3rd year key points

Question 1

WD loading requirements

Answer 1

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

Question 2

WD daily checks

Answer 2

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

Question 3

how should you rinse items?

Answer 3

below surface in a separate sink

Question 4

steriliser daily checks

Answer 4

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

Question 5

why should you manually wash below surface?

Answer 5

minimise contamination and aerosol production

Question 6

sinner circle

Answer 6

chemicals
time
temp
energy

Question 7

transport

Answer 7

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

Question 8

what water is used for rinsing?

Answer 8

RO

purified and easy to make in large quantities

Question 9

4 types of demineralised/purified water

Answer 9

sterile
distilled
deionised
RO

Question 10

cleaning

Answer 10

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”

Question 11

what does cleaning presuppose?

Answer 11

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

Question 12

corrosion

Answer 12

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

Question 13

non-immersion cleaning

Answer 13

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

Question 14

immersion cleaning

Answer 14

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

Question 15

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

Answer 15

start the whole process again

Question 16

what shouldn’t be processed in an US?

Answer 16

handpieces

Question 17

how do US machines work?

Answer 17

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

Question 18

why should you degass first?

Answer 18

air will inhibit cavitation

Question 19

water stages

Answer 19

manual wash
US
manual rinse
WD
steriliser

Question 20

cold mains water

Answer 20

manual washing
US
WD

Question 21

hot mains water

Answer 21

manual washing

WD

Question 22

what suspended particles do you need to remove?

Answer 22

hard particles
soft particles
colloidal (insoluble) particles

Question 23

water for manual washing

Answer 23

use as a solvent to dilute detergents

water v good as a wetting agent to break down soiling

Question 24

how do detergents work?

Answer 24

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

Question 25

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

Answer 25

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

Question 26

rinsing and water

Answer 26

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

Question 27

decon

Answer 27

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

Question 28

why use RO for final disinfection rinse?

Answer 28

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

Question 29

how is RO water made?

Answer 29

RO membrane under pressure

Question 30

how is distilled water made?

Answer 30

boiled - turns to steam | steam caught and condenses

Question 31

how is deionised water made?

Answer 31

ion exchange resin - chemical process

Question 32

how is sterile water made?

Answer 32

deionise then distil then sterilise | £££

Question 33

LDU

Answer 33

segregation of dirty and clean | linear flow

Question 34

decon life cycle of an instrument

Answer 34

``` (acquisition) cleaning disinfection inspection (disposal) packaging sterilisation transport storage use transport ```

Question 35

disinfection

Answer 35

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

Question 36

sterilisation

Answer 36

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

Question 37

why disinfect if going to sterilise?

Answer 37

makes load and machine safe for operator | adds reassurance for safety of pt

Question 38

inspection

Answer 38

visual (lit magnifier) vs protein residue detection - assurance - FMIs

Question 39

to be "sterile"

Answer 39

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

Question 40

when are prions removed?

Answer 40

wash stage (not sterilisation)

Question 41

advantages of using steam

Answer 41

``` 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 ```

Question 42

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

Answer 42

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

Question 43

dangers of steam

Answer 43

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

Question 44

WD detergent

Answer 44

neutral ph7 enzyme detergent

Question 45

what is sterilisation?

Answer 45

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

Question 46

air in steriliser

Answer 46

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

Question 47

what are steam sterilisers?

Answer 47

pressure vessels that generate and maintain steam under pressure

Question 48

steam sterilisers legislation

Answer 48

Pressure Systems Safety Regulations 2000

Question 49

can you reprocess single use items?

Answer 49

no

Question 50

policy

Answer 50

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

Question 51

procedure

Answer 51

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

Question 52

work instructions

Answer 52

specific steps needed to carry out the procedures | - tells you how to do something