All germicides are decontaminants

Hydrophilic viruses are easier to kill than lipophilic ones

Quaternary Ammonia compounds are stronger than Halogen

FDA is concerned about sterilants and antiseptics

An immersion sterilant need not be tested periodically for viability

TB kill time is the disinfection time

Both surface disinfection and use of surface barrier are needed, not one or the other

Rinse-spray-rinse is done with impressions for decontamination

Digital impression wands must be decontaminated by following the manufacture's IFUs

Bleach is good for decontaminating suction lines

Decontaminating hands is better than Handwashing because we use gloves regularly

Infection control is only microbiology

Deep sinks are better than shallow sinks for handwashing

You must only use a prescribed emollient for you hands

Hand washing is very important in patientcare

Surgical Handwash is different from the one for General Dental Purposes

You need to do a handwash before wearing exam gloves

Wearing gloves only prevents gross contamination

Wearing exam gloves does not protect the employee from the patient's blood o saliva

Applying the acrylic-bandage does not effectively protect cuts and bruises

A 6% chlorhexidine antiseptic soap is recommended for handwashing in dentistry

You should aseptically remove used gloves to reduce contamination

Commensal microbes can multiply rapidly on gloved hands due to warmth and moisture

A 60% alcohol rub for hands is recommended

A moisturizer for hand is need after a session

Appropriate PPE will protect the employee from blood and body fluid, dust and mist during dental care

You also need to clean protective shields (engineering controls) on a device in the clinic

Use of appropriate PPE is based on how infective a patient is

If no splash or spatter is generated, full PPE is not needed

Side-shield must be worn by every dental health care worker

Use of N-95, KN-95 masks and PAPRS became more prevalent during COVID-19

White and Blue light leads to macular degeneration

At least 3 green goggles are needed during the use of curing light in each operatory

Soft, Hard and soft & hard tissue LASERs are used in dentistry

LASER inserts are available for those using loupes

Level 1 to level 3 masks prevent blowby

Single-Use disposable face-shields are available

If you add 20 lbs or more, you should get fit tested again

Use of surface barriers and disinfection MUST be done between patients

Cling-Wrap' is FDA cleared as a medical device for dentistry

All surface barriers used in patient care need to have FDA approval

Surface barriers used must extent at least 6" below the coupling

The bracket table and electrical switches can us a barrier

Preformed barrier should not be used as they are expensive

Some key pads and mouse can be disinfected

The CDC and ADA have agreed that dental treatment water must not exceed 500 cfu/mL

Stagnant water in dental water systems build biofilms

Tap water can be used for dental care as it is consistently below 500cfu/mL

Salts, bacteria and endotoxins can be present in dental treatment water systems

You can reduce the hard ness of water

TDS varies in each state

All dental patients seen in the clinic have low risks

Only non-TB infections have been investigated

Dentistry is self regulated as a profession

It is the dentists license that allows dental care in a dental clinic

Use od certain disinfectant can interact with biofilms and can generate disinfection byproducts

To get good quality dental treatment water you must control biofilms and the dental treatment water quality in the clinic

Some germicides are safer on patients and the equipment

R2A agar is more accurate than other in-office water tests

Most decontaminating agents d not affect bond strength

Instrument reprocessing is over rated

Dry heat is the most common method of sterilization in dentistry

Handpieces can also be sonicated with other instruments

You can use exam gloves during reprocessing

You should test the ultra sonic machine weekly

Change ultra sonic solution at least daily

You must degas daily

You can use a domestic dishwasher in the clinic

N-class sterilizers have a pre-vac and a post-vac cycle

All state require you to biologically validate your sterilizer monthly

The CDC says you MUST use a chemical indicator

What the dental sales person says supersedes what the CDC says

Class 2 or bowie-dick indicators should be used daily on B class sterilizer for air removal

According to the CDC All employees should stay home if they are sick, or if they feel sick

