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Cleaning and Disinfection Flashcards

1
Q

What is bioburden?

A

The measure of the total number of viable micro-organisms (total microbial count)

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2
Q

Describe potentially pathogenic organisms which may make up part of the bioburden

A
  • BBV (HIV, Hep B, Hep C)
  • VCJD (prions)
  • Bacterial infections (MRSA)
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3
Q

Name 4 ways to mitigate risk

A
  1. Reduce
  2. Transfer
  3. Accept
  4. Avoid
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4
Q

Describe 3 levels of risk for the Spaulding classification

A
  1. Critical
  2. Semi-critical
  3. Non-critical
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5
Q

What is a critical level of risk according to Spaulding?

A

Entry or penetration into sterile tissue, cavity or bloodstream

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6
Q

What is a semi-critical level of risk according to Spaulding?

A

Contact with intact non-sterile mucosa or non-intact skin

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7
Q

What is a non-critical level of risk according to Spaulding?

A

Contact with intact skin

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8
Q

What is the processing required for a critical level of risk according to Spaulding?

A

Sterility required

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9
Q

What is the processing required for a semi-critical level of risk according to Spaulding?

A

Sterilisation preferred where possible but if not, high-level chemical disinfection required

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10
Q

What is the processing required for a non-critical level of risk according to Spaulding?

A

Clean as necessary with detergent and water

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11
Q

Name 3 examples of critical levels of risk

A
  1. Surgical instruments
  2. Extraction forceps
  3. Surgical dental burs
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12
Q

Name 2 examples of semi-critical levels of risk

A
  1. Dental mirror in mouth

2. Wards carver

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13
Q

Name 2 examples of non-critical levels of risk

A
  1. Blood pressure cuff

2. Dental chair

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14
Q

What is the function of high level disinfection?

A

Kill all microorganisms except high numbers of bacterial spores

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15
Q

Name 3 liquid chemical sterilizing agents

A
  1. Aldehydes
  2. Hydrogen peroxide
  3. Peracetic acid
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16
Q

Describe instrument decontamination in NI

A
  • Thermal disinfection in washer disinfector

- Involves exposing all surfaces of the load to water heated between 80 and 95 degrees C for required holding time

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17
Q

What regulations govern decontamination in primary care dental practices?

A

HTM 01-05 (Pel 13 13)

18
Q

Give a summary of the requirements in Pel 13 13

A
  • Separate decontamination room
  • Evidence of correct workflow
  • Automated cleaning
  • Correctly applied processes
  • Training of staff and defined roles
  • Testing of equipment
19
Q

What 5 things should be periodically checked to ensure compliance with Pel 13 13?

A
  1. Facilities
  2. Process
  3. Training
  4. Equipment validation etc
  5. Quality management
20
Q

What is the manager with regards to Pel 13 13?

A

Person ultimately accountable for operation of LDU, usually practice principal partner

21
Q

Name 6 defined roles with regards to LDU (2 of which the manager appoints)

A
  1. User*
  2. Decontamination lead
  3. Operator*
  4. Authorising engineer
  5. Microbiologist
  6. Control of Infection offer
22
Q

What is the role of the user?

A
  • Person responsible for the day to day management of the decontamination equipment
23
Q

Name 4 main responsibilities of the user

A
  1. Certify sterilizers fit for use
  2. Hold all documentation relating to decontamination equipment
  3. Ensure periodic testing / maintenance / records retained
  4. Appoint and ensure training of operators
24
Q

What is the role of the operator in the LDU?

A

This is the person with the authority to operate decontamination equipment

25
Name 5 main duties of the operator
1. Daily and weekly tests washer disinfector / sterilizers 2. House keeping duties 3. Segregation and safe disposal of single use items 4. Manual cleaning of reusable devices 5. Safe use of all decontamination equipment
26
Describe a CDU
- Central decontamination unit - Governed by specific regulation and guidance - Processes for other users
27
Describe an LDU
- Local decontamination unit - Standards set by HTM01 05 (Pel 13 13) - Process only for use by the same entity
28
What are the components of LDU design?
- Dirty area set down, with dirty to clean workflow with clear segregation - Surfaces should be continuous and easily cleaned - Air movement should be from dirty to clean with external input - Separate hand washing facilities - PPE station - Clean area for storage and administration
29
Name 5 examples of single use items
1. PPE 2. Matrix bands 3. Endodontic files 4. Steel burs 5. Single use diamond burs
30
Describe how instruments should be moved from surgery to LDU
- Safety lockable lidded boxes - Clean and dirty zones - Position in the surgery - Technique for moving
31
What is stage 1 decontamination?
Cleaning
32
What are the functions of cleaning during decontamination?
- Greatly reduces bioburden on device - Removes organic contaminants which could provide protection for microbes during sterilisation - Essential to maximise chances of item finishing sterilized
33
Give 4 reasons why enzymatic enzyme detergents are best suited for dental instruments
1. Remove proteinaceous bioburden 2. Dissolve mineral encrustation 3. Remove stains 4. Allows lower temperatures and shorter periods of mechanical cleaning to be employed
34
Describe how cleaning is physically carried out
- May be manual or automated - Manual no longer acceptable routinely but may be used as backup - Automated is washer disinfector
35
Describe how manual cleaning is carried out
- Specific detergent with specific volume of <45 degree water - PPE used - Wash below the water line to avoid aerosol - Long handled nylon bristle brush - Keep kits together and be aware of Sharps - Rinse in separate sink with RO water
36
What is stage 2 decontamination?
Disinfection
37
Name 3 types of disinfection
1. High 2. Intermediate 3. Low
38
What is the biggest difference between disinfection and sterilization?
Lack of sporicidal power
39
What are 5 parts of the cycle within a washer-disinfector?
Cleaning - Cold rinse to prevent coagulation, rinse to encourage germination and kill off at higher temps Detergent - Antiprotein low temp, antilipid high temps Rinse - High water flow Disinfection - Inactivation of viruses >90 degrees Drying
40
Name 2 items in particular which may be problematic for washer disinfectors
1. Burs | 2. Handpiece (lumen)
41
Name 3 things to inspect when checking if washer disinfectors have worked properly
1. Clean from visible debris 2. Functional 3. Good repair / No rust areas
42
Describe wrapping before sterilisation
- Clean hands or gloves - Specific sterilisation bags with exp date - Instruments should not touch in the package - Ensure sealed across opening and place in rack ready for sterilisation

Conservation (27 decks)

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