me Safety Procedures a Ee LM od. @ od F: Lex-) Table of Contents . Training And Educating Our Team . Cautionary Practices For The Okada Team . Patient Interactions And Social Distancing . Measures Upon Arrival . Measures Taken Upon Patient Entry To The Clinic . Reception Room And Front Desk Safety Measures . Protocols Of The Clinical Team . Patients In The Operatory . Protocols After The Clinical TreatmentSafety Procedures Wane eae) Ce ae in the Workplace 1. Training And Educating Our Team Training and educating our skilled and compassionate staff is one of Dr. Okada's top priorities. Prior to interacting with patients, staff is trained in the use of personal protective equipment (PPE) before caring for a patient to prevent contamination of any kind. Refresher trainings on proper handwashing and other techniques are mandatory. This may seem simple; however, research shows that is the most effective procedure we can practice inorder to prevent the spread of the virus. We ensure to spend as much time as necessary to ensure that our team does it well and often - especially between patient interactions. Staff that is not feeling well are explicitly encouraged to stay home for two weeks. Backup staff is always on standby. Before officially coming into work we take the temperature of everyone in the office and will immediately send home any staff with a high temperature (100.4 and above) or a pulse oximeter reading of less than 90%. The number of staff providing care on the workday is limited in order to adequately facilitate social distancing within the office. In order to keep staff healthy when they arrive to the office and before they leave for their homes, we have created a safety protocol checklist so all parties (including their family at home) stay healthy.Safety Procedures re er Pe in the Workplace 2. Cautionary Practices For The Gada Team Before coming to the office... ¢ Take your temperature. Do not come into work if you or anyone you live with is experiencing symptoms such as a high fever, sore throat, cough, etc. Leave watches, rings and other accessories at home. Keep nails short and tie up your hair if long Place phone in a Ziplock bag that you will discard at the end of the day If bringing a lunch, place in disposable wrapping Pack work clothes in a washable bag (i.e. pillow case) Practice appropriate use of personal protective equipment (PPE) prior to caring for a pariente to prevent contamination. At work * Change into scrubs and work shoes (preferably wipeable) as soon as you arrive * Use PPE as appropriate * Leave clutter (phones, books, pens, etc.) outside of patient op rooms | ‘© We highly discourage workers from using or sharing other workers desks, phones, workplace tools and equipment when possible # Wipe down phone handset after use; discourage cell phone use at work After work © Always wash hands and arms with soap * Remove scrubs and glace in washable bag or leave at work * Wash hands and put clean clothes on * Sanitize phone, glasses, etc.Sanitize hands immediately afterwards At home * Do not touch anything until you sanitize Remove shoes and clothes Wash clothes / scrubs in washing machine with detergent and hot water * Shower immediately with sap and water before touching anything (including family) Lorna L. Okada, D.D.S., Inc. Address: 7176 Santa Teresa Blvd Ste-B1 San Jose, CA 95139-1349 Phone: 408-226-2522 SM eC Rr GsSafety Procedures vm ere in the Workplace 3. Patient Interactions And Social tancing Before patient arrival every effort is made to... * Use established and updated screening checklists and sensitivity scripts to vet and filter patients during the phone call when scheduling appointments for care * Prepare scripts and questions to recognize potential carriers. * Reschedule patients who show any symptoms (cough, sore throat, etc.) or who illustrate other concerning warning signs. « Instruct patients to call before their appointment and reschedule if they develop symptoms of a respiratory infection (e.g., cough sore throat or fever) on the day of their appointment. To promote social distancing Prioritize high risk patients (immune compromised, over 60 y.o. etc.) with early morning appointments in order to facilitate less contact with people. When booking patients, we spread out the schedule so there are less people in the waiting room (a maximum of one person at a time) If a patient is being accompanied, their escort is ordered to wait in the car or uiside the office to limit the number of people in the waiting room and promote social distancing Facilitate a “virtual” waiting room: patients hava the option to wait in their car or outside the office where they can be contacted by mobile phone at their appointment time. Safety measures taken upon arrival * Limit points of entry to the clinic. * Post explicit visua! alerts (e.g. signs, posters) at the entrance door advising patients of the COVID-19 risk and advising them not to enter the facility when ill. * Sanitation supplies (alcohol-based hand rub (ABHR) with 60-95% alcohol, tissues, etc.) are accessible immediately upon entry alongside instructions on how to use said tools. Ex. use tissues to cover nose and mouth when coughing or sneezing and then dispose of contaminated items on clearly marked waste receptacles.Safety Procedures Lorne L. Okada DDS, Inc Tam il) Workplace 4, Measures Upon Arrival Patients are... * Asked to call office upon arrival, and will be notified how long they may need to wait in their car. « Wear a mask to appointment, then place mask back on after dental treatment is complete. * Asked about the presence of symptoms of respiratory infection and history of travel or contact with possible COVID-19 patients. IF fever temperature of 100.4 degrees F or higher, pulse oximeter read is lower than 90%, or respitory symptoms are present, they will be advised to seek medical treatment and their appointment will be rescheduled. (Temperature will be taken with non-contact digital infrared thermometer, oxygen saturation level with be taken with pulse oximeter) Given hand sanitizer or escorted to a hand washing station. Directed to rinse with 1% hydrogen peroxide before entering for an appointment as pretreatment. © As testing for the virus becomes more accessible, this incorporation of screening will benefit patients. 