HTM-0105

Nikki, I totally agree.
I am so pleased that this HTM 01 05 is obligatory and I so like the thought of the outcome.
It is very unfortunate that it is under a very short time we have to change things and to an enormous cost, hard work and sometimes driving people out of the business.
That is not very pleasant.
Our overheads are now three times greater than before. So, the one who is going on about that the dentists are earning so much,I can tell you they are not. They are earning more than dental nurses, that is only what they should, but millionaires and all that sort of comments are not true.
The HTM 01 05 is our law, at least for the time being and I think it is good. A few things are misleading or not clear but overall it is a good idea.

In 5 years , no one will even think about not doing what HTM 01 05 are suggesting.
MLA

feb of this year i took on the role as ICL at my practice as our ICL/senior nurse went onto mat leave, and yes i agree you have to read the HTM01-05 over and over again, i have been a dental nurse for 8years and the amount that has changed is unblievable, taking on this role has helped me to enjoy and do my job better, we are bringing more and more into the dental nurse role, yes it takes time and yes there are those who have done the job for years and find change hard, but it is the bible at the moment and rule and reg's are in every role you take on. i think as long as you are doing HTM01-05 and also what CQC set out they you cant go wrong

Hi
Will still have the Inf Ctrl Nurses but maybe not in the same place as before.
We are still working in our PITID group and the nurse is still with us.

The HTM 01 05 will give us most answers.It is difficult to read it once and get the hang of it, I think that some parts I have read five times or so...

As HTM 01 05 is our "law" we cannot go ahead an do as we want, would like to or what others are doing unless it is according to HTM 0105.

MLA

I keep getting conflicting comments about this HTM 10-15. Who do we turn to now we no longer have PCTs Cross infection Nurses.?????? I need to know what is correct etc.

Our dirty instruments are transferred to central sterilising in locked boxes, (we have red for dirty and green for clean).

On a course I attended recently on cross infection we were told that washer disinfectors have been shown to be ineffective in removing debris, therefore we should manually scrub (immersed in warm soapy water) rinsed in clean water, transferred to ultrasonic, rinsed again, washer disinfector then examined then put in the autoclave, bagged, stamped (21days for our autoclave), transferred in locked boxes and put away in the drawers.

It was also highlighted that all lab work should be disinfected on arrival from the lab and diluted hibiscrub in a small container was sufficient ( I already did this) it should also be recorded in the notes that the work as disinfected prior to insertion. Stock trays should also be disinfected in this way.

I rotate my instruments so that the furthest date is the last to be used however my room is so busy that I rarely go a day or two without using all my instruments, and I reprocess anything which has 'expired'.

Incidentally we weren't told anything about drying instruments hence my separate post on that matter.

Yes, I do feel that we should get a payrise, so many nurses are still being paid the same without a reflection in the extra work we have to do, the extra duties we can do if qualified, retention fee, indemnity and CPD fees. I also feel that there is only so much that can be done to improve patient care before paint care starts being put at risk, I know my dentist and I have had to reduce the amount of time we spend with a patient due to the amount of time I need for processing instruments etc.

Assessor wrote:

Our washer has had to go for repair weve not as yet been left with a replacement. Luckily its Easter so we are closed till Tuesday. Im from the old school fo Dental nursing and Ive been told about things from my collegue Ive never heard of where is it were told no hand contgact on teh mouth rinses etc. Im a NVQ assessor as well as a tutor but no one keeps me up to date. Does any one Know of any of these HT 01-05 courses to go on.

The Infection Control Nurse in Your PCT(or what is left of it) will have some idea.
We have a group , The PITID (preventing infection together in dentistry) where we can get advice and help with these things.
MLA

Hello,
It is really a lot of things that must be done nowadays, regarding Infection Control, and therefore difficult to get the right information about everything. Some says this, some says that.
In the good old HTM 01-05 is says that
a washer disinfector is best practice. But , if you don't have one, an ultrasonic cleaner is what to use. Now, it must be serviced, maintained and checked.(foil test etcetera). Some practices keep the instruments moist (gel or foam up to 2 hours) hand clean (brushed fully emerged in lukewarm water)the instruments, check instruments under magnifying lamp, then put them in an ultra sonic cleaner, and finally autoclave them. It is also done when the washer disinfector isn't working, serviced etcetera.

I must say, I have never heard that we aren't allowed to use the ultrasonic cleaner.
Vms118, who actually told you not to use the ultrasonic cleaner? It is the part of the cleaning that makes the instruments clean enough so they can be sterilised, so I agree that is sounds very wrong.(washer disinfectors also, of course)

I guess the CQC will put us right....

