Great Falls Dentistry’s COVID–19 Preparedness Plan establishes and explains the policies, practices and conditions Great Falls Dentistry incorporates to meet the Centers for Disease Control and Prevention (CDC) and Virginia Department of Health (VDH) guidelines for COVID–19 and federal Occupational Safety and Health Administration (OSHA) standards related to exposure to COVID–19. Our plan has the strong commitment of our management and has been developed and implemented with the full participation and cooperation of our staff.
The following COVID–19 Preparedness Plan includes and describes how Great Falls Dentistry implements the following:
- Infection prevention measures;
- Prompt identification and isolation of sick persons;
- Engineering and administrative controls for social distancing;
- Housekeeping, including cleaning, disinfecting and decontamination;
- Communications and training for managers and workers necessary to implement the plan; and
- Provision of management and supervision necessary to ensure effective ongoing implementation of the plan.
Great Falls Dentistry is committed to providing a safe and healthy facility for our patients and staff. To ensure this, we have developed the following Preparedness Plan in response to the COVID–19 pandemic. Our goal is to mitigate the potential for transmission of COVID–19 within our workplaces using the full cooperation of our staff. Through this cooperative effort, we have established and are maintaining safety and promoting health at Great Falls Dentistry.
Screening and policies for staff and patients exhibiting signs and symptoms of COVID–19
Even before COVID–19, our policy for all staff-members regarding illness was to self-monitor, and stay home if they had signs of illness. COVID–19 is no different in this respect. In addition to our staff staying home and self-monitoring, we are also asking all patients exhibiting signs and symptoms during the COVID–19 pandemic to reschedule after a minimum quarantine period of 14 days, and are providing patients with the flexibility to easily do so. We in constant communication with our staff about what the evolving symptoms of the COVID–19 virus are, and are working with our staff to clearly communicate these symptoms to our patients so they know what symptoms they should be attentive of. Any person within Great Falls Dentistry, whether it be a patient or staff-member, communicating a self-monitored symptom will be sent home immediately. The following policies and procedures are being implemented to assess workers’ health status prior to entering the workplace and for workers to report when they are sick or experiencing symptoms.
Great Falls Dentistry has implemented leave policies that promote staying at home when a staff-member or member of their household is sick, or when required by a health care provider to isolate or quarantine themselves or a member of their household, including providing our staff with sick leave and providing our staff with additional leave for qualified medical and family reasons through the Family Medical Leave Act (FMLA).
Great Falls Dentistry has implemented screening measures for patients and staff. Patients are required to fill out a screening form online the day before their visit to the office asking them about any symptoms they may be experiencing. They are also required to notify us by phone of their arrival so they may have a temperature check by one of our clinical staff before they enter the facility. If patients are exhibiting any symptoms of COVID–19 or have a high-risk travel, their appointment is postponed for a minimum of 14 days. If they exhibit a fever of 100.4 or more upon their temperature check, their appointment will be cancelled, and they will be sent home. Staff are required to have a temperature check daily when they check into work and are sent home if they exhibit a fever of 100.4 or more. They are required to answer daily the same screening questionnaire that we are asking our patients to fill out online. Staff are also required to report promptly any contact with a suspected or confirmed COVID–19 case.
Great Falls Dentistry has also implemented a policy for informing patients or staff if they have been exposed to a person with COVID–19 at our office requiring them to quarantine for the required amount of time. Should a person who was seen in the office be diagnosed with COVID–19 within 14 days of their visit, all patients who were seen on the same day will be notified of potential exposure to take necessary steps of quarantine and testing, and all staff in the office will be referred for COVID–19 testing and quarantined for 14 days since the exposure. Should a staff member become diagnosed with COVID–19, all patients seen by that staff member would be notified of potential exposure. In addition, we continue strict adherence to the Health Insurance Portability and Accountability Act of 1996, (HIPAA) to protect the privacy, health status and health information of both our patients and our staff.
Stringent infection prevention measures are being implemented at Great Falls Dentistry at all times. Patients and staff are instructed to wash their hands for at least 20 seconds with soap and water, or use hand sanitizing wipes, frequently throughout the day, with special attention paid to handwashing before and after each dental appointment, any breaks and after using the toilet. All visitors and patients to Great Falls Dentistry facility will be required to use hand sanitizing wipes prior to or upon entering our dental office. Great Falls Dentistry uses hospital grade disinfectants to sanitize all work surfaces between every appointment, and patients are provided facilities with soap and water or sanitizers with greater than 70% alcohol. Patients are required to rinse with 3% Hydrogen Peroxide for 1 minute prior to any procedure.
