3rd year key points Flashcards

1
Q

WD loading requirements

A

basket furniture
no shadowing/overlap
hinged items kept open
disassemble instruments

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2
Q

WD daily checks

A
load carrier - damage or debris/instruments
spray arms rotating freely
jets not blocked
door seal intact
strainer not blocked
enough chemical detergent
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3
Q

how should you rinse items?

A

below surface in a separate sink

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4
Q

steriliser daily checks

A

door seal intact
load carrier and chamber
- no debris/instruments/damage
fill water reservoir - pure water

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5
Q

why should you manually wash below surface?

A

minimise contamination and aerosol production

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6
Q

sinner circle

A

chemicals
time
temp
energy

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7
Q

transport

A
ASAP
container
 - rigid, durable, leakproof
 - tight fitting lid
 - easy to clean and disinfect
 - clearly labelled as contaminated
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8
Q

what water is used for rinsing?

A

RO

purified and easy to make in large quantities

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9
Q

4 types of demineralised/purified water

A

sterile
distilled
deionised
RO

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10
Q

cleaning

A

removal of contamination from an item to the extent necessary for its further processing and intended use
“a soil removing process that requires energy which removes a high proportion of all microbes present inc bacterial spores”

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11
Q

what does cleaning presuppose?

A

nature of any likely contaminant is known and that it is possible to define a level below which it will have no adverse effect

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12
Q

corrosion

A

resistance - protective passivation layer
- easier to clean and harder for bacteria to cling on to
avoid damage - avoid wire brushes

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13
Q

non-immersion cleaning

A

wiping
wipe with detergent solution
clean non-linting cloth
never use brushes - aerosols

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14
Q

immersion cleaning

A

brushing
30-35 degrees
scrub under water using long-handled brushes with soft plastic bristles
minimise aerosols - never scrub under running water
neutral enzymatic detergent

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15
Q

if you find an item dirty at any stage what should you do?

A

start the whole process again

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16
Q

what shouldn’t be processed in an US?

A

handpieces

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17
Q

how do US machines work?

A

apply high freq sound wave
produce microbubbles
cause cavitation when they implode
energy released helps remove soil

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18
Q

why should you degass first?

A

air will inhibit cavitation

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19
Q

water stages

A
manual wash
US
manual rinse
WD
steriliser
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20
Q

cold mains water

A

manual washing
US
WD

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21
Q

hot mains water

A

manual washing

WD

22
Q

what suspended particles do you need to remove?

A

hard particles
soft particles
colloidal (insoluble) particles

23
Q

water for manual washing

A

use as a solvent to dilute detergents

water v good as a wetting agent to break down soiling

24
Q

how do detergents work?

A

suspend removed soil in water
hydrophobic end sticks to surface of soiling
leaves soiling coated in hydrophilic ends of the molecules so it ‘likes’ being in water and can be washed away

25
Q

why do you need to change water/detergent solution in an US bath?

A

detergent loses its properties as the molecules become saturated by the soiling
validated with clean water

26
Q

rinsing and water

A

need water with low mineral content
mineral deposits turn to limescale
- produced when water boiled off and minerals left behind

27
Q

decon

A

sum of those processes required to make the used device available in a form that is safe and fit for use on subsequent pts

28
Q

why use RO for final disinfection rinse?

A

one of the recommended waters low in mineral content

only one capable of making water in high enough vols quickly enough to keep up with the WD

29
Q

how is RO water made?

A

RO membrane under pressure

30
Q

how is distilled water made?

A

boiled - turns to steam

steam caught and condenses

31
Q

how is deionised water made?

A

ion exchange resin - chemical process

32
Q

how is sterile water made?

A

deionise then distil then sterilise

£££

33
Q

LDU

A

segregation of dirty and clean

linear flow

34
Q

decon life cycle of an instrument

A
(acquisition)
cleaning 
disinfection
inspection
(disposal)
packaging
sterilisation
transport
storage
use
transport
35
Q

disinfection

A

destruction of pathogenic and other MOs by physical or chemical means
less lethal than sterilisation
destroys most recognised pathogenic MOs, but not necessarily all microbial forms e.g. bacterial spores
doesn’t ensure margin of safety associated with sterilisation processes
90-95 degrees 12s

36
Q

sterilisation

A

use of a physical/chemical procedure to destroy all MOs inc a large number of resistant bacterial spores

37
Q

why disinfect if going to sterilise?

A

makes load and machine safe for operator

adds reassurance for safety of pt

38
Q

inspection

A

visual (lit magnifier) vs protein residue detection

  • assurance
  • FMIs
39
Q

to be “sterile”

A

theoretical probability of a viable MO after successful validated sterilisation ≤1 in a million
process to render reusable medical devices free from viable MOs

40
Q

when are prions removed?

A

wash stage (not sterilisation)

41
Q

advantages of using steam

A
rapid heating
rapid penetration of load
rapid destruction of MOs inc bacterial spores
no toxic residues - no chemicals used
low cost
easily controlled and monitored
42
Q

contamination with residual tissue, body fluids, oil or other deposits

A

prevent contact between steam and surfaces
might become fixed to items and be difficult to remove
might contaminate water in steriliser and encourage bacterial growth
could cause adverse effects in pts

43
Q

dangers of steam

A

steam takes up much more vol than water - high pressure
to prevent explosion need a device to relieve the pressure
- pressure control valve - lifts at set pressure

44
Q

WD detergent

A

neutral ph7 enzyme detergent

45
Q

what is sterilisation?

A

exposing medical devices to conditions that are not detrimental to the device but which are lethal to MOs on device
a result of direct contact of medical devices with saturated steam in absence of air
need clean and dry prior

46
Q

air in steriliser

A

can prevent attainment of temp and contact of load items with steam

47
Q

what are steam sterilisers?

A

pressure vessels that generate and maintain steam under pressure

48
Q

steam sterilisers legislation

A

Pressure Systems Safety Regulations 2000

49
Q

can you reprocess single use items?

A

no

50
Q

policy

A

overall statement of intent/set of rules/requirements to be followed to achieve a given process/outcome

51
Q

procedure

A

guidelines of major methods to be used to meet the policies as defined by the company/practice
tells you who does what and when

52
Q

work instructions

A

specific steps needed to carry out the procedures

- tells you how to do something