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
Q

Name 5 main duties of the operator

A
  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
Q

Describe a CDU

A
  • Central decontamination unit
  • Governed by specific regulation and guidance
  • Processes for other users
27
Q

Describe an LDU

A
  • Local decontamination unit
  • Standards set by HTM01 05 (Pel 13 13)
  • Process only for use by the same entity
28
Q

What are the components of LDU design?

A
  • 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
Q

Name 5 examples of single use items

A
  1. PPE
  2. Matrix bands
  3. Endodontic files
  4. Steel burs
  5. Single use diamond burs
30
Q

Describe how instruments should be moved from surgery to LDU

A
  • Safety lockable lidded boxes
  • Clean and dirty zones
  • Position in the surgery
  • Technique for moving
31
Q

What is stage 1 decontamination?

A

Cleaning

32
Q

What are the functions of cleaning during decontamination?

A
  • 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
Q

Give 4 reasons why enzymatic enzyme detergents are best suited for dental instruments

A
  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
Q

Describe how cleaning is physically carried out

A
  • May be manual or automated
  • Manual no longer acceptable routinely but may be used as backup
  • Automated is washer disinfector
35
Q

Describe how manual cleaning is carried out

A
  • 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
Q

What is stage 2 decontamination?

A

Disinfection

37
Q

Name 3 types of disinfection

A
  1. High
  2. Intermediate
  3. Low
38
Q

What is the biggest difference between disinfection and sterilization?

A

Lack of sporicidal power

39
Q

What are 5 parts of the cycle within a washer-disinfector?

A

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
Q

Name 2 items in particular which may be problematic for washer disinfectors

A
  1. Burs

2. Handpiece (lumen)

41
Q

Name 3 things to inspect when checking if washer disinfectors have worked properly

A
  1. Clean from visible debris
  2. Functional
  3. Good repair / No rust areas
42
Q

Describe wrapping before sterilisation

A
  • 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