1996--No. 174 DENTAL TECHNICIANS REGISTRATION ACT 1975-- REGULATION (Relating to infection control standards) NEW SOUTH WALES [Published in Gazette No. 61 of l7 May 19941 HIS Excellency the Governor, with the advice of the Executive Council, and in pursuance of the Dental Technicians Registration Act 1975, has been pleased to make the Regulation set forth hereunder. Andrew Refshauge Deputy Premier and Minister for Health. Commencement l. This Regulation commences on 8 July 1996. Amendments 2. The Dental Technicians Registration Regulation 1993 is amended: (a) by inserting after clause 7A the following clause: Infection control standards for dental technicians (other than dental prosthetists) 7B. (1) This clause does not apply to dental prosthetists. (2) A dental technician must not, without reasonable excuse, fail to comply with the infection control standards set out in Schedule 3 to the extent that they apply to the dental technician in carrying out technical work. (3) In determining whether or not a dental technician has a reasonable excuse for failing to cornply with a standard, particular consideration is to be given to whether the dental technician's employer failed to provide the necessary equipment, including providing access to it and training in its use, that would have 2 1996--No. 174 enabled the dental technician to comply with the standards (and whether the failure to provide such equipment was reported by the dental technician to the Director-General of the Department of Health). (b) by inserting after Schedule 2 the following Schedule: SCHEDULE 3--INFECTION CONTROL STANDARDS FOR DENTAL TECHNICIANS (OTHER THAN DENTAL PROSTHETISTS) (Cl. 7B) Part l--Preliminary Definitions 1. (1) In this Schedule: "body substance" includes any human bodily secretion or substance other than blood; "patient" includes (but is not limited to) a person who is accessing medical or health services or who is undergoing any dental treatment. (2) The requirements set out in this Schedule apply to a dental technician who is assisting in carrying out technical work in the same way as they apply to a dental technician who is actually carrying out the work. Part 2--General standards applying to dental technicians General precautions 2. ( 1 ) Precautions must be taken to avoid direct exposure to a patient's blood or other body substances. This requirement applies regardless of whether there is any perceived risk of infection. (2) Recognised work practices to prevent contamination must be used in the course of complying with the requirements of this Schedule. Hand and skin washing 3. (1) Hands must be washed and dried immediately before and after handling any instrument, equipment or appliance that has been in direct contact with a patient. (2) Hands or other skin surfaces that are contaminated with a patient's blood or other body substance must be washed as soon as it is practicable to wash them. (3) The requirement to wash and dry hands applies regardless of whether gloves are also required to be worn. 3 1996--No. 174 Protective gowns and aprons 4. A protective gown or apron (or other similar clothing) must be worn while carrying out any technical work where there is a likelihood of clothing being splashed or contaminated with blood or other body substances. Gloves 5. ( 1 ) Gloves must be worn while handling any instrument, equipment or appliance that has been in direct contact with blood or other body substances. (2) Gloves must be changed and discarded as soon as they are tom or punctured. Masks and protective eye wear 6. (1) A mask and protective eye wear must be worn while carrying out any technical work where there is a likelihood of splashing or splattering of blood or other body substances. (2) In cases where a mask is required to be worn, it must be worn and fitted in accordance with the manufacturer's instructions. (3) A mask that is not capable of being disinfected must be discarded once it has been worn and it must not be used again. (4) A mask that is capable of being disinfected may be re-worn after it has been disinfected in accordance with the manufacturer's instructions. Management of waste 7. (1) Contaminated waste must be segregated, placed in a suitable leak proof bag or container and contained at the place it is generated before being disposed of in an appropriate manner. Contaminated waste includes microbiological waste or pathological waste, or any material or item that is soiled or contaminated with blood and that is likely to cause infection or injury to any person. ( 2 ) Contamination of skin while disposing of blood or body substances must be avoided as far as practicable. Part 3--Processing of instruments and equipment Prosthetic appliances 8. Any prosthetic appliance or material that is sent to a laboratory for processing must be disinfected before carrying out technical work. 4 1996--No. 174 Cleaning of instruments and equipment 9. (1) Any instrument, equipment or substance that comes into contact with intact skin must be cleaned before it is used. (2) Any instrument, equipment or substance that is required to be disinfected must be cleaned before it is disinfected. (3) The process of cleaning must involve water, mechanical or physical action (such as an ultrasonic cleaner) and a cleaning agent (such as detergent or a proteolytic enzyme). Disinfection of instruments and equipment 10. (1) Any instrument, equipment or appliance that comes into contact with non-sterile tissue must be disinfected before it is used. They should also be sterilised if they are capable of withstanding that process. (2) The process of disinfection must involve either thermal or chemical methods. Chemical disinfection may only be used in cases where thermal methods are unsuitable. (3) Before any prosthetic appliance leaves a laboratory, the appliance must be cleaned and disinfected. EXPLANATORY NOTE The object of this Regulation is to specify the standards for controlling infection that are required to be followed by dental technicians (other than dental prosthetists) in carrying out technical work (i.e. the mechanical construction or renewal or repair of artificial dentures or restorative dental appliances). The standards are designed to enhance protection of patients against infectious diseases. The standards to be followed include general requirements (e.g. hand washing before and after handling equipment). The standards also require the cleaning and disinfection of instruments and equipment (including prosthetic appliances). This Regulation is made under the Dental Technicians Registration Act 1975, including section 35 (the general regulation making power, in particular section 35 (2) (j)).