MLA

Our washer has had to go for repair weve not as yet been left with a replacement. Luckily its Easter so we are closed till Tuesday. Im from the old school fo Dental nursing and Ive been told about things from my collegue Ive never heard of where is it were told no hand contgact on teh mouth rinses etc. Im a NVQ assessor as well as a tutor but no one keeps me up to date. Does any one Know of any of these HT 01-05 courses to go on.

Hi all,
i work in lots of practices...
1 practice we spray the intruments. then soak them. then rinse.
then they are eithe hand scrubbed or put into ultrasonic bath. then rinsed .
then put in washer then into autoclave then bagged up.

most other practices i work in just soak their instruments then place them in washer, then into autoclave then bagged.

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The CQC are only people who do not do our jobs telling us how to do our Jobs. in 26 yrs of dental nursing I have never come across any body catching anything from contaminated instruments. I statrted my carer with glass beads for sterilization which wer e heated and you dipped the intsruments into the beads and re use. The needles were also reused but im taliking back in 1984/85 the dentist kept using the same needle till it went blunt. We never wore gloves or any PPE. I didnt have my Hep b till 1991. The amalgam was mixed up in a petle n mortor then use the fingers between pieces of gorse.

I'm hoping that so many will be put off in the coming years that a shortage of qualified hard workers occurs and practices have to improve DN renumiration to what it should be. But I'm not sure that will happen and I think i'll be out of the industry by then anyway.

yep i think that many people new to a career in dental nursing will soon be put off by all the stuff we have to do for little money. very frustrating.

What's even weirder is that we were instructed NOT to use the ultrasonic, as in no option, not allowed! I mean come on! Surely if it is emptied and refilled with an appropriate solution after every session then surely this will IMPROVE the sterilisation cycle because it's more thorough right?

I really think that the older school nurses must get sick of this and that they're probably the last of their kind. I mean who could honestly deal with a life time of this sort of stick for the wage level that most DN's get?

yes we were told that we are no longer to scrub instruments and that we no longer need to use the ultrasonic if we are putting instrument in washers prior to bagging and autoclaving. you are right though things change all the time apart from our wages!!

thanks for your reply, our set up is very similar to yours, its working ok but its exhausing. we need a pay rise thats for sure. x

I get frustrated by this. It seems we are all told different things. My practice was told that hand scrubbing and ultrasonic are now not allowed in the sterilisation process. Apparently straight to washer...inspect...autoclave. many regions seem to get different advise.

Hi,

I work in a 4 surgery practice with surgeries upstairs and downstairs. Dirty instruments are transported in a box with a locking lid from the surgery up to the autoclave room.

From there, we put on our PPE and empty the instruments into the washer except for the hand pieces which are oiled and bagged immediately. They are colour coded with a highlighter pen and date stamped.

Once the instruments have finished in the washer they are then rinsed thoroughly and inspected (we are supposed to inspect underneath a magnifying lamp but we are having technical issues with that at the moment). Once inspected they are then bagged up in individual bags, colour coded then stamped.

From there they move along the work top into the autoclaves and once finished in there they are moved into the hatch.

The nurse then collects her instruments from the other side of the hatch, transfers them into the locking box designated for clean instruments only and then returns to surgery.

Yes its a nightmare. Especially with 4 very busy surgeries. We need a sterilising technician but lets face it, that's never going to happen!!

thanks for your reply and glad u agree with me. things have moved on a lot over the years and we have more responsibility now but not the wages!! take care

Hi I work in a single handed practice private in preston. we have central streilisation. We place the used trays in to a hatch in the treatment suite. Then we go round to the other side of the hatch into central and we scrub, ultra sonic, washer, autoclave bag up. and place everything the other end of the hatch. I have been dental nursing for 26yrs and Im digusted at our low pay as well. In fact im find an alternative to the BADn fee scale. We work hard for our practices etc the practice wouldnt be able to funtion with out us nurses.

Hi we have just bought our second practice and are working to best practice by using HTM - 0105. I,d love to hear from any other nurses who use htm-0105, as in washer disinfecter machine, bagging up machine, autoclaving, stamping and storage in separate room. Love to hear how you are geting on. I personally am enjoying the new system but i feel that after 23 yrs of dental nursing my job has become even more demanding. i lLOVE hard work dont get me wrong but i swear with HTM - 0105 you dont even get a chance to go to the loo. Us dental nurses need pay rises if we are to be able to comply with new regulations. love to hear from anyone else who feels the same xx