13th May 2021

Five COVID-19 SOP changes that you may have forgotten to update

Article featured in Dentistry, May 2021

Fran covers five COVID-19 SOP changes that many dental practices have missed and need updating.

We are now over a year into the pandemic and are learning a lot more about COVID-19. So naturally our SOP needs tweaking and updating to reflect this.

A Socrates quote fitting to this situation is: ‘I can’t change the direction of the wind. But I can adjust my sails to always reach my destination’.

Some commonly missed updates that may prevent us from our ships sailing in the right direction are self-isolation protocols, personal protective equipment, respiratory protective equipment, high-volume aspiration and COVID-19 audits.

Self-isolation protocols

A few practices I have come across have left me reminiscing about the days when seven-day isolation periods were still a thing. That’s because their self-isolation protocols were left in 2020 and not only have the requirements changed, but changed a few times over. We now have 10 (down from 14) days of not brushing your hair, because let’s face it, you’re not going anywhere (legally).

Luckily, there’s a simple solution. If you’re not lucky enough to have Icomply, set yourself some time aside in your diary to look through the Gov.uk website periodically to see if any changes have been made and apply those changes to your SOPs.

Then hold a team meeting to discuss the changes, because how else would your team know?

If you are lucky enough to have Icomply, we make the changes for you. We release updated versions of the protocols so that you can adapt them.

Personal Protective Equipment (PPE)

COVID-19 has forced practices into increasing their usage of PPE. So naturally everyone is looking for alternatives. However, you may not realise that cutting a few corners can put everyone at risk.

I met a lovely practice manager that was happy to find a cost-effective way by implementing reusable gowns and using FFP2 masks for AGPs.

What she may not have realised is that reusable gowns should only be used as a contingency if disposable gowns are unavailable and proper disinfection procedures are in place.

As for FFP2 masks, whilst they are a good alternative for low-risk procedures, guidance now requires FFP3 masks/hoods for AGPs.

So, what should you do if you find yourself in the same situation?

Luckily, this is an easy fix. Purchase disposable gowns and keep the reusable ones as a backup when needed. Then discontinue the use of FFP2 masks for AGPs and implement FFP3/hoods instead.

Don’t forget to have your team fit tested for any new masks, securely storing away the certificates.

Respiratory protective equipment (RPE)

With more information about the virus, comes even greater responsibilities. That rings true for your RPE.

Using FFP3 masks/powered hoods for AGPs is now a must and includes some logging requirements. Several practices whose SOPs I reviewed did not have anything in place for tracking the usage and maintenance of their RPE. Nor a protocol on how to do so.

So how can we rectify this? Well, all we need to do is create logs for the following:

Filter usage tracking. This is to ensure they are not used for longer than 28 days (based on eight hours a day)
RPE decontamination. To provide proof that decontamination and deep cleans occur at the recommended intervals
Maintenance and repairs of all RPE. This is to evidence that the RPE is in safe working order and that all the necessary actions have been taken.

Lastly, write the procedures down and train your team on its contents.

For Agilio Icomply members, the hard work is already done. We have added the RPE decontamination and filter usage tracking to the daily infection prevention checklist.

Pretty smooth sailing, right?

High volume aspiration

Reducing your fallow time is essential to maintaining a viable business. A critical part of this is using high-volume aspiration (HVA).

As stated by the FGDP: ‘High volume suction is considered to be the equivalent of greater than 250l/minute and it is advisable to have this checked at regular intervals.’

So how do you make sure you’re compliant with something when information is so scarce?

Well, as we have always done for the past 40 years – we gather information and create compliance advice that makes the most sense.

We’ve done our research and spoke to multiple leading manufacturers and engineers, all with differing opinions on the frequency of these checks. Ranging anywhere from daily, weekly to even quarterly – which makes it even more difficult.

However, they all agreed on one thing: using a flow meter/gauge to validate your HVA in between your engineer visits.

Our recommendation is having daily checks to avoid any unwanted surprises. However, you can always request this advice from the manufacturer directly.

Icomply members are already covered. We have added HVA validation to our SOP update and have even added these checks to your workflow in our Daily Infection Prevention Checklists.

COVID-19 audits

Forgive me when I say the ‘A’ word: audit. Yes, another audit.

As clearly stated by the FGDP: ‘All staff need to understand the importance of following these guidelines and managers will be required to carry out regular audits to ensure compliance.’

Here at Agilio, we recognised that a COVID-19 audit was now necessary. So we researched and designed an essential list of all items to audit in the practice to ensure that your practice is following its SOPs.

However, you don’t necessarily need someone to create your audit for you, although it certainly makes it easier.

Have a look through key guidance documents from your CDO, PHE, and the FGDP, making a list of all compliance considerations. Then go through each of those items to identify if they are being followed.

If not, create an action plan to get the practice running at top notch again. The important factor here is knowing your guidance in detail, giving you the competence to audit effectively.

To help our members, we recently released new intelligent audit tools in Icomply. These include COVID-19, sedation and infection control, with radiography and clinical records coming soon.

These ‘intelligent’ audits know the correct answers, then suggest and track any follow up actions. This helps to reduce human error. Although you still should receive training so you’re competent enough to do the audit.

So much information, so little time.

Being a practice manager, especially during COVID-19, is a tough job. By keeping yourself up to date and proactive, you can reduce the risks for your team and patients. All whilst keeping inspectors at bay.