BUMEDINST 6600.10, Dental Infection Control Program Flashcards
Each year, approximately how many health care workers become infected with the Hepatitis B virus (HBV)?
18,000
The CDC estimates that HBV infection in health care personnel actually results in some 600 hospitalizations and how many deaths annually?
200
Commanding officers and officers in charge must develop and implement universal protocols of infection control strategies to prevent transmission of HBV and other pathogens of what type?
Bloodborne pathogens
The ability of HBV to survive in the environment, coupled with its high titers in the blood, makes it an excellent model for which practices?
Infection control
COs and OICs must appoint who in writing to assist in implementing the infection control program?
Infection Control Office (ICO)
Infection control involves taking steps to prevent the spread of what?
Infectious agents
What is the process of preventing the access of micro-organisms?
Asepsis
The use of rubber, plastic, paper, foil, or other fluid resistant materials to cover surfaces and protect them from contamination is known as what technique?
Barrier technique
What is the number of micro-organisms contaminating an object and is sometimes also known as bioload or microbial load?
Bioburden
What is an unprocessed biological monitor from the same lot as the test monitor and when cultured serves as a control by verifying the viability of the unexposed organisms?
Biological control
What is a bacterial endospore test designed assess whether sterilization has actually occurred?
Biological monitor
What are pathogenic micro-organisms that are present in human blood and capable of causing disease in humans?
Bloodborne pathogens
What test is a diagnostic test of a prevacuum sterilizer’s ability to remove air from the chamber and prevent air reentrant?
Bowie-dick
What is the destruction of inhibition of most viruses and bacteria while in their active growth phase?
Chemical disinfection
What are chemical dyes used to determine whether the conditions required for sterilization are met?
Chemical indicators
The presence or reasonably expected presence of blood or other potentially infectious material on an item or surface is said to be what?
Contaminated
What is the propagation and growth of micro-organisms or living tissue cells in or on a nutrient medium?
Culture
Dental items are classified in one of three ways, based on the pathways through which cross contamination may occur and the location and technique of instrument use. They are what?
Critical
Semi-critical
Non-critical
What items are instruments, and materials that penetrate the skin, mucous membranes, or bone?
Critical
What items are instruments, equipment, or materials that frequently contact mucous membrane but cannot be sterilized due to their design or inability to withstand heat?
Semi-critical
What items are instruments, equipment, or materials that do not normally penetrate or contact mucous membranes but which are exposed to splatter, spray, or splashing of blood, or are touched by contaminated hands?
Non-critical
What are equipment or methods which isolate or remove bloodborne pathogens from the workplace?
Engineering controls
A surgical entry into the tissues, cavities, organs or repair of major traumatic injuries is what type of procedure?
Invasive
Bacteria, fungi, viruses, and bacterial spores are classified as what?
Micro-organisms
An infection originating in the environment of a hospital or freestanding dental treatment facility is a what?
Nosocomial infection
What is a process which uses steam heat under pressure for sufficient length of time to kill all forms of micro-organisms?
Saturated steam sterilization
What is an acceptable method of cleaning and disinfecting?
Spray-wipe-spray
The process which destroys all types and forms of micro-organisms is called what?
Sterilization
The quantity of materials or supplies required to treat a single patient is called what?
Unit dose
The ICO must ensure that infection control functions are addressed at least how often as part of the command quality assurance program?
Quarterly
The ICO must review and revise all infection control policies and procedures at least how often?
Annually
The ICO must include a briefing in the command orientation for all new employees and staff on infection control policies and infectious disease hazards in the workplace per what instruction?
BUMEDINST 6010.13
Who directs continuous review and upgrade of the sterilization and infection control syllabus at the Naval School of Dental Assisting and Technology (NSDAT) for the dental technician, basic “A” school?
BUMED
Commands must review and upgrade their staff and new employee orientation presentation as directed. As a minimum, all personnel will receive initial training within how many days of reporting onboard and at least annually thereafter?
90
All personnel assigned duties in sterilization areas or functioning as surgical assistants will receive additional documented training in sterilization and what other techniques?
Aseptic
Commands must document infection control training sessions with names of persons attending and conducting, dates, and a summary of the contents of the training and mush maintain these records for at least how many years?
3
Commands must use what, through the appropriate chain of command, to identify total resources required to meet the guidelines of this directive and those of OHSA and EPA?
PPBS
A period of up to how long often exists between the time a person becomes infected with a virus and the time when laboratory tests can detect the antigens or antibodies to it?
Several weeks
Approximately what percentage of patients with HIV or HBV show no symptoms and may be unaware of their infectious disease state?
80%
The same infection control practices must be used with all patients regardless if they show symptoms or not and this approach is known as what?
Universal precautions
Since what infection is presently the standard model for infection control practices and is more infectious than HIV, those established procedures known to prevent the spread of it serve as the basis for universal precautions?
HBV
Which instruction mandates that all active duty health care personnel receive HIV testing on an annual basis during each calendar year?
SECNAVINST 5300.30C
Since washing increases the porosity of gloves up to what percent, repeated use of a single pair of gloves is not permitted?
60%
What must have solid side shields to provide maximum protection?
Eyewear or goggles
What particles can remain airborne long after a procedure is completed, making it so staff and patients must not eat or drink in the DTRs?
Aerosol
At the beginning of each work day when preparing the DTR, flush each of the unit water lines and hoses for at least how long, beginning with the cup filler and cuspidor even if their use is not anticipated?
1 minute
When preparing the DTR after each patient, remove the handpiece, lubricate and run for how long?
30 seconds
Dental procedures usually generate aerosol particles that average how many microns in diameter?
