Bowie & Dick tests: legal requirements
The legislation on autoclaves
Sterilization is very important in dental practices, for the protection of both the patients and the staff, as dentistry is a field in which there is frequent contact with potentially infected blood and mucous membranes. To protect dental staff, legislators states that the employer (which is usually the self-employed dentist in dental practices) must take measures to allow materials and waste to be handled, decontaminated and removed without risks. This means that the employer would be legally liable for any harm to third parties caused by the failure to provide suitable decontamination systems. The regulations require chemical and chemical/physical methods to be used to inactivate or eliminate potentially dangerous pathogenic agents.
In dental practices, there are a number of porous materials that must be sterilized with steam and a suitable autoclave. They include gauzes, bandages, gowns and various fabrics. As well as putting sterilization measures in place, the regulations require their efficiency to be assessed. Bowie & Dick tests can do this by assessing the steam penetration capacity in porous items. The tests are performed using paper which changes colour if it is exposed to a certain saturated steam pressure. A standard porous pack is placed inside a sterilizer capable of creating a vacuum. If the sterilizer is efficient and therefore capable of uniformly sterilizing the porous pack, there will be uniform penetration and the Bowie & Dick test sheet will turn a uniform colour, without patches of different colours. The type of colouring that is supposed to be produced depends on the manufacturer. Details will be provided in the instructions with each Bowie & Dick test pack.
If the test is unsuccessful (possibly with air retained inside the porous pack), it means that the sterilization system is not efficient. This may be for a number of reasons:
– The steam produced by the sterilizing machine may be of poor quality.
– The vacuum may not have been created properly, meaning that there is still air present.
– Air may have infiltrated the machine during the creation of the vacuum.
Bowie & Dick tests do not give information about the causes of problems, so if a sterilization system is found to be running inefficiently, it will be necessary to carry out further investigations in order to identify and eliminate the cause.
A Bowie & Dick test must be carried out:
– After repair or maintenance work on sterilization devices.
– After an autoclave has remained inactive for long periods.
– In addition to the two cases above, regular tests must be carried out, the frequency of which will partly depend on the use of the autoclave.
The results and date of every Bowie & Dick test must be recorded in sequential order in the sterilization cycle logs, which can be used as evidence in a trial.
Carrying out Bowie & Dick tests is an inexpensive way to:
– Protect the health of employees and patients.
– Show that your dental practice meticulously performs all sterilization procedures, thus ensuring that you cannot be held liable in a court of law.