Cleanliness champions/Decon/CPD/GDC Flashcards
You are working at a dental practice as a dentist, you arrived exceptionally early and saw 2 nurses getting off the bus in their uniforms.
Name 2 concerns you would raise with the nurses?
Infection control – wearing uniform out-with the practice
Practice and profession reputation as the nurses have uniform that shows where they work
Name 6 key learning outcomes from a learning session on PPE?
Always wear PPE when carrying out procedures
Wear fresh PPE when cleaning
Change PPE between patients and cleaning
Correct disposal of PPE in orange stream waste Protection of hands, eyes, clothing with PPE Protect the patient with glasses and apron
How would you ensure staff follow instructions on PPE?
Clinical audits
Regular inspections Reflections
Decontamination
Why do we need to do manual cleaning (4 examples)
To remove gross contamination
Contamination with deposits prevents direct contact between the steam and surfaces of the instruments that is necessary for effective sterilisation
To remove organic material
- Any material left on instruments may become fixed during sterilisation and be more difficult to remove later and they can encourage growth of microorganisms.
Remove restorative materials Aid Disinfection and sterilisation Mexico-legal requirement Restore function
Why do we need to test the washer disinfector/steriliser?
To ensure it is working correctly and to its optimum
Testing ensures validity of the machine and warranty
Testing helps detect procedural errors and equipment malfunctions
Chemical indicators verify that sterilising agent has penetrated the package and reached the instruments inside.
Describe the 5 steps of the washer disinfector
- Pre-wash/flush
<45oC to remove gross contamination- Washing
Physical force of water, chemical action of detergents, thermal heat which activates and facilitates action of detergent to remove any
remaining soil - Rinsing
4. DisinfectingTemperature only with holding time 1-10minutes
5. Drying
Circulation air heated to 90oC for 20 minutes to clear chamber of remaining moisture - Washing
Decontamination
What are the differences between type B and type N sterilisers?
- Type N (non-vacuum):Cycle intended for sterilisation of non-wrapped solid products such as small metallic items that aren’t lumened.
Air is displaced passively from the chamber and load by gravity displacement, as steam is generated within the chamber.
Items aren’t wrapped and should be used immediately after processing and not stored-Type B (vacuum):Cycle intended for sterilisation of wrapped solid, hallow and porous productsVacuum pump actively removes air from the chamber and load.Products are vacuumed packaged and are sterile at point of use and can be stored before use.
Decontamination
Name 4 key personnel involved in the decontamination process and give a description of each of their roles
Decontamination user:
Person responsible for the day-to-day management of the steriliser (dental practitioner, senior nurse, recycle manger)
They maintain records, ensure tests and maintenance are carried out.
Operator:
Trained in the operation of all equipment and practices, simple housekeeping and maintenance
Manager: Person who is ultimately responsible for decontamination Generally the practice owner
Authorising engineers:
Provide expert advice and perform independent audits quarterly and annually, advises validation, maintenance and testing ‘
Test person:
Conducts and reports on validation and periodic tests, must be qualified >2year experience
Maintenance person: Routine and requested maintenance, qualified personnel.
What type of water is used for the final rinse cycle and why use this as opposed to mains water?
Demineralised water – reverse osmosis water; distilled water sterile water for irrigation or deionised water
SHTM 2010 states that we need to use clean steam for sterilisation which rules out the use of mains water as it contains organic and mineral compounds.
Demineralised water types do not contain bacterial endotoxins which means it is safe for humans and there will be no mineral deposits present which reduces the formation of limescale on the instruments and cleaner.
As a member of the dental profession, CPD is one of the standards of practice
What is CPD?
Continuing professional development:
It refers to the process of tracking and documenting the skills, knowledge and experience that you gain both formally and informally throughout your career, beyond any initial training to advance your professional development.
It is a requirement by the GDC that a registered member must adhere to specific CPD training every 5 years to stay registered.
CPD supports dentists and dental care professionals in maintaining and updating their skills, knowledge and behaviour throughout their working life, contributing to delivery of good quality care and service provision, that patients and the public trust if sage and the best it can be.
How many hours of CPD are to be done in a 5 year cycle and how many are to be verifiable?
