Post-COVID-19 lockdown: A process audit of standard operating procedures in the department of periodontology

ABSTRACT

Background and Aim: This study aims to audit the process of patient management with aerosol generating procedure (ultrasonic scaling) while adherence to the guidelines for healthcare workers during the COVID-19. Methods: Audits records at the Department of Periodontology at University College of Dentistry Hospital Lahore - Pakistan were collected (prospectively) over the period of 1 October to 30 November 2020 (1st cycle) and 14 December 2020 to 12 February 2021 (2nd cycle). The audit was divided into three components based on the guidelines (i) Physical environment, (ii) patients/appointments and (iii) COVID SOPs related to HCWs. Results: The recommended physical layout and procedural factors, as suggested by the guidelines for dental clinics, were observed during the first cycle of audit, and discrepancy of ventilation system was fixed after the first cycle. Only one house officer got COVID positive (PCR) on 3rd day of house job. There were four procedural slots per day with three fallow time of half an hour each in the first cycle. Audit team reported the observance of fallow time three times daily, which revealed that 83.3% observance of fallow time. Later in the 2nd cycle when the extra oral high volume air evacuator was installed, the fallow time was reduced to 15 min and not only we did five procedural slots per day but our fallow time was also observed 100% of the time. There were few occasions in each cycle where the appointed patients had to wait more than 10 min before they were seated, and waiting time decreased in the cycle 2 when the dental staff were sensitized with its importance repeatedly as part of our weekly dissemination of knowledge. Conclusions: Following the standard guidelines resulted in more efficient working environment and lesser risk for health care workers while performing aerosol-generating procedures.