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Past MSAs > Decon > Flashcards

Decon Flashcards

1
Q

You see two nurses getting off bus in uniform. What would you bring up with them?

A

Appropriate infection control
professionalism
maintaining pts confidence
reputation of practice and profession

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2
Q

What would you include in a learning session on PPE?

A 
ppe needs to be worn
- during procedures
- during cleaning
- during decontamination - eyes, hands, clothes
 needs to be changed between pts
correct disposal after usage and soiling
patient ppe - eyes, clothes
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3
Q

how can you check staff are adhering to ppe regulations?

A

clinical audit

regular inspections by supervisor

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4
Q

4 reasons why you should manually clean before disinfection and sterilisation

A
  • removal of gross debris - as could inhibit sterilisation process
    • removal of restorative materials, e.g prophy paste and gic - as makes more difficult to clean on subsequent occasions or can affect function
    • could contaminate biospy devices- causing mis-diagnosis
    • required by law under Medical Devices Directive
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5
Q

Name and describe the classification of the types of instruments?

A

A critical instrument will be in contact with the blood stream. Therefore it must be sterile.
A semi-critical instrument are in contact with intact mucous membranes. Therefore sterile is preferable, or a
high level disinfectant.
A non-critical instrument are in contact with intact skin. These should be disinfected or cleaned

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6
Q

how does classification of instuments affect steriliser use?

A

A critical device must be sterile at the point of use. This requires sterile packaging, therefore a B or S type
steam steriliser.

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7
Q

4 main critical control points in life of instrument?

A
  • Acquisition of the reusable device
  • Cleaning
  • Inspection
  • Sterilisation
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8
Q

what characterises a LDU

A
  • Sterilises singly wrapped or unwrapped items
  • Processed items are not transported out the building or off-site
  • Under the control of one or more clinicians who use the reprocessed devices
  • Does not supply a third party
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9
Q

4 main elements of cleaning

A
  • Chemicals - detergent
  • Temperature - should not exceed 55 degrees- as coagulates proteins
  • Energy - brushing, ultrasonic energy or water jets
  • Time - as much needed to clean protein strip
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10
Q

What kind of water should be used for cleaning? why?

A

RO - reverse osmosis

Reverse osmosis as is demineralised so will not leave residue on instruments, the only water that can provide enough volume in a short time

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11
Q

What can you use to dry instruments?

A

dry non-linting disposable wipes/cloths

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12
Q

ppe used for decontamination

A

waterproof apron
face mask
rubber gloves
visor/ goggles

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13
Q

what should be near a manual cleaning station

A

first aid kit

eye wash bottle

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14
Q

washer disinfector cycle?

A
  • Pre-wash (Flushing) - cold water, remove gross debris
  • Wash
  • Rinse
  • Disinfecting
  • Drying
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15
Q

classification of sterile?

A

there must be less than 1 in a million remaining viable micoorganisms

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16
Q

what can sterilisers not kill?

A

prions

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17
Q

standard time and temp for sterilisation?

A

134-137o
for a minimum of three
minutes holding time

18
Q

result of not fully cleaning device before sterilisation?

A

It prevents steam coming into contact with the load
• The deposits may become fixed and difficult to remove
• It might contaminate the water in the steriliser encouraging bacterial growth
• Could cause adverse reactions in patients

19
Q

what steriliser type(s) can produce sterile instruments?

A

B and S
- as can process wrapped instruments

Instruments processed unwrapped by N are just known as sterilised. not sterile, as cannot maintain sterility.

20
Q

How do the steriliser types differ?

A

N - normal - passive air removal only. .:. cannot be used for anything wrapped or anything hollow

B - better - active air removal with vacuum. can take hollow, porous (dressings) and wrapped.

S - special - active forced air removal w/ vacuum. daily steam penetration test, periodic testing and maintenance required.

21
Q

how to test sterilisers are working properly?

A

Parametric Release process.

22
Q

Relevant legislation?

A

Consumer Protection Act

NHS (GDP) (Scotland) Regulations 2010

The Health and Safety at Work Act 1974

The Health and Safety at Work Regulations 1992

The Medical Devices Directive (93/42/EEC)

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 1995

Control of Substances Hazardous to Health (COSHH) 2002

23
Q

What is meant by Standards?

produced by?

