Decon Questions / GDC/ Cleanliness champions Flashcards
1
Q
Why do we need to do manual cleaning? (6)
A
- To remove gross contamination
- To remove organic material
- Remove restorative material
- Aid disinfection and sterilisation
- Medico-legal requirement
- Restore function of instrument
2
Q
Why do we need to remove gross contamination prior to sterilisation?
A
Because it can prevent direct contact between the instrument and steam during sterilisation
3
Q
Why do we need to remove organic material prior to sterilisation?
A
- May be fixed to the instrument during sterilisation
- May be difficult to remove later
- May encourage the growth of micro-organisms
4
Q
Why do we need to test the washer-disinfector / steriliser?
A
- To ensure it is working correctly and optimally
- Ensure machine’s warranty and validation
- Help detect procedural errors
- Chemical indicators ensure that sterilising agent has penetrated the package and reached the instruments inside
5
Q
Describe the 5 steps of the washer disinfector?
A
Pre-wash - 30-35 degrees to remove gross contamination
** Washing** - Physical force of water, chemical action of detergents, thermal heat to remove any remaining soil
Rinsing - removal of cleansing agents
Disinfecting - 90-95 degrees for 1 minute ,
Drying - hot air circulation to clear chamber from remaining moisture (15 mins - 103 degrees)
6
Q
What is the difference between Type N and Type B sterilisers?
A
** Type N (non-vacuum) **
* Sterilisation of non wrapped solid products such as small metallic items that are not lumened
* Air displaced passively from the chamber and load by gravity displacement, as steam is generated within the chamber
* Items are not wrapped and should be used immediately after processing and cannot be stored
** Type B (vacuum) **
* For sterilisation of wrapped hollow or porous solid products
* Vacuum pump actively removes air from the chamber and load
* Products are vacuumed packaged and can be stored after the process
7
Q
Where can instruments be stored after ?
A
An area that is
* free of dirt and contamination
* free of moisture
8
Q
Sterilisation holding time
A
3 mins
9
Q
sterilisation temperature
A
134-137
10
Q
Who is the decontamination user?
A
- Person responsible for the day-to-day management of the sterilisers
- Maintain records and ensure day to day tests and maintenance are carried out
- Can be dentist, senior nurse, recycle manager
11
Q
Who is the operator?
A
- trained in the operation of all equipment and practices
- Responsible for simple housekeeping and maintenance
12
Q
Who is the Manager?
A
- The practice owner
- Who is ultimately responsible for decontamination
13
Q
Who is the Authorising engingeer?
A
- Provide expert advice and perform independent audits quarterly and annually
*Advises validation, maintenance and testing
14
Q
Who is the test person?
A
- Conducts and reports in validation and periodic tests
- must be qualified for over 2 years
15
Q
Who is the maintenance person
A
A qualified person who carries out requested and routine maintenance
16
Q
What type of water is used in the final rinse cycle and why use this as opposed to main water?
A
Deminarlised such as
* Reverse osmosis
* Distilled
* Sterile
* Deionised
** because they are safe as they do not contain bacterial endotoxins and they will not leave mineral deposits which will reduce the formation of limescale **
17
Q
What does CPD stand for?
A
- Continued professional development
18
Q
What is CPD ?
A
The process of tracking and documenting the skills, knowledge and experience that you gain throughout your professional career
19
Q
How often to do CPD training ?
A
Every 5 years as a requirement by the GDC
20
Q
Why is CPD important ? (3)
A
- Allow dentists to maintain and update their skill knowledge and behaviour throughout their career
- Ensures good quality of healthcare provided
- To gain the trust of the public
21
Q
How many hours of CPD are to be done in a 5 year cycle and how many are to be verifiable?
A
- At least 250 in 5 years
- 75 hours to be verifiable
22
Q
Give 3 suggested CPD topics and the hours per cycle?
A
- Medical emergencies - 10 per cycle 2 per year
- Disinfection and decontamination - 5 per cycle
- Radiography and radiation protection - 5 per cycle
23
Q
What are the 7 components of clinical governance?
