Education and Training

Background

Compliance with the exposure control/infection control protocol is significantly improved if OHCP understand the rationale for the written policies and practices intended to prevent HAIs. The objectives of the education and training program are to enlighten OHCP regarding (1) the risk of HAIs, (2) preventive strategies, (3) post-exposure evaluation and follow-up and (4) administrative controls.

1. Infection, an invasion and multiplication of microorganisms in body tissues, results from local cellular injury as a consequence of:

   1. Competitive metabolism

   2. Toxin production

   3. Immune-mediated reaction

2. “Chain of infection,” the transmission of infectious agents in healthcare settings, requires three elements:

   1. Source or reservoir of infectious agents

      1. Pathogens associated with HAIs are derived primarily from humans, but contaminated objects and environmental sources are also implicated.

   2. Susceptible host with a portal of entry receptive of the agent

      1. Establishment of infection and its severity relate to the state of host defense mechanisms; however, the numbers, pathogenicity, virulence, and antigenicity of organisms are important determinants.

   3. Mode of transmission for the agent

      1. Pathogens may be transferred from the source to a host by contact transmission, i.e., direct or indirect contact transmission; or respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission).

3. Pathogenic organisms of concern in the oral healthcare setting

   1. HBV, HCV, and HIV

   2. Measles, mumps, and rubella

   3. Herpes simplex, varicella (chicken pox), and varicella zoster (shingles)

   4. Influenza, syncytial viruses, group A streptococci

   5. Mycobacterium tuberculosis

   6. Emerging pathogens (methicillin-resistant staphylococcus aureus (MRSA), Ebola virus, SARS-CoV-2, others)

4. Preventive strategies

   1. Education and training

   2. Immunizations

   3. Personal protective equipment

   4. Hand hygiene

   5. Engineering and work-practice controls

   6. Environmental infection control

   7. Transmission-based precautions

   8. Respiratory hygiene and cough etiquette

   9. Post-exposure evaluation and follow-up

   10. Administrative controls and work restrictions

Execution/Compliance

1. An education and training program is completed by all OHCP prior to initial assignment to tasks and procedures in which exposure to blood and OPIM may occur and at least annually thereafter.

   1. The program is scheduled at an acceptable time for and at no cost to OHCP.

   2. The presentation is appropriate in content and vocabulary for the educational level of participants.

   3. The program is conducted by person(s) knowledgeable about the subject.

   4. The speaker provides an opportunity for interactive questions and answers.

2. Training record

   1. An individual Training Record is maintained on all OHCP for the most recent 3-year period.