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With the recent release of new guidelines concerning dental infection control procedures, Dr Rosyln Franklin has been helping guide those practitioners who are confused about their implementation. By John Burfitt
Ever since the release of Standard Australia’s new guidelines regarding dental infection control procedures late last year, consultant Dr Roslyn Franklin admits she’s been kept busy helping establish the standard across the profession.
The standard, officially known as ‘AS 5369:2023 Reprocessing of reusable medical devices and other devices in health and non-health related facilities’, provides uniform minimum requirements for the cleaning, disinfection and sterilisation of reusable instruments and equipment so that they’re safe for use and pose no risk of transmission of infection.
Dr Franklin calls the standards “a game changer” in how dentists need to deal with infection control and prevention, noting it’s central to providing a safe working environment for those who work in healthcare settings as well as high-quality health care for patients.
At the same time, however, she believes there’s a certain level of confusion about them among many dental practitioners and clinical staff.
“This has probably caused more angst and comment among dentists than anything I’ve ever seen as a consultant,” Bunbury-based Dr Franklin says. “This now requires dental practices to improve some of their sterilisation processes and comply with more standards at a hospital-level than ever before.
“All of this is about a risk-based approach to infection control, which can be like a foreign language to not only those in the clinic but also many across the profession, and yet everyone I work with is seriously committed to wanting to do the right thing for their team and patients. This just means we have some work to do in getting everyone onto the same page.”
All this is so important for where we are going and also essential to have under control in a practice if APHRA comes knocking and then asks why these latest standards are not being followed. This is a good standard that has been set for everyone’s benefit and must become part of the regular way a practice operates. Understanding this needs to become a priority.
Dr Roslyn Franklin, owner, Amalgamate Consulting
Dr Franklin calls the new initiative a game changer because it involves a number of key changes in the vital cleaning and sterilisation of instruments including stricter requirements on the quality of water used in cleaning, design of the sterilisation room, storing of sterilised instruments, airflow and ventilation, and annual staff infection control training.
A dental graduate of the University of Western Australia in 1994, Dr Franklin initially stepped away from seeing patients almost a decade ago to focus on infection control and prevention procedures. She set up her own company, Amalgamate Consulting, and completed post graduate studies in infection prevention and control at Griffith University in 2018.
In her advisory work, Dr Franklin attends clinics to conduct an inventory on their processes, provide information about the latest regulations, and works with the teams to adopt and implement a best practice approach to applying infection control measures.
She reveals some practices she’s observed lack the necessary level of awareness in implementing correct infection control procedures.
“I’ve had experiences where a practice manager will take me into a sterilising room or a treatment space and in good faith believe they have it under control, but the reality is there is room for improvement and that’s where I can help,” she says. “In such cases, there are just elements that need attention to bring the clinic up to a better standard.”
The state of the sterilising room is the main offender according to Dr Franklin. “It comes down to the ways the staff are cleaning and sterilising equipment and then storing them ready for re-use,” she says. “The AS 5369:2023 standard sets out what needs to be done, and for some people, that will necessitate significant changes in work procedures that will just need to be adopted.”
Another problematic area of compliance is the wearing of contaminated personal protective equipment outside the clinic and sterilising rooms, and into reception, the staff room or even out of the building. There also remains big problems with the correct way to sanitise hands.
All of this is about a risk-based approach to infection control, which can be like a foreign language to not only those in the clinic but also many across the profession, and yet everyone I work with is seriously committed to wanting to do the right thing for their team and patients.
Dr Roslyn Franklin, owner, Amalgamate Consulting
“So many of these issues come down to a lack of knowledge about quality infection control training among staff,” she says.
A vital aspect of staff management and practice cultures can also lead to confusion among the team, Dr Franklin says.
“I have seen practices where there’s a lot of different views on infection controls, the result being no-one is completely clear on what is the right way,” she says. “This is when up-to-date and thorough training is essential, so everyone follows and understands the one process.”
Taking on a significant guiding role on the implementation of AS 5369:2023 through the services she offers through Amalgamate Consulting, Dr Franklin is now running introductory and intermediate infection control courses and a subscription advisory service on all matters regarding controls.
While she welcomes the new standard for the improvements she believes it will help achieve with infection control, Dr Franklin admits she remains concerned there is no timeline for dental practices to implement the requirements of AS 5369:2023.
“As a result, there is some greyness to all of this and I’ve had some practices ask me if they really need to give it any attention, so it is a little blurry,” she says. “The profession did so well when the COVID-19 regulations were quickly put in place, but I’m seeing some complacency now about infection protocols, and we can’t allow that.
“All this is so important for where we are going and also essential to have under control in a practice if APHRA comes knocking and then asks why these latest standards are not being followed. This is a good standard that has been set for everyone’s benefit and must become part of the regular way a practice operates. Understanding this needs to become a priority.”
