1. When treatment is complete, the dentist will push the “over the patient” delivery arm back across the patient to the nurse’s side.  The nurse must remove all instruments from the tray attached to the arm, together with the paper tray liner.  Place the instruments in the nurse’s wash basin.  Place the tray liner and any other waste (eg extracted teeth, cotton wool rolls, etc) in the appropriate waste container.

2. Remove the aspirator, saliva ejector, triple spray tip, ultrasonic insert, light cure insert, electric motor hand piece, air turbine hand piece, patient’s mouth rinse cup and spittoon filter.  Remove the rubber mat on which the hand pieces rest and the sleeves from the handles on either side of the delivery system.  Remove the sleeves from the handles on the operating light.  Don’t forget to run the hand pieces into the sink for 30 seconds (with the water spray turned on) before removing them.  Place the saliva ejector and the patient’s mouth rinse cup in the clinical waste bin.  Place the aspirator and triple spray tip, rubber mat and handle sleeves in the nurse’s wash basin with the instruments.  Place the ultrasonic insert, light cure insert, electric motor hand piece and air turbine hand piece neatly on the work surface at the side of the wash basin next to the autoclave, NOT IN THE WASH BASIN.  Empty the spittoon filter into the clinical waste bin taking care to ensure that if it contains any waste amalgam this is removed and placed in the appropriate container.  Then wash out the filter under the tap and put it back in place.

3. Next, remove any dirty instrument trays from the work surface to the left of the nurse’s wash basin and place them in the wash basin together with all instruments on them.  Ensure that any waste material on the trays is placed in the appropriate waste container.

4. When clearing away waste products, remember that all surgery waste products are to be treated as clinical waste EXCEPT the following items which must be placed in the appropriate waste containers:

   a) partially discharged local anaesthetic cartridges – in their own special waste container

   b) fully discharged local anaesthetic cartridges – in the sharps bin

   c) needles, scalpel blades or other sharp objects – in the sharps bin

   d) amalgam or extracted teeth that have been filled with amalgam – in the special amalgam waste container

   e) amalgam capsules – in their own special container

   f) precious metal waste – in its own special container

5. NOW REMOVE YOUR EXAMINATION GLOVES AND PLACE THEM IN THE CLINICAL WASTE BIN.  PUT ON YOUR HEAVY DUTY GLOVES.

6. Sterilise all contaminated instruments, hand pieces, handle sleeves and the rubber mat and following the detailed guidance in the cross infection control policy.

7. REMOVE THE HEAVY DUTY GLOVES AND PUT ON A FRESH PAIR OF EXAMINATION GLOVES.

8. Set up and switch on the Hygiflex aspirator cleaning system - let it run while you clean the rest of the surgery.  Make sure that it is topped up with cleaning solution before you switch it on.

9. Empty all surgery bins into a yellow clinical waste sack.  Place this on the carpeted area at the far end of the surgery until you finish cleaning.

10. Place both operators’ stools on the carpeted area.

11. Wipe down x-ray tube and arm, x-ray control unit & hand switch, digital x-ray sensor, capsule mixer, surgery music system and clock, telephone, operators’ stools, patient chair (upholstered part, base and around headrest), delivery unit and foot controls.

12. Wipe down the entire “over the patient” delivery unit.  Wipe down the outlets on the delivery unit (both the leads and the couplings on the end of them), paying particular attention to ensure that no blood, restorative materials or other debris remain.  Wipe down the dentist’s tray and tray holder.  Wipe down the arm supporting the aspirator and saliva ejector tubes, together with the nozzles on the end of each tube. Flush and wipe out the cuspidor (spittoon).

13. Wipe down the protective Perspex cover, the surround and the on/off switch on the operating light.

14. Wipe down the patient chair and head rest.

15. Switch off the ultrasonic bath at the socket and empty it.  Empty the detergent from the end furthest away from the mains flex.  Clean the ultrasonic bath and leave it to dry.  Pour the bleach solution used for disinfection of impressions and prosthodontic appliances down the sink and clean the container.  Wipe down the autoclave, Assistina, and towel dispenser.

16. Wipe down all work surfaces, cupboard & drawer fronts, desk area, the dentists’ sink and taps, the nurses’ sink and taps, window sills and inside cabinetry drawers & cupboards.

17. Ensure that the surgery is fully restocked with all necessary materials.

18. Put the sterilised instruments away.  Replace the operating light handle sleeves and the rubber mat and sleeves from the handles on the “over the patient” arm.

19. Check that the dentist’s patient list for the following day has been placed next to the computer.

20. Check the appointment book for the following day for any treatment that involves the fitting of laboratory made items.  Check to ensure that these have been received and are ready for fitting.  If not, inform the dentist and the receptionist.  Make certain action is taken to ensure either that the work will be received in time or, if this is not possible, that the patient’s appointment is rescheduled giving the maximum possible notice.

21. Switch off the surgery music system.

22. Switch off the air conditioning system (in the winter, set it to timer mode when the surgery is in use the next day).

23. Elevate the patient chair to its highest position to facilitate easy cleaning of the surgery floor.

24. Close the blinds on the windows.

25. Hoover the carpeted area.

26. DO NOT proceed any further unless the autoclave and Hygiflex system have finished their cycles.  Wait until they have.

27. Switch off the surgery electricity supply at the consumer unit in the surgery (push the three breakers on the right into the “off” position).

28. Sweep the non-slip flooring.  Ensure that any debris is removed from the corners of the flooring and around the base of the dental chair and delivery unit.

29. Next, mop the non-slip flooring.  Ensure that stubborn marks (such as wax) are fully removed – mopping alone may not achieve this.  Empty the mop bucket.

30. Always mop the floor last.  NEVER walk on a wet floor.

31. Switch off the surgery lights.

32. Switch off electrical supply to compressor and suction unit (in the staff room).

33. Remove your clinical footwear and place it in the staff room.

34. Tie the top of any full clinical waste sacks (in accordance with the practice waste disposal policy), take them to the clinical waste bin and place them inside, ensuring that the bin is locked afterwards.

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