1.3
When inhaled, particles less than how many microns in diameter can penetrate directly to the terminal bronchioles and alveoli of the lungs?
5
Having patients brush their teeth or rinse with a mouthwash before treatment reduces the microbial concentration of their oral flora. Three 10 second rinses will temporarily reduce a patient’s microbial count by up to what percent?
97%
Use of a chlorhexidine gluconate preoperative rinse of what percentage significantly decreases the infectivity of an aerosol?
0.12%
Using opened, properly decanted irrigation solutions is acceptable for up to how long when used for nonsurgical use?
1 week
Using opened, properly decanted irrigation solutions is acceptable for up to how long when used for surgical procedures?
1 day
Never recap a needle using a two-handed technique. Instead, use one of the commercially available sheath holders or what technique
Scoop technique
Sterilizable or disposable syringe tips are recommended. For nonsterilizable tips, flush water syringe for 30 seconds. Disinfect by wiping with a high-level disinfectant to clean, then wrap with disinfectant saturated gauze for how long?
10 minutes
Do not use 2 percent glutaraldehyde as a surface disinfectant because of what?
Caustic vapors
When securing a DTR at the end of the work day you must flush each unit water line and hose for how long?
30 seconds
To clean uncarpeted floors and other horizontal surfaces regularly and when spills occur use launderable mops with a detergent and an EPA-registered disinfectant or a detergent with sodium hypocholorite at what dilution?
1:100
Mops must not be used for more than how long without laundering?
1 day
Contaminated laundry may be laundered on-site if OSHA and CDC guidelines are followed. A wash cycle must be of at least 25 minutes duration with a water temperature of at least what?
160 degrees F
Infectous waste must be placed in closable, leak-proof containers or bags that are labeled as what?
Biohazard
What is one of the most important procedures in preventing the transfer of micro-organisms from one person to another?
Handwashing
The skin harbors two types of flora. What are they?
Resident
Transient
What can survive and multiply on the skin, can be cultured repeatedly from the skin, are usually of low virulence and are not easily removed?
Resident organisms
What do not survive and multiply on the skin and are not firmly attached?
Transient bacteria
The mere mechanical action of rubbing the hands together and rinsing them under running water is effective in removing what?
Transient bacteria
What are water soluble complexes of iodine with organic compounds which are effective against all gram positive and gram negative bacteria and viruses?
Iodophors
Chlorhexidine gluconate antiseptic is an effective antiseptic for reducing transient and resident microbial hand flora, has a sustained antimicrobial effect and does not appear to affect what adversely?
Skin
Seventy percent isopropyl alcohol also known as waterless handwashing agents virtually disinfects the skin in how long?
20 seconds
Personnel should empty, disassemble, and clean all refillable hand cleansing agents dispensers at what interval?
Weekly
What sterilization is preferable for all equipment and materials that can withstand high temperatures?
Heat
What is safer and more effective than manual scrubbing?
Ultrasonic cleaning
What is the most effective means of sterilization for almost all items used in dentistry?
Steam under pressure
Dry heat at temperatures above what will achieve sterilization?
320 degrees F
A typical dry heat cycle is how many minutes at 320-345 degrees F, plus the time required to bring the load up to sterilization temperature?
90
A mixture of alcohols, formaldehyde, water, and other chemicals heated under pressure forms a gas that can achieve sterilization, also known as what type of sterilization?
Chemical vapor
Chemical vapor sterilization requires 20 minutes at what temperature?
270 degrees F
Sterilization at relatively low temperatures is possible with what type of gas?
Ethylene oxide
Using a heated unit, ethylene oxide sterilization can be achieved in how long at 120 degrees F?
2-3 hours
COs should not purchase new ethylene oxide equipment, it may not survive in today’s dental health care environment because ethylene oxide is a serious problem of what sort?
OSHA problem
Who classifies chemical disinfectants that are sporicidal as disinfectant or sterilants?
EPA
As a minimum you should perform biological monitoring how often?
Weekly
Use dosage indicators inside and process indicators outside each what?
Instrument pack
What is a less lethal process than sterilization?
Disinfection
EPA classifies disinfectants as what, based on the contact time of the solution and the biocidal activity of an agent against bacterial spores, mycobacterium tuberculosis, lipid and non-lipid viruses, and vegetative bacteria?
High, intermediate, or low level
Glutaraldehyde-based solutions are classified as what level disinfectant or sterilant?
High-level
Iodophors are classified as what level disinfectants if the product label claims tuberculodical activity?
Intermediate-level
Chlorine dioxide-based solutions have limited use patterns because of their what?
Corrosiveness
All semi-critical category items require at least what level disinfection?
High-level
All non-critical category items require at least what level disinfection?
Intermediate-level
Infection control in prosthodontics and orthodontics is divided into two distinctly different areas, what are they?
DTR and the dental laboratory
You should soak reusable impression trays in an EPA-registered disinfectant for how long, scrub in soapy water, and seal in peel packs before autoclaving?
10 minutes
You should consider all prosthetic devices received contaminated and scrub them with a brush using a bacteriocidal soap. Store the brush in a glutaraldehyd solution of what percentage between uses?
2%
After scrubbing a prosthetic device, place the prosthesis in a container filled with an EPA-registered disinfectant such as an iodophor, chlorine dioxide, or a synthetic phenol compound. Place the container in an ultrasonic cleaner for how long?
10 minutes
It is extremely important to pay attention to infection control when taking what?
Radiographs
When disposable covers are not available, treat bite blocks as you would a what?
Film holding device
For an X-ray chair you should disinfect at least daily or when visibly contaminated using an EPA-registered disinfectant at what level?
Intermediate-level