A
- Audit
- Clinical effectiveness and research
- Clinical information and IT
- Education and training
- Service user, carer and public involvement
- Staffing and staff management
- Risk management
ACCESS R
24
Q
Dive 6 members of the dental team that have to be registered with the GDC?
A
- Dentists
- Dental nurses
- Dental hygienist
- Dental therapist
- Orthodontic therapist
- Dental technicians
25
What is a clinical audit and what is it for?
* It is a quality improvement process that seeks to improve patient care and outcome through systematic review of care against criteria and implementing change
* It is used to observe gaps in knowledge, learning, attitudes protocols and training
26
What are the stages of a significant event analysis ?
* Identify significant event
* Collect data about the event
* Convene a meeting for educational purposes (no blaming)
* Undertake a structural analysis
* Monitor progress on actions agreed upon
* Write up event analysis
* Seek educational feedback - peer review
27
List the stages in the chain of infection? (6)
* infectious agent
* Reservoir
* Portal of exit
* mode of transmission
* Portal of entry
* Susceptible host
| IR PM PS
28
How to break chain of infection for dirty forceps ?
* broken at reservoir by cleaning, disinfecting and sterilizing
29
Chlorine releasing agents and concentration?
* Sodium hypochlorite or Sodium dichloroisocyanurate
* 10,000 ppm
30
How long does the chlorine agent left for?
3-5 minutes
31
Give waste streams and examples of each (6)
* Black - domestic waste - cups
* Orange - low clinical waste - gloves
* Yellow - hazardous - teeth, sharps , needles
* Red - hazardous - amalgam
* Brown - confidential - confidential documents
32
What are the principles of waste disposal?
* Segregation
* Storage
* Disposal
* Document
| SSDD
33
In which stream does a tooth with amaglam go into?
Red stream - hazardous waste labelled amaglam
34
Provide two safety features of amalgam waste container? (2)
* Spill and leak proof
* Mercury vapur suppressant
35
What do you legally need to keep about waste and for how long?
Consignment note for 3 years
36
What does waste consignment note consist of ? (5)
* Description of waste
* Quantity of waste
* Destination of waste
* Origin of waste
* Transport of waste
37
What is clinical governance?
* It is a systematic approach to maintain and improve patient care in the healthcare setting
38
What are the 3 division of NHS Scotland dental services?
Primary care - general dental practices
Secondary care - hospital services
Public dental services - community services
39
List the 9 GDC standards for dental proffessionals
* Put patient interest first
* Communicate effectively with patients
* Obtain vaild consent
* Maintain and protect patient information
* Have a clear and effective complaints procedure
* Work with colleagues in a way that is in the patient best interest
* Maintain, develop and work within your proffessional knowledge and skills
* Raise concerns if patient are at risk
* Make sure your personal behaviour maintains patients confidence in you and the dental profession
40
List the sinner cycle (components of cleaning)
* Time
* Temperature
* Chemical
* Energy/mechanics
41
What are 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
42
What are the 4 pillars of ethics?
* Respect for autonomy - respect will of others
* Non-maleficence - do no harm
* Beneficence - good behavior
* Justice - fair and responsible
43
What is negligence?
* The omission to do something a good practitioner would do or to do something a reasonable practitioner would not do
* Dentist fail to meet standards of ordinary care which result in harm
44
What is the criteria for clinical negligence?
* The dentist owned a duty of care
* This duty of care was breached
* The breach resulted in or contributed to damage
* This damage was was reasonably foreseeable
45
How long should notes be kept for?
3 years after end of treatment and 11 years or until the age of 25 for children
46
What should notes be ?
* Confidential
* Concise
* Complete
* Current
* Retrievable
* Retained
* Accurate
* Legible
| CCCC RR AL
47
Who is on the GDC board?
* 12 members including
^ 6 registrants (including chair)
^ 6 lay members
48
What is the decontamination cycle in order?