EPA gives registered surface disinfectants an EPA number

General Duty Clause is a Common-sense clause

Common citation include eye protection and eyewash stations

Any clinic employee can complain to OSHA

OSHA inspection are not common in dentistry

Abatement of Fines are common

The clinic must comply and set abatement dates with OSHA

You can demand a legal warrant to terminate inspections

A Labor lawyer can represent you on OSHA citations

Posters need not be changed periodically

Evacuation or egress during emergencies is not needed for dentistry

Fire is the only emergency for dental clinics

A safe gathering place should be predetermined

Emergencies include fire

Emergencies do not include shelter n place

You should put down an active shooter

Working out doors is common in dentistry

Every state in the continental US is at risk for earthquakes

Hurricanes are common in coastal areas

Tornadoes occur only in the tornado alley

Smoke from wildfire affects people at risk for Asthma

You need to put salt on the driveways and walkways during a freeze

compress gas cylinders are uncommon in dentistry

You should inspect eyewash stations and run them weekly

You must not put sharps in regular waste

Only registered waste management company can pick up regulated waste

Multiple plugs on one circuit is not allowed

GFCI stands for Ground For Circuit Intentionally

Rubbermaid step stool can be used in the clinic as they are sturdy

ANSI stands for American National Standards Institute

Each state may have their own rules on radiation safety

Ambubags are checked and maintained hygienic

You must wait till all the pressure is bled while handling a pressurized system

BBP covers dust control

Extracted teeth fall under BBP

OSHA is not concerned about exposure determination

Every clinic must have a written exposure control plan

You must make compliance with the exposure control plan mandatory for all employees

You are not supposed to test engineering controls in the clinic

Sharp instruments can stick out as ling as you use cassettes

Secondary containers are over rated

All employees must be provided PPE irrespective of their size

Scrubs are not PPE

A trained employee should handle contaminated laundry

Use of full PPE is need while handling suction traps

Saliva soaked gauzes are regulated waste

Disposable sharps are regulated waste

Employee health records are necessary

HBV vaccine must be offered within 2 weeks of joining

Annual TB skin tests for employees is a good idea

Even a trained nurse practitioner can test and prescribe if employee is exposed to blood and body fluids

A post exposure protocol is needed and understood by each employee

If exposed to blood, suck the wound out as a first aid

If exposed to blood, suck the wound out as a first aid

All employees should know the hazards they pose at the dental clinic

Right to Know Law is what dangers an employee faces at the workplace

All employees in my clinic know how to read and interpret an SDS

The clinic must train each employee in HCS

My clinic has a written exposure control plan for HCS

My clinic taught me about the dangerous chemicals at my workplace as soon as I joined work

My clinic talked about dangers posed by employees in the job listing

We have an annual OSHA meeting

GHS training on labeling is offered to all at my clinic

The clinic has trained all in GHS Pictograms

GHS is used by many countries worldwide

By 2013 all clinics must have taught the GHS

Right to understand is a law that must be taught to all employees

Every at risk employee reads labels and SDS of chemicals in the clinic

The clinic maintains an SDS folder for which I have quick access

Old MSDS and discontinued SDS are archived by the clinic

Adequate PPE must be used while handling any chemical

The HCS has to be updated annually

All employees need to be trained on HCS before starting work

There are about 250,000 registered chemicals in the US

About 1 of 6 employees may contact chemical hazards in their lifetime

NFPA labeling is as easy as the GHS labeling

Name, date of expiry and emergency contact of the manufacturer are the only information on the secondary bottle

Secondary contains are not used in Dentistry

1-4 is the pecking order on how dangerous a chemical is

Pictograms are divided into Physical Hazards and Health Hazards

Skull and Cross bones means acute toxicity

Ultra sonic baths used in the clinic are secondary container

There are 5 items to be listed on a secondary chemical label

The act is not HIPPA

HB-300 is only for offices Texas

All employees handling patient data in this clinic are trained in HIPAA within 90 days of employment