California practices, do you have a quality assessment (QA) review coming up? Are you just interested in making sure your practice is up to standards? Keep your eye out for these common QA violations to stay on track for great review results.

1. Instruments and handpieces not properly cleaned, sterilized or stored.

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Tip: If you have two or more sterilizers in the office, indicate on bag labels which sterilizer was used in case you receive a positive spore test result.

2. Medical emergency drug kit not on-site.

Violated guideline: All dental offices must be equipped with an emergency drug kit. Dentists must know when and how to use each drug.

Tip: Include a log in the kit that lists all emergency drugs on hand and their expiration dates. Do not include any drugs that have expired. A basic emergency kit should include:

  • injectable epinephrine
  • injectable diphenhydramine
  • nitroglycerin tablets
  • bronchodilator (albuterol)
  • chewable aspirin
  • a sugar source

3. Biological (spore) testing of sterilizers not done weekly.

Violated guideline: Each sterilizer in the office must be spore tested at least weekly.

Tip: Document in a log the spore testing process for all sterilizers, including the pass/fail results of each test. Maintain the results for at least 12 months and be sure they are on site and available for inspection during your QA review.

4. Handpieces and waterlines not flushed appropriately.

Violated guideline: Operatory unit waterlines must be flushed for two minutes in the morning before use and for 20 seconds between patients, according to the California Code of Regulations, section 1005 of Division 10 Title 16.

Tip: All staff should be able to demonstrate this task before your QA examiner.

5. Cold-sterilization log not kept.

Violated guideline: Disinfection solutions must be changed regularly, according to the manufacturer’s recommendations. When establishing change schedules also consider usage.

Tip: Keep a log of every sterilization solution change. In your log, include the brand name, date changed, name of person changing the solution and the calendar date of expiration. Make sure the log is available during your QA review.

Getting acquainted with the aspects of a QA review is an important way to improve your practice’s policies and procedures, while also preparing for future on-site assessments.