* Acquisition - the device is purchased or loaned
* Cleaning - the device is cleaned manually
* Disinfection - the device is disinfected using washer - disinfector
* Inspection inspected for any signs of damage or contamination
* Disposal - If damaged it is scrapped or returened to lender
* Packaging - device is then packaged
* Sterilisation - device is then sterilised using type B steriliser (or type N if not packaged)
* Transport - transported using the transport box
* Storage - stored in a dry and clean area
* Use - used
* Transport - transported back to LDU
49
Name legislations for decontamination? 5
* The health and safety at work act 1974
* The medical device directive 2007/47/EC
* The National Decontamination Standards for NHS Scotland (NDSSH)
* Consumer protection act
* Control of Substances Hazardous to Health (COSHH) Regulations 2002
50
What does the health and safety at work outline?
Ensures employers' responsibility to provide a safe workplace, including proper training for handling hazardous substances.
51
What does COSHH outline?
Requires employers to assess and control risks posed by hazardous substances + provide adequate training to employees.
52
What does The national decontamination standards for NHS scotland outlines?
detailed standards for decontamination practices of reusable medical devices in NHS Scotland facilities
53
What is the aim of the medical device directive?
Clarify and strengthen regulations for medical devices within the EU
54
Five common reasons for hand-piece faults ?
* Incorrect compressor settings
* Lack of maintenance
* Incorrect instrument use
* Incorrect or damaged bur inserted into chunk
* Incorrect cleaning and processing of instrument
* Inadequate lubrication
55
What are the 2 types of manual washing? give example of instruments for each
* Immersion - probe/mirror
* Non-immersion - handpieces
56
Why you are not supposed to put the hand-piece in ultrasonic cleaner?
It should not be immersed as ultrasonic can damage the turbine of the hand-piece
57
Describe immersion manual washing
* Reusable cleaning brushes used to remove gross contamination of instruments that are immersed in under
* Drying of instruments using sterile, dry and non longing disposable towel
58
Describe non-immersion manual washing
* Used for hand pieces and similar instruments
* non limiting disposable wipes are used to wipe instruments
* detergent used should be 30ml to 8L of water with PH of 7 at 30-35 Degrees
59
Briefly describe the ultrasonic bath in decontamination?
* Ultrasonic cleaners use high-frequency sound waves to create micro-bubbles, which implode to produce cavitation energy, aiding in soil removal.
* Prior degassing is necessary to prevent oxygen interference which inhibit cavitation
* They should be used before washer disinfection for gross or tough contamination
60
What maintenance and tests are carried out for an AWD?
* Daily tests - automatic control test to ensure machine is operating as designed. Used on 1st cycle with instruments + wipe door seal + clean filter
* Weekly test - cleaning efficacy of machine at same time of daily test
* Quarterly and annual validation - series of tests carried out and checked against manufacturers specifications by authorised engineer
61
Give 3 PPE used for manual washing and what do each protect?
* Marigold gloves - protects hand from detergent
* Full face visor - protect face from aerosol
* Gown - protect clothing from splashes
62
Why do we de-gas the ultrasonic bath?
* Oxygen inhibits cavitation
* Which results in bubble
* This reduces efficiency of cleaning
63
When do we de-gas the ultrasonic bath?
* After filling machine with water
* Before loading instruments
64
What temperature , pressure and time is sterilisation carried out at?
* 134-137 C
* 2.05 - 2.35 Bar
* 3 minutes
65
3 types of sterilisers and compare use?
* Type S (special) - only used according manufacturer instructions for specific instruments
* Type N (non vacuum) - non vacuum , passive air removal for non lumened instruments that are not wrapped
* Type B (vacuum) - vacuum , active air removal using pump , for lumened devices that are wrapped and sterile at point of use
66
What Daily tests and maintenance are carried out for sterilisers?
* Wipe door seal and chamber
* Check door safety device
* Change water (drain and refill)
* Check printer paper
* Automatic control test
67
How can you check steam penetration ?
* Using bowie dick or helix device
* Chemical colour changes from yellow to blue when sterilised
68
What weekly tests and maintenance are carried out for sterilisers?
* Automatic control tests
* Vacuum leak test
* Air detection test
69
