Regarding cassettes, we have assistants taking the instruments out of cassettes or opening them before they are put in the ultrasonic cleaner. I informed them that the point of the cassettes and the ultra sonic cleaner is to remove the debris and reduce risk of punctures and injuries. Where can I find this information to hand out at our office meetings?
Thank you for your questions. I have included a copy of the 2003 CDC Guidelines for Infection Control in Dental Health-Care Settings, and it can be viewed here: CDC Guidelines. Although the guidelines are from 2003, they are still the most current gold standard of practice and a resource every dental office should have. The CDC guidelines were developed after numerous literature reviews were conducted on a variety of topics by a large group of infection control experts. The guidelines will answer many of your questions, however I will further explain based on your questions.
Regarding cassette - you are correct. Cassettes are designed specifically to reduce the potential for exposure to sharp instruments. CDC guidelines page 23 covers this information. It states, "Contaminated instruments should be handled carefully to prevent exposure to sharp instruments that can cause a percutaneous injury. Instruments should be placed in an appropriate container at the point of use to prevent percutaneous injuries during transport to the instrument processing area." So, cassettes are considered "appropriate containers." They should not be opened or items taken out (unless absolutely necessary) or else that defeats the purpose of the cassette.
It states, "Use of automated cleaning equipment (e.g., ultrasonic cleaner or washer-disinfector) does not require pre-soaking or scrubbing of instruments and can increase productivity, improve cleaning effectiveness, and decrease worker exposure to blood and body fluids. Thus, using automated equipment can be safer and more efficient than manually cleaning contaminated instruments."
Furthermore, "To avoid injury from sharp instruments, DHCP should wear puncture resistant, heavy-duty utility gloves when handling contaminated instruments and devices. Employees should not reach into trays or containers holding sharp instruments that cannot be seen (e.g., sinks filled with soapy water in which sharp instruments have been placed). Because splashing is likely to occur, a mask, protective eyewear or face shield, and gown or jacket should be worn." So the use of cassettes eliminates the need to handle instruments and is a safer practice.