Decon Flashcards
Who is the ‘User’?
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
What does SHTM 01-01 part C cover?
Sterilisation by steam
What does SHTM 01-01 Part D cover?
Automated cleaning and disinfection equipment
What does SHTM 01-05 include?
Management, equipment and process of the decontamination of dental instruments in a Local Decontamination Unit (LDU) in NHS Scotland
What BS EN number does sterilising instrumentation have to refer to ?
BS EN 285
What BS EN number does Washer-Disinfector refer to?
BS EN 15883
What types of water are used for the production of steam for sterilisation processes?
Purified water
-Reverse osmosis
-De-ionised
-Distilled
-Sterile
Why is cleaning an important prerequisite before disinfection and sterilising?
Gets rid of gross debris
Removes restorative materials
Restore function
Aids disinfection
What are the 5 stages of the Washer-Disinfector?
Description of each.
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
Name 4 daily checks for a WD.
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)
List the chain of infection.
Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
What is in the Sinner Circle?
Time
Temperature
Chemical
Energy
What are the roles and responsibilities involved in the decontamination cycle?
Operator
User
Manager
Test person
Authorised engineer for all equipment testing
Maintenance person
Competent person (pressure vessels)
Quality
What is the ‘Operator’?
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)
What is the ‘Manager’?
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
What is a critical instrument?
A critical instrument will be in contact with the blood stream. Therefore, it must be sterile
What is a semi-critical instrument?
A semi-critical instrument are in contact with intact mucous membranes. Therefore sterile is preferable or a high level disinfectant
What is a non-critical instrument?
A non-critical instrument that in contact with intact skin. These should be disinfected or cleaned.
What are the critical control points in the life cycle of an instrument?
Acquisition of the reusable device
Cleaning
Inspection
Sterilisation
What should instrumentation be transported to the decontamination unit in?
A box that is rigid sided, leak proof with a tight-fitting lid and colour coded or clearly parked
What are the loading requirements for a Washer-Disinfector?
No instrumentation is overlapping or shadowing
Any assemblies are disassembled when washing
Any hinged instruments are open at the hinge
What are Standard Operating Procedures?
They are the way activity is standardised within the department to make it reproducible and consistent
What does inspection include?
Using an illuminated magnifier to check for any contamination on the surfaces of instruments
What do you use if the instruments fail inspection?
Ultrasonic bath
–forces exerted by the ultrasonic can be greater and get to hard to reach places
Then use the WD again
What must the temperature be and how long for in steam sterilisation?
134-137 degrees for 3 minutes
What does steam sterilisation aim to do?
Used to render product free from viable microorganisms
What is a guidance document?
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
What is a legislation document?
The statutory acts, directives and regulations released by the government to provide a legal framework for managing the facilities, equipment and process
What are the standards document?
Documents used to provide technical information about all aspects of the decontamination process and the materials and equipment used
What SHTM 01-05 relates to management?
Part A
What SHTM 01-05 relates to decontamination equipment, operation, validation, periodic testing, maintenance and test methods?
Part B
What SHTM 01-05 relates to process- guidance on decontamination processes, including elements applicable to the dental environment?
Part C
What SHTM 01-01 relates to management?
Part A
What SHTM 01-01 relates to testing equipment/methods?
Part B
What is a medical device?
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
What information must be collected from the first cycle of the day for a WD?
Date
Time Operator
Cycle number
Disinfection temperature
Daily tests performed
Detergent added
Disinfection successful
Machine identified cycle completed successfully
What information must be collected from the first cycle of the day for a steam steriliser?
Date
Time started
Operator
Cycle number
Sterilisation temperature
Daily tests performed
Bowie and dick successful
Sterilisation successful
Machine identified cycle completed successfully
How often do you carry out an automatic control test?
Weekly basis
What do you record for the ACT for a WD?
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
When should the handpiece be cleaned and how?
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
What are the top 5 causes of handpiece faults?
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
Why is lubrication essential for handpieces?
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
