Whether we realize it or not, the design of the world around us is one of the most powerful influences in our lives. Space design – including the design of your practice – cannot only affect moods and emotions, but movement and behaviors. When done right, practice design can subconsciously spur behaviors that enhance safety, wellbeing, and infection control. In a post-pandemic environment these behaviors are more vital than ever before.
When layered with smart spatial arrangement and engineering controls, design is a fundamental way to promote asepsis and efficiency. This article will discuss support space options for sterilization and storage.
The State of Sterilization
The dental industry has adopted sterilization practices per the Centers for Disease Control and Prevention, which recommend a safe, dirty-to-clean workflow. Sterile processing is divided into four parts to ensure this:
- Receiving, Cleaning and Decontamination, where debris and contaminants are removed through scrubbing/ultrasonic cleaning;
- Preparation and Packaging, where instruments are sorted and packaged for sterilization;
- Sterilization, where instruments are loaded, processed and cooled in a mechanical sterilizer; and Storage, where wrapped instruments are kept safe from contaminants in a closed cabinet.1
The pre-fabricated sterilization centers manufactured by dental equipment companies are designed to make this process intuitive and seamless, with dedicated cabinets, surfaces and storage: a place for everything, and everything in its place.
How Can a Two-Room Solution for Sterilization and Clean Supplies Be Beneficial
Hospitals and health care facilities also use this universal dirty-to-clean workflow, but with a key enhancement: confining decontamination procedures to a closed, designated room with negative air pressure, separate from an adjacent clean workroom.
The recommendation came in 2018 from the Facility Guidelines Institute, the widely recognized organization responsible for developing safe and effective health care design standards. Concerns had been raised that one-room sterilization layouts made it difficult to ensure proper workflow –and safe airflow.2 While dentistry was exempt to allow flexibility, it’s interesting to consider how a two-room solution could be beneficial.
Imagine a scenario where dental sterile processing steps one through three occur in a closed room with a door on each end to drive one-way traffic. Closed spaces boost the effectiveness of air purification or make it possible to achieve negative air pressure to safely contain and exhaust contaminated air. Step four, or the storage of sterilized instruments, is beneficial in a separate, adjacent room with a pass-through window for safe transfer of clean cassettes when removed from the sterilizer.
By hospital standards, a clean storage room should contain positive air pressure, or an increased supply of clean air as compared to surrounding spaces. Separation allows staff to retrieve clean instruments and supplies without having to enter sterilization, thereby reducing the risk of cross-contamination via air or surfaces.
How to Implement Clean Supply Storage Enhancements
Speaking of clean supplies, apart from keeping them in a space separate from sterilization, having a smart method for organization promotes safe habits while boosting efficiency.
Supply storage is often an afterthought in practice design, but the right system saves time, steps and stress.
- Bulk storage of PPE and other supplies should be stored up off the ground on shelving.
- For smaller supplies that are ready to unpackage, clear tip-out bins allow staff to take quick, visual inventory when locating what they need or determining what to order.
Organization is a practice that requires some work and maintenance, but it’s easier to drive desirable behavior when things like visibility, access, frequency of use and restocking are considered at the onset.
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This article is an excerpt from a five-part series appearing in Dental Economics, by Melissa Sprau.
Melissa Sprau, NCIDQ, brings over a decade of commercial and hospital design experience to the dental industry as Benco Dental Design Manager. As a licensed interior designer with a background in health care facilities planning and design, her approach combines best practices for health and safety with the details required to support positive patient and caregiver experiences. Sprau coaches practitioners to discover their brand and infuse it into the built environment, aligning quality of space with quality of care.
SOURCES:
[1] https://www.cdc.gov/mmwr/PDF/rr/rr5217.pdf
[2] https://www.hfmmagazine.com/articles/3620-fgi-requirements-for-sterile-processing-facilities , FGI requirements for sterile processing facilities, Designing facilities that support the workflow necessary for safe sterile processing, www.hfmmagazine.com
[3] https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html Coronavirus Disease 2019 (COVID-19), CDC provides credible COVID-19 health information to the U.S., www.cdc.gov
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