Our staff are to wear the same level of PPE required for caring for COVID–19 patients. Any staff member that would come within 6 feet of a patient is to wear an N95 mask, isolation gown, surgical cap and gloves. During any aerosol generating procedure, staff are to wear face shields and/or goggles and a surgical mask over their N95 mask. Gloves and surgical masks are to be removed before exiting patient rooms. All PPE is to be changed regularly, as well as when soiled or after aerosol generating procedures. Hand hygiene is to be performed after taking PPE off and before putting on new PPE.
Engineering controls are to be introduced to minimize aerosol generation and maximize its recapture. High-volume dental suction capacity for the facility has been doubled from standard size. High volume suction is to be utilized wherever possible. Aerosol generation is to be minimized by utilizing alternative dental techniques and instruments (Low speed instead of high speed handpieces when possible, hand scaling instead of ultrasonic scaling, and water-streaming syringes instead of air/water syringes). High capacity air filtration units (capable of replacing the entire air volume in the room in 2 minutes) are to be added to patient treatment rooms. These units will capture aerosols at the source during procedures to run it through 4 levels of filters including H13 HEPA filters, plasma and UV sterilization, thus minimizing the spread of the aerosols and staff exposure.
Stringent housekeeping practices are being implemented, we are providing staff with extra time to clean and disinfecting all work surfaces and equipment, as well as areas open to the public, including waiting room, front desk and bathroom. Frequent attention towards cleaning and disinfecting of high-touch areas, such as chairs and armrests, counters, phones, keyboards, touch screens, controls, door handles, will also be conducted on an ongoing basis using our EPA hospital grade disinfectant or disinfectants containing greater than 70% alcohol.
Visitors are being encouraged to wear masks when entering and exiting Great Falls Dentistry, and asked to cover their mouth and nose with their sleeve or a tissue when coughing or sneezing and to avoid touching their face, in particular their mouth, nose and eyes, with their hands. They should dispose of tissues in the trash and wash or sanitize their hands immediately afterward. Disposable surgical masks and gloves are available for patients’ use at the front office. Respiratory etiquette will be demonstrated as required by staff with tissues and trash receptacles readily available for this purpose to all visitors and staff. All staff members are required to wear masks all day long.
Social distancing is being implemented at Great Falls Dentistry through administrative and schedule controls. As a small private practice, we are better prepared and equipped to maintain social distancing guidelines. There is no more than 5 staff members and 2 patients in the facility at any single time. The office design of separated individual patient rooms allow for the most isolation during treatment. We are strictly limiting the number of patients scheduled in the facility to no more than 2 at any given time. We are working hard to ensure that no 2 patients cross paths. We are eliminating the use of the waiting room. Patients are to contact us by phone when they arrive for their appointments and wait in their cars until we are ready. We will call our waiting patients back when a team member is ready to greet them at the door, check their temperature, and escort them directly to their designated sanitized room. No companions are allowed in the facility except 1 guardian for a minor patient. Large Plexiglass shield have been added to the front office area to maintain separation between front office staff and patients entering the facility. All our patient forms are available online to be prefilled prior to the scheduled appointment. If any paperwork is to be filled in the office, it will be presented to our patients on a disinfected touchscreen and will be received back with gloves on and instantly disinfected. Online payments are available for patients on our website to pay from their phones at the end of their appointment if preferred. If a credit card is to be used, patient will keep the pen used for signing, and the countertop will be disinfected immediately afterwards.
The use of the staff breakroom is suspended. Staff may not congregate for lunch or breaks. They are to have their lunch break outside the office. They are required to keep masks on during their daily interactions.
Communications and training
This Preparedness Plan was communicated to our staff and put into motion before we reopened from the government ordered COVID–19 closure and our staff was trained accordingly.
Additional communication and training will be ongoing as we continually reevaluate the situation, and how effective our response to the situation has been. We will continue to update our response as necessary.
This Preparedness Plan has been certified by Great Falls Dentistry management and was posted at our office on May 1st, 2020. It will be updated as necessary.
Certified by: Dr. Mo Dahman ## Appendix A – Guidance for developing a COVID–19 Preparedness Plan
Employees exhibiting signs and symptoms of COVID–19