#11 Sterilization /Disinfection of Patient-Care Items

Question 1

What some components of the Standard Precautions ?

Answer 1

1) Hand washing
2) Personal Protective Equipement
3) Controls to Prevent Injuries
4) Proper Management of Patient CareItems & Environment Surfaces

Question 2

What is bloodborne transmission?

Answer 2

• Transfer of bloodborne pathogens from an infected host to a susceptible person
• Can occur through;
• Cuts
• Punture Wounds
• Cracks in the Skin
• Splashes or Splatter

Question 3

What are the Patient-Care Item Categories?

Answer 3

1) Critical -High Risk
2) Semicirtical -Moderate Risk
3) Non-criitcal- Low Risk

Question 4

What is the Critical category ?

Answer 4

• Penetrate SOFT TISSUE, contacts BONE, enter into or contact the bloodstream or other normally sterile tissue.
• Heat sterilize btwn uses or use sterile single use devices

Question 5

What is the Semi critical category?

Answer 5

• Contact MUCOUS MEMBRANES, but not soft tissue, bone, or enter into or contact the bloodstream or other normally sterile tissue.
• Dental mouth mirror amalgam condenser, reusable dental impression trays, dental hand-pieces

Question 6

What is the noncritical category?

Answer 6

• Contact w/ intact skin

- Blood pressure cuff, stethoscope, pulse oximeter

Question 7

Regarding the critical category, the greatest risk of disease transmission = _______________

Answer 7

Heat sterilization

Question 8

Regarding Semicritical the lower risk of disease transmission _____________________

Answer 8

Should be heat sterilized if heat tolerant. If NOT heat tolerant, use high-level disinfectant/liquid sterilant. Consider replacing items w/ disposable or heat-tolerant versions

Question 9

Dental Hand-pieces ___________

Answer 9

• Semi-critical

- Ensure patient safety, ALWAYS sterilize hand pieces using heat

Question 10

Non critical items can generally be cleaned how?

Answer 10

By Low-level disinfected. If visibly soiled w/ blood, clean and disinfect w/ intermediate-level disinfectant before use on next patient.

Question 11

Which procedures need to be performed correctly evert time to insure desired result?

Answer 11

1) Cleaning: MOST important step in processing. All remaining blood, fluids, and other debris must be cleared away from sterilizing method to work

2) Prepare and package:
Prepare instruments for heat sterilization by wrapping or bagging

3) Sterilize: Use of physical (heat) or chemical procedure to destroy all microbes. (spores also)
4) Store: In an area that is dry & away from contaminants

Question 12

What are ultrasonic cleaners?

Answer 12

• Special solutions

- High energy sound waves

Question 13

What are instrument washers?

Answer 13

-High water flow rates special detergents fully automated

Question 14

What are the Sterilization methods? *Autoclave

Advantages?
Disadvantages?

Answer 14

• HIGH TEMP, STEAM under pressure, create an environment where microbes cannot survive
• Advantage: SHORT cycle time, steam penetrates well, easiest loading, appropriate for most dental items
• Disadvantage: corrosion of some materials, wet packages, dulling of some sharp edges (Instruments must be totally dry)

Example: Gravity displacement 30 min (250F)
Pre-vacuum sterilizer 4 min (270F)

Question 15

What are the Sterilization methods? *Dry Heat Sterilizer

Advantages?
Disadvantages?

Answer 15

“Static air” –>High heat (340 F) for 60 min(340F), 120 min (320F), 150 min(300F)

“Forced air” –> 12 min (375F)

Advantage: Does not DULL SHARP EDGES, no corrosion

Disadvantages: LONG CYCLE time, poor penetration of heat to all surfaces, destroys heat sensitive materials, difficult to load evenly

Question 16

Instrument processing:

-Unsaturated chemical vapor?

Advantages?
Disadvantages?

Answer 16

-20 min (270F)

Advantage: Short cycle time, DOESNT DULL SHARP EDGES, corrode carbon steel.

Disadvantages: Instruments must be DRY, chemical odor, destroys heat sensitive plastics

Question 17

How is Sterilization Monitoring done?

Answer 17

1) Mechanical: Asses cycle time & temp w/ each cycle by observing gauges
2) Chemical indicators: Monitor sterilization parameters like time, temp, and pressure indicators on package that change color. (Placed in each package of each cycle)
3) Biological indicators: Heat resistant organisms (BACTERIAL ENDOSPORES) in vials or strops placed in a load at least weekly incubated along w/ control vial or strip. No growth = sterilization killed the spores

Question 18

For dry heat sterilization at a temp of 320F, how long does it take to sterilize instruments?

Answer 18

-2 hours (120 min)

Question 19

The minimum temp required for sterilization by autoclave is?

Answer 19

-250F

Question 20

Regarding Record keeping what is kept in a log?

Answer 20

1) Date/cycle load
2) Duration & temp of cycle
3) General description of load
4) Operators name
5) Biological result for test & control spore
6) Repair & preventative maintenance log

Question 21

What are examples of critical instruments?

Answer 21

1) Surgical instruments
2) scalpel blades
3) periodontal scalers
4) surgical dental burs

Question 22

What are examples of semi-critical instruments?

Answer 22

1) Dental mouth mirrors
2) Amalgam condensers
3) dental handpieces

Question 23

What are examples of noncritical instruments?

Answer 23

1) X-ray heads
2) Facebows
3) pulse oximeter
4) blood pressure cuff