Decon

Question 1

Who is the ‘User’?

Answer 1

The user is defined as the person designated by the executive manager to be responsible for the management of the process
The user is also responsible for the operators for the management of the process.
In primary care, the user could be a general practitioner, dentist, senior, dental nurse or other health professional

Question 2

What does SHTM 01-01 part C cover?

Answer 2

Sterilisation by steam

Question 3

What does SHTM 01-01 Part D cover?

Answer 3

Automated cleaning and disinfection equipment

Question 4

What does SHTM 01-05 include?

Answer 4

Management, equipment and process of the decontamination of dental instruments in a Local Decontamination Unit (LDU) in NHS Scotland

Question 5

What BS EN number does sterilising instrumentation have to refer to ?

Answer 5

BS EN 285

Question 6

What BS EN number does Washer-Disinfector refer to?

Answer 6

BS EN 15883

Question 7

What types of water are used for the production of steam for sterilisation processes?

Answer 7

Purified water
-Reverse osmosis
-De-ionised
-Distilled
-Sterile

Question 8

Why is cleaning an important prerequisite before disinfection and sterilising?

Answer 8

Gets rid of gross debris
Removes restorative materials
Restore function
Aids disinfection

Question 9

What are the 5 stages of the Washer-Disinfector?
Description of each.

Answer 9

Flush/prewash
–this stage saturates the contamination and removes gross contamination (large parts of biological matter removed) <35 degrees
Main Wash
–this stage is supplemented by detergent to more effectively remove biological matter
Rinse
–this stage removes any remaining residue, biological or chemical before disinfection <65 degrees
Thermal Disinfection
–kills microorganisms with the use of heated water
–90-95 degrees for a minimum 1 minute
Drying
–stage uses hot air to remove any remaining moisture from the surface of the instruments

Question 10

Name 4 daily checks for a WD.

Answer 10

Check that the spray arms spin freely without obstruction
Check that the spray jets (on the spray arms) are not blocked
Make sure there is no debris on the strainer/filter and that there are no parts of instruments or any potential blockage’s
Check the condition of the door seal and wipe and clean if necessary
Verify there is a suitable amount of chemical in the reservoir
Record the disinfection temperature of the first cycle every day (ACT- automated control test)

Question 11

List the chain of infection.

Answer 11

Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host

Question 12

What is in the Sinner Circle?

Answer 12

Time
Temperature
Chemical
Energy

Question 13

What are the roles and responsibilities involved in the decontamination cycle?

Answer 13

Operator
User
Manager
Test person
Authorised engineer for all equipment testing
Maintenance person
Competent person (pressure vessels)
Quality

Question 14

What is the ‘Operator’?

Answer 14

This is the person with the authority to operate decontamination equipment. This includes noting readings from instruments, replenishing detergents and simple housekeeping duties (ensuring equipment is cleaned and ready to be used)

Question 15

What is the ‘Manager’?

Answer 15

The person ultimately responsible for producing sterile instruments. They are defined as the owner, employer, general manager, chief executive or other person who is accountable for the sole operation of the premises.
They will assign the roles of user and operator

Question 16

What is a critical instrument?

Answer 16

A critical instrument will be in contact with the blood stream. Therefore, it must be sterile

Question 17

What is a semi-critical instrument?

Answer 17

A semi-critical instrument are in contact with intact mucous membranes. Therefore sterile is preferable or a high level disinfectant

Question 18

What is a non-critical instrument?

Answer 18

A non-critical instrument that in contact with intact skin. These should be disinfected or cleaned.

Question 19

What are the critical control points in the life cycle of an instrument?

Answer 19

Acquisition of the reusable device
Cleaning
Inspection
Sterilisation

Question 20

What should instrumentation be transported to the decontamination unit in?

Answer 20

A box that is rigid sided, leak proof with a tight-fitting lid and colour coded or clearly parked

Question 21

What are the loading requirements for a Washer-Disinfector?

Answer 21

No instrumentation is overlapping or shadowing
Any assemblies are disassembled when washing
Any hinged instruments are open at the hinge

Question 22

What are Standard Operating Procedures?

Answer 22

They are the way activity is standardised within the department to make it reproducible and consistent

Question 23

What does inspection include?

Answer 23

Using an illuminated magnifier to check for any contamination on the surfaces of instruments

Question 24

What do you use if the instruments fail inspection?

Answer 24

Ultrasonic bath
–forces exerted by the ultrasonic can be greater and get to hard to reach places
Then use the WD again

Question 25

What must the temperature be and how long for in steam sterilisation?

Answer 25

134-137 degrees for 3 minutes

Question 26

What does steam sterilisation aim to do?

Answer 26

Used to render product free from viable microorganisms

Question 27

What is a guidance document?

Answer 27

Documents used to provide a structure or frame-work that can be followed and implemented in practice. Providing numerous templates and information on standardised processes

Question 28

What is a legislation document?

Answer 28

The statutory acts, directives and regulations released by the government to provide a legal framework for managing the facilities, equipment and process

Question 29

What are the standards document?

Answer 29

Documents used to provide technical information about all aspects of the decontamination process and the materials and equipment used

Question 30

What SHTM 01-05 relates to management?

Answer 30

Part A

Question 31

What SHTM 01-05 relates to decontamination equipment, operation, validation, periodic testing, maintenance and test methods?

Answer 31

Part B

Question 32

What SHTM 01-05 relates to process- guidance on decontamination processes, including elements applicable to the dental environment?

Answer 32

Part C

Question 33

What SHTM 01-01 relates to management?

Answer 33

Part A

Question 34

What SHTM 01-01 relates to testing equipment/methods?

Answer 34

Part B

Question 35

What is a medical device?

Answer 35

The description covers any of the instrumentation used for carrying out procedures on humans and also covers any of the equipment that we use to re-process this instrumentation, even down to the software that is used to operate and control equipment

Question 36

What information must be collected from the first cycle of the day for a WD?

Answer 36

Date Time Operator Cycle number Disinfection temperature Daily tests performed Detergent added Disinfection successful Machine identified cycle completed successfully

Question 37

What information must be collected from the first cycle of the day for a steam steriliser?

Answer 37

Date Time started Operator Cycle number Sterilisation temperature Daily tests performed Bowie and dick successful Sterilisation successful Machine identified cycle completed successfully

Question 38

How often do you carry out an automatic control test?

Answer 38

Weekly basis

Question 39

What do you record for the ACT for a WD?

Answer 39

Temperature of each stage The time each stage is active for Disinfection start and end for stage duration Volume of chemical closed Cycle time overall

Question 40

When should the handpiece be cleaned and how?

Answer 40

After every patient use, cleaning should take place Manual cleaning is the first step The cleaning cycle should be carried out in a washer disinfector that meets requirements Handpiece should be lubricated after wash and before sterilisation A steriliser with vacuum capability is necessary for adequate air removal Ultrasonic baths are never used Manufacturers instructions should always be taken into account

Question 41

What are the top 5 causes of handpiece faults?

Answer 41

Incorrect or inadequate lubrication Poor or inadequate cleaning, including incorrect positioning Incorrect instrument usage Damaged or oversized bur fitting Incorrect compressor settings and lack of maintenance

Question 42

Why is lubrication essential for handpieces?

Answer 42

Cleans and flushes the spray air channels --prevents build up of scale --keeps the fine spray nozzles free from build up Automatic oil dispensing system --guarantee optimum lubrication --no excess oil