A

A document established by a consensus and approved by a recognised body, that provides, for common and
repeated use, rules, guidelines or characteristics for activities and their results, aimed at the achievement of
the optimum degree of order in a given context.

These standards may be either:
• British Standard
• European Norm
• International Standards Organisation

BS EN ISO

standards in processing:
• Validation
• Quality system
• Controlled environment

24
Q

testing requirements in legislation of

A

SHTM 2030 part 3

• SHTM (Scottish Health Technical Memorandum

25
Q

washer disinfector testing should include:

A

• A visual display of cycle complete
• During the whole operational cycle the values of the cycle variables as indicated by the instruments
23
Decontamination
on the WD are within the limits established as satisfactory
• The disinfection temperature in the hold period are appropriate for disinfection and the time is too
• The door cannot be opened until the cycle is complete
• The person conducting the test does not observe any mechanical or other anomaly
• Record in the log book

26
Q

test for WD

test for sterilisers

A

wd: protein test strip

s: steam penetration test- bowie dick
+ air leakage test

27
Q

chemicals used to clean blood spill?

how long is this applied for

A

Sodium hypochlorite or sodium dichloroisocyanurate -> 10000ppm

3-5 minutes

28
Q

What are the different waste streams. e.g of what goes into each?

A 
Black: domestic waste ; 
Orange: low risk e.g PPE ; 
Sharps box: sharps ; 
Red hazardous: amalgam ; 
Yellow hazardous: teeth
29
Q

document required to be kept on waste disposal?

what needs to be written on it

A

Consignment note, 3 years.

Description, destination, quantity, origin and transport

30
Q

principles of waste disposal?

A
  1. Segregation
  2. Storage
  3. Disposal
  4. Document.
31
Q

chain of infection?

A 
Infectious agent, 
reservoir, 
portal of exit, 
mode of transmission, 
portal of entry, 
susceptible host.
32
Q

sinner cycle?

A

time, temperature, chemical, energy

33
Q

name 10 sicps?

A
  1. Cough etiquette
  2. Hand hygiene
  3. Equipment management
  4. Waste disposal
  5. Fluid management
  6. Linen management
  7. Environmental control
  8. Sharps exposure
  9. PPE
  10. Pt placement.
34
Q

decontamination cycle?

A

Cleaning→ Disinfection→ Inspection→ (Disposal) → Packaging →Sterilisation →Transport → Storage → Use

35
Q

4 common reasons for fault with handpiece

A
  1. Air pressure 2. Incorrect bur 3. Incorrect use 4. Poor cleaning 5. Poor lubrication.
36
Q

Briefly describe manual washing

A

Use PPE (marigold gloves, gown, face mask, visor),
30-35°C water,
neutral enzymatic detergent (30ml/8L), pH7,
immersion or non-immersion as appropriate,
rinse w/RO water,
inspect w/lit magnification

37
Q

Briefly describe how ultrasonic works

A

Use ultrasound to create micro-bubbles which cause cavitation when they implode,
the energy released helps remove soil from the surface of the instrument,
de-gas to remove air,
20-400kHz,
neutral enzymatic detergent (25ml sachet)

38
Q

what maintenance and tests are carried out for WD?

A

Daily → wipe door seal, check spray arms, clean filter, automatic control test (ACT) with print out.

Weekly → ACT, Cleaning Efficacy Test (protein test strip), staple result into log book

Quarterly/Annually → by validated engineer

39
Q

maintenance and tests carried out for sterilisers?

A

Daily →wipe clean, change water, Automatic Control Test (ACT), Steam Penetration Test (Bowie-Dick or Helix)

Weekly → ACT, Steam Penetration Test, Vacuum Leak Test, Air Detector Function Test

40
Q

name 4 key decon personnel and their role?

A

Manager → responsible for LDU.
User → day-to-day running of LDU, maintains records, ensures tests and maintenance carried out.
Operator → uses equipment, simple housekeeping and maintenance
Authorising Engineer (Decon) → free NHS Scotland service, advises on validation, maintenance and testing.
Test Person → conduct and report on validation and periodic tests, must be qualified with >2yrs experience.
Maintenance Person → routine and requested maintenance, qualified.
Competent Person → responsible for pressure vessels

Past MSAs (23 decks)

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