5. Measures Taken Upon Patient Entry To The Clinic © If an examination for a patient is not readily available, ensure social distancing in the by placing a seating minimum of 6 feet apart.e Remove clutter not easily disinfected from the waiting room (magazines, toys, pillows, pens, etc.) * Cover furniture that cannot be disinfected with disposable covers (chairs and couches) that can be replaced after each patient. * Frequently wipe down waiting rooms, bathrooms, door handles, light switches, keyboards, etc. Lorna L. Okada, D.D.S., Inc. Address: 7176 Santa Teresa Blvd Ste-B1 San Jose, CA 95139-1349 Cae eel eeLeed Website: www.drokada.com anSafety Procedures SE Lorna L. Okada DDS, Inc. in the Workplace 6. Reception Room And Front Desk Safety Measures ¢ Install physical barriers or partitions (e.g., glass and plastic windows) if possible, at reception areas to deter close contact between reception and potentially infectious patients. * Hand-free headphone use is encouraged, so only one person can use it © We have added medical grade air purifiers w/ HEPA and PECO filtration throughout the office in order to remove contaminants from circulating in the air. 7. Protocols Of The Clinical Team Team Okada adheres to the standard, recognized transmission-based precautions in the operatory but with a strict attention to detail that ensures all safety procedures are followed consistently and correctly. Hand hygiene is performed by our staff. © Before and after patient contact, contact with potentially compromised material, and before putting on and after removing personal protective equip[ment (PPE), including gloves. ‘* After removing PPE in order to remove any pathogens that might have been transferred to bare hands during the removal process. * Consistently wash hands with soap and water for 20 seconds minimum. Personal protective equipment (PPE) * Appropriate PPE (eg. masks, gloves, cap, eye protection, face shields, gowns will be worn at all times). © Masks are one time use and replaced if soiledSafety Procedures Wee Ma) 27. ESD mil) Workplace 7. Protocols Of The Clinical teain (dontinued) hy Eye protection Put on eye protection (i.e., goggles or face shit ‘of the face) upon entry to the patio: Seabin’ at cary ‘ « Remove eye protection before leavitig'the patient oom or cave area. * Reusable eye protection (see above) must be cleaned and sanitized according to the manufacturer's reprocessing instructions prior to re-use. Gloves Put on clean, non-sterile gloves upon entry into the patient room and care area. * Change gloves if they become damaged and/or contaminated * Delicately remove and discard gloves when leaving the patient room or care area, and immediately practice hand hygiene. Gowns * Put on a clean isolation gown upon entry into the patient room or care area. ‘* Change the gown if it becomes contaminated. Remove and discard the gown in a dedicated container for waste or linen before exiting the patient room or care area. * Disposable gowns should be discarded and cloth gowns should be laundered after each use. 8 ‘* Gowns should be prioritized for all aerosol-generating procedures and during activities where splashes and sprays are anticipated. Shoe covers * These must be worn over running shoes unless staff is wearing plastic shoes that can be wiped down and disinfected. Nee) CCS eC a CR CoC) Me Mn eee RolSafety Procedures Lorna L. Okada DDS, Inc: in the Workplace nts in The Gperstony Before a patigint enters the tgeement room, all surfaces, such as the dental chair, dental light, drawer handies, cabinets, and countertops will have been cleaned and disinfected. '. ° Health care personnel (HCP) should always strictly follow basic infection control practices betvesn platisnts (e'g,, hand hygiene, cleaning and disinfecting shared equipment). Limit transport and movement of the patient outside of the room in order to practice social distancing. * Always use PPE as described above. ‘* Once the patient has exited the operatory, HCP should refrain from entering the operatory until sufficient time has elapsed to remove potentially infectious particles. © After this time has elapsed, the room should undergo appropriate sanitation and disinfection by next use. © Special precautions must be taken when performing Aerosol Generating procedures (AGP), in particular procedures that are likely to induce coughing are avoided if possible, 9. Protocols After The Clinical Treatment * After treatment is completed, patients will be asked to sanitize hands before leaving operatory. * All non-disposable medical equipment: routinely clean and disinfect according to manufacturer's instructions. * Ensure environmental cleaning and disinfection procedures are followed correctly and consistently. * Practice routine cleaning and disinfection procedures are appropriate for SARS-CoV02 in healthcare settings, including those patient-care areas in which aerosol-generating procedures are performed. Ex. utilizing cleaners and water to pre-clean surfaces prior to applying and EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on product labels.Safety Procedures ea ene in the Workplace 9. Protocols After The Clinical Treatment (continued) ¢ We are in the process of purchasing a mobile, self-contained germicidal cleaning device that uses proven ultraviolet emitting radiation technology to help reduce and eliminate bacteria, viruses and other pathogens on environmental surfaces and is approved by the FDA, including microbes in the air. Safety measures after the visit Treatment Plans, Financial Arrangements, & Informed Consents - A pen/stylus will be provided if you do not have one, to sign or e-sign any documents. We will be encouraging over the phone credit card payments, and will be offering other forms of contactless payment options. * Review of estimates and insurance forms can be carried out via phone call, video conferencing and email. * Patients wash hands before leaving. * In addition, will be offering teledentistry services and virtual consultations for follow up reports or communication that can be done by phone, online, or through video. Although our friendly, caring team is the same, things will be a bit different in our office the next time you visit. We have spent the last several weeks researching and securing equipment in order to protect you and our team. This is in addition to extensive team training on infection control and patient management protocols. These enhanced precautions and changes will help us ensure the safety of our patients, staff, and community. - The Okada Team eT Nee) cca Sao 176 Santa Teresa Blvd Ste-B1 San Jose, CA 95139-1349 Cua Oye Lees Tce ou oe