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
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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

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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
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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
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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)

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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

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7
Q

Where can instruments be stored after ?

A

An area that is
* free of dirt and contamination
* free of moisture

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8
Q

Sterilisation holding time

A

3 mins

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9
Q

sterilisation temperature

A

134-137

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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
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11
Q

Who is the operator?

A
  • trained in the operation of all equipment and practices
  • Responsible for simple housekeeping and maintenance
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12
Q

Who is the Manager?

A
  • The practice owner
  • Who is ultimately responsible for decontamination
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13
Q

Who is the Authorising engingeer?

A
  • Provide expert advice and perform independent audits quarterly and annually
    *Advises validation, maintenance and testing
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14
Q

Who is the test person?

A
  • Conducts and reports in validation and periodic tests
  • must be qualified for over 2 years
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15
Q

Who is the maintenance person

A

A qualified person who carries out requested and routine maintenance

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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 **

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17
Q

What does CPD stand for?

A
  • Continued professional development
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18
Q

What is CPD ?

A

The process of tracking and documenting the skills, knowledge and experience that you gain throughout your professional career

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19
Q

How often to do CPD training ?

A

Every 5 years as a requirement by the GDC

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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
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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
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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
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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

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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
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25
Q

What is a clinical audit and what is it for?

A
  • 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
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26
Q

What are the stages of a significant event analysis ?

A
  • 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
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27
Q

List the stages in the chain of infection? (6)

A
  • infectious agent
  • Reservoir
  • Portal of exit
  • mode of transmission
  • Portal of entry
  • Susceptible host

IR PM PS

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28
Q

How to break chain of infection for dirty forceps ?

A
  • broken at reservoir by cleaning, disinfecting and sterilizing
29
Q

Chlorine releasing agents and concentration?

A
  • Sodium hypochlorite or Sodium dichloroisocyanurate
  • 10,000 ppm
30
Q

How long does the chlorine agent left for?

A

3-5 minutes

31
Q

Give waste streams and examples of each (6)

A
  • Black - domestic waste - cups
  • Orange - low clinical waste - gloves
  • Yellow - hazardous - teeth, sharps , needles
  • Red - hazardous - amalgam
  • Brown - confidential - confidential documents
32
Q

What are the principles of waste disposal?

A
  • Segregation
  • Storage
  • Disposal
  • Document

SSDD

33
Q

In which stream does a tooth with amaglam go into?

A

Red stream - hazardous waste labelled amaglam

34
Q

Provide two safety features of amalgam waste container? (2)

A
  • Spill and leak proof
  • Mercury vapur suppressant
35
Q

What do you legally need to keep about waste and for how long?

A

Consignment note for 3 years

36
Q

What does waste consignment note consist of ? (5)

A
  • Description of waste
  • Quantity of waste
  • Destination of waste
  • Origin of waste
  • Transport of waste
37
Q

What is clinical governance?

A
  • It is a systematic approach to maintain and improve patient care in the healthcare setting
38
Q

What are the 3 division of NHS Scotland dental services?

A

Primary care - general dental practices
Secondary care - hospital services
Public dental services - community services

39
Q

List the 9 GDC standards for dental proffessionals

A
  • 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
Q

List the sinner cycle (components of cleaning)

A
  • Time
  • Temperature
  • Chemical
  • Energy/mechanics
41
Q

What are 10 SiCPs

A
  • 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
Q

What are the 4 pillars of ethics?

A
  • Respect for autonomy - respect will of others
  • Non-maleficence - do no harm
  • Beneficence - good behavior
  • Justice - fair and responsible
43
Q

What is negligence?

A
  • 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
Q

What is the criteria for clinical negligence?

A
  • 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
Q

How long should notes be kept for?

A

3 years after end of treatment and 11 years or until the age of 25 for children

46
Q

What should notes be ?

A
  • Confidential
  • Concise
  • Complete
  • Current
  • Retrievable
  • Retained
  • Accurate
  • Legible

CCCC RR AL

47
Q

Who is on the GDC board?

A
  • 12 members including
    ^ 6 registrants (including chair)
    ^ 6 lay members
48
Q

What is the decontamination cycle in order?

A
  • 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
Q

Name legislations for decontamination? 5

A
  • 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
Q

What does the health and safety at work outline?

A

Ensures employers’ responsibility to provide a safe workplace, including proper training for handling hazardous substances.

51
Q

What does COSHH outline?

A

Requires employers to assess and control risks posed by hazardous substances + provide adequate training to employees.

52
Q

What does The national decontamination standards for NHS scotland outlines?

A

detailed standards for decontamination practices of reusable medical devices in NHS Scotland facilities

53
Q

What is the aim of the medical device directive?

A

Clarify and strengthen regulations for medical devices within the EU

54
Q

Five common reasons for hand-piece faults ?

A
  • 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
Q

What are the 2 types of manual washing? give example of instruments for each

A
  • Immersion - probe/mirror
  • Non-immersion - handpieces
56
Q

Why you are not supposed to put the hand-piece in ultrasonic cleaner?

A

It should not be immersed as ultrasonic can damage the turbine of the hand-piece

57
Q

Describe immersion manual washing

A
  • 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
Q

Describe non-immersion manual washing

A
  • 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
Q

Briefly describe the ultrasonic bath in decontamination?

A
  • 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
Q

What maintenance and tests are carried out for an AWD?

A
  • 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
Q

Give 3 PPE used for manual washing and what do each protect?

A
  • Marigold gloves - protects hand from detergent
  • Full face visor - protect face from aerosol
  • Gown - protect clothing from splashes
62
Q

Why do we de-gas the ultrasonic bath?

A
  • Oxygen inhibits cavitation
  • Which results in bubble
  • This reduces efficiency of cleaning
63
Q

When do we de-gas the ultrasonic bath?

A
  • After filling machine with water
  • Before loading instruments
64
Q

What temperature , pressure and time is sterilisation carried out at?

A
  • 134-137 C
  • 2.05 - 2.35 Bar
  • 3 minutes
65
Q

3 types of sterilisers and compare use?

A
  • 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
Q

What Daily tests and maintenance are carried out for sterilisers?

A
  • Wipe door seal and chamber
  • Check door safety device
  • Change water (drain and refill)
  • Check printer paper
  • Automatic control test
67
Q

How can you check steam penetration ?

A
  • Using bowie dick or helix device
  • Chemical colour changes from yellow to blue when sterilised
68
Q

What weekly tests and maintenance are carried out for sterilisers?

A
  • Automatic control tests
  • Vacuum leak test
  • Air detection test
69
Q
A