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Minimum Defensible Infection Control Procedures

Infection Control Procedures - Regulation AND / OR Recommendation ?

The Infection Control debate around the world is sadly marred by the Infection Control 'Minimalists' who indicate that they will comply with the Board Regulations but ignore their professional Association Recommendations claiming that these are not compulsory.

Every dentist wants to know what the law specifies is the minimum that must be done?

Unfortunately " THE LAW " tells us very little about specific acceptable procedures.
A better question, and one that is easier to answer, is
what is a MINIMUM DEFENSABLE set of procedures?
Any less is illegal or foolhardy, any more is optional.
There are four hearings where dentists may be called upon to defend complaints based on lack of proper infection control procedure.

1. The Criminal Courts where inferior standards of protection for employees may result in financial or imprisonment penalties. The Standard here is usually the Recommendations AND the Regulations. It may also include specific WorkSafety regulations such as U.S. Federal or State OSHA Standards. In Australia there is the Federal NOHSC Code of Practice for Health Care Workers AND State Legislation
   
   
2. The Civil Courts where a patient sues the dentist for financial damages for negligence. The standard here is ALWAYS the professional Recommendations and usually ALSO the Regulations.
   See the "Sharpe Case" Ref A and Ref B
   
   
3. The Dental Board Hearing where a dentist may be financially fined and/or suspended or struck off. Dental Board powers are often limited to interpretation of the Dentists Act and Regulations including if present any new Infection Control Regulations. Dentists Registration Acts usually require that a dentist exercise adequate skill, knowledge and care.
   
   
4. The Professional Association's Ethics Committee where a complaint regards improper behaviour may be based upon the Association's accepted Code of Practice AND the Recommendations of the Professional Association AND the Regulation.

As you can see it is only in a Dental Board Hearing that minimum compliance with the Regulations and NOT the Recommendations MIGHT be taken as a defence. Even then this MINIMUM will only be an acceptable defense if the local Dental Board has NOT endorsed or adopted professional or Department of Health Recommendations as policy for interpretation of any requirement to use "recognised techniques" of infection control. In a number of juristictions the minimum standards are clearly set out. Such is the Case in California, and in Australia where in New South Wales there are the Infection Control Regulations to the Dentists Act. In the Australian Capital Territory dentists must comply with the
Skin Penetration Procedures Act and Code of Practice

The debate about Regulations and Recommendation is about COSTS.
What cost the dentist's right to practice? What cost the confidence of your patients?
What cost the damage of a newspaper report of your lost defence of a patient's law suit?
Lets make it clear, the "Minimalists" are an embarrassment to the profession.
Lets protect the profession's excellent record at all costs instead of risking it to save costs.

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