At least 250 hours of CPD every 5 years
75 hours must be verifiable CPD
Give 3 suggested CPD topics and the hours per cycle
Medical emergencies – atleast 10 hours in every CPD cycle; 2 hours per year
Disinfection and decontamination – atleast 5 hours every CPD cycle Radiography and radiation protection – atleast 5 hours every CPD cycle
What are the 7 components of clinical governance?
Clinical effectiveness and research
Audit Risk management Education and training Service user, carer and public involvement Clinical information and IT Staffing and staff management
What are the 6 dimensions of healthcare quality?
Safe – avoiding harm to patients from the dare that is intended to help them
Effective – providing services based on scientific knowledge to all who could
benefit and reframing from providing services to those not likely to benefit
Patient centred – providing care that is respectful of and responsive to individual patient preferences, needs and values Timely – reducing waits and delays for both those who receive and those who give care Efficient – avoiding waste, equipment, supplies, ideas and energy Equitable – providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, location and socioeconomic status.
Give 6 members of the dental team that have to be registered with the GDC
Dentists
Dental nurses
Dental hygienists
Dental therapist
Orthodontic therapists Dental technicians Clinical dental technicians
What is a clinical audit, what is it for?
It is a quality improvement process that seeks to improve patient care and outcome through systematic review of care against explicit criteria and the
implantation of change
It is used to observe gaps in knowledge, learning, attitudes, protocols and training.
What is the audit cycle?
Identify problem or issue
Set criteria and standards
Observe practice/data collection
Compare performance with criteria and standards
Implementing change
What are the stages of significant event analysis (SEA)?
Step 1 – identify significant event
Step 2 – collect and collate as much information as possible relating to the event Step 3 – convene a meeting – non-threatening, no blame – educational focus Step 4 – undertake a structured analysis Step 5 – monitor progress of all actions agreed upon Step 6 – write up event analysis Step 7 – seek educational feedback – peer review
Cleanliness champions
List stages in the chain of infection
Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Name and concentration of chlorine releasing agent(s)
Sodium hypochlorite (Actichlor) 10,000ppm
Sodium DiChloroisocyanurate 10,000ppm
How long is the agent left for?
5 minutes
Give waste streams and an example for each?
Black – domestic waste
Orange low risk – PPE
Yellow hazardous – teeth, sharps, needles
Red hazardous – amalgam
Brown confidential – confidential documents
Tooth with extracted amalgam what stream does it go into
Red stream special hazardous waste labelled amalgam
What are the principles of waste disposal?
Segregation
Storage
Disposal
Document
What do you legally need to keep and for how long?
Description of waste
Quantity of waste Destination of waste Origin of waste Transport of waste
Clinical governance
What is clinical governance?
It is a systematic approach to maintain hand improving patient care in the health system.
What are the dimensions of healthcare quality?
Safe – avoiding harm to patients from the dare that is intended to help them
Effective – providing services based on scientific knowledge to all who could benefit and reframing from providing services to those not likely to benefit Patient centred – providing care that is respectful of and responsive to individual patient preferences, needs and values Timely – reducing waits and delays for both those who receive and those who give care Efficient – avoiding waste, equipment, supplies, ideas and energy Equitable – providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, location and socioeconomic status.
What are the components of clinical governance?
Clinical effectiveness and research
Audit
Risk management
Education and training
Service user, carer and public involvement o Clinical information and IT
Staffing and staff management
What are the 3 divisions of NHS Scotland dental services?
Primary care – general dental practices
Public dental services – community services
Secondary care – hospital services
List the 9 GDC standards for dental professionals
o Put patient’s interests first
o Communicate effectively with patients o Obtain valid consent
o Maintain and protect patients information
o Have a clear and effective complaints procedure
o Work with colleagues in a way that is in patients best interests
o Maintain, develop, and work within your professional knowledge and skills
o Raise concerns if patients are at risk
o Make sure your personal behaviour maintains patients confidence in you and the dental profession
Chain of infections
List the sinner circle
Time
Temperature
Chemical
Energy/mechanics
Name the 10 SiCPs
Patient placement
Hand hygiene
Respiratory and cough etiquette Personal protective equipment Safe management of care equipment Safe management of care environment Safe management of linen Safe management of blood and body fluid spillages Safe disposal of waste (including sharps) Occupational safety – prevention and exposure management including sharps
