Decon Flashcards
You see two nurses getting off bus in uniform. What would you bring up with them?
Appropriate infection control
professionalism
maintaining pts confidence
reputation of practice and profession
What would you include in a learning session on PPE?
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
how can you check staff are adhering to ppe regulations?
clinical audit
regular inspections by supervisor
4 reasons why you should manually clean before disinfection and sterilisation
- 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
Name and describe the classification of the types of instruments?
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
how does classification of instuments affect steriliser use?
A critical device must be sterile at the point of use. This requires sterile packaging, therefore a B or S type
steam steriliser.
4 main critical control points in life of instrument?
- Acquisition of the reusable device
- Cleaning
- Inspection
- Sterilisation
what characterises a LDU
- 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
4 main elements of cleaning
- 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
What kind of water should be used for cleaning? why?
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
What can you use to dry instruments?
dry non-linting disposable wipes/cloths
ppe used for decontamination
waterproof apron
face mask
rubber gloves
visor/ goggles
what should be near a manual cleaning station
first aid kit
eye wash bottle
washer disinfector cycle?
- Pre-wash (Flushing) - cold water, remove gross debris
- Wash
- Rinse
- Disinfecting
- Drying
classification of sterile?
there must be less than 1 in a million remaining viable micoorganisms
what can sterilisers not kill?
prions
standard time and temp for sterilisation?
134-137o
for a minimum of three
minutes holding time
result of not fully cleaning device before sterilisation?
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
what steriliser type(s) can produce sterile instruments?
B and S
- as can process wrapped instruments
Instruments processed unwrapped by N are just known as sterilised. not sterile, as cannot maintain sterility.
How do the steriliser types differ?
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.
how to test sterilisers are working properly?
Parametric Release process.
Relevant legislation?
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
What is meant by Standards?
produced by?
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
testing requirements in legislation of
SHTM 2030 part 3
• SHTM (Scottish Health Technical Memorandum
washer disinfector testing should include:
• A visual display of cycle complete
• During the whole operational cycle the values of the cycle variables as indicated by the instruments
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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
test for WD
test for sterilisers
wd: protein test strip
s: steam penetration test- bowie dick
+ air leakage test
chemicals used to clean blood spill?
how long is this applied for
Sodium hypochlorite or sodium dichloroisocyanurate -> 10000ppm
3-5 minutes
What are the different waste streams. e.g of what goes into each?
Black: domestic waste ; Orange: low risk e.g PPE ; Sharps box: sharps ; Red hazardous: amalgam ; Yellow hazardous: teeth
document required to be kept on waste disposal?
what needs to be written on it
Consignment note, 3 years.
Description, destination, quantity, origin and transport
principles of waste disposal?
- Segregation
- Storage
- Disposal
- Document.
chain of infection?
Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host.
sinner cycle?
time, temperature, chemical, energy
name 10 sicps?
- Cough etiquette
- Hand hygiene
- Equipment management
- Waste disposal
- Fluid management
- Linen management
- Environmental control
- Sharps exposure
- PPE
- Pt placement.
decontamination cycle?
Cleaning→ Disinfection→ Inspection→ (Disposal) → Packaging →Sterilisation →Transport → Storage → Use
4 common reasons for fault with handpiece
- Air pressure 2. Incorrect bur 3. Incorrect use 4. Poor cleaning 5. Poor lubrication.
Briefly describe manual washing
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
Briefly describe how ultrasonic works
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)
what maintenance and tests are carried out for WD?
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
maintenance and tests carried out for sterilisers?
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
name 4 key decon personnel and their role?
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
