Deconatmination Flashcards
What is the splauding classification?
A classification that classify devices into critical , semi-critical and non-critical and describes how to process each
What is a critical device?
- A device that penetrated soft tissues
What is a semi-critical device ?
A device that comes into contact with non intact skin or mucous membranes but does not penetrate them
What is a non-critical device?
A device that only contacts with skin and intact mucous membranes
Example of a critical device?
Surgical and biopsy instruments , forceps
Example of a semi-critical device?
- Dental mirror
- Anesthetic syringe
Example of a non critical device?
- Chair light handle
How do you process forceps (critical)
Cleaned then sterilised
How do you process a dental mirror? (semi critical)
The device must be cleaned and high level of disinfection required (steam sterilisation)
How do you process a chair light handle?
Cleaned followed by low level disinfection
What are the stages in the life cycle of processing instruments?
- Acquisition
- Cleaning
- Disinfection
- Inspection
- Disposal
- Packaging
- Sterilisation
- Transport
- Storage
- Use
- Transport
What is the first step of the instrument processing and what happens in it?
- Cleaning
- Removes biological matter from the surface
What are 5 reasons instruments need to be cleaned?
- Functionality of instrumentation
- To minimise the spread of contamination
- To prevent failed procedures
- To achieve steam contact
- It is a legal requirement
What is the main method of cleaning?
Washer disinfector
What is the secondary method of cleaning?
Ultrasonic bath
What is the next step after visible contamination has been removed and instrument inspected?
- Sterilisation through a steam steriliser
Define the operator ?
An operator is a person designated by management to operate a washer disinfector
What are 3 duties of an operator?
- Recording WD readings
- Refill WD detergent
- Simple housekeeping
What are the 3 PPE that a person carrying out manual cleaning should wear after hand hygiene? and why?
- Apron - protect the person clothing
- Face shield - protect from splashing the face and eyes
- Rubber gloves and heavy duty rubber gloves - to protect the hand
Why is it required to have a 30-35 degrees water for manual cleaning in the dedicated instrument cleaning sink?
A temperature above 35 will cause the protein to coagulate making them difficult to remove
Describe how should the chemical detergent be for manual washing?
- enzymatic or PH neutral
What are the two types of manual cleaning?
- Immersion
- Non-immersion
3 recommendation for manual cleaning ?
- 30-35 degrees
- 5ml of detergent per 1L of water ( or follow manufacturer instructions)
- Temperature sensitive to avoid damage to efficacy of chemicals
Why a metallic brush should never be used for manual cleaning? what would you use instead?
- It may damage the instrument
- long handled soft bristle brush
Why is it important to scrub the instrument below the surface of the water in immersion manual washing?
- The instrument must be contact with the water and detergent
- Scrubbing above the water will create aerosols
- To minimise splashing
When should manual cleaning be carries out replacing the WD and USB ?
- recommended by the manufacturer
- no other alternative
- WD or USB did not remove the contamination
Describe how the ultrasonic bath works?
- Use high frequency sound-waves that create bubbles that expand and collapse due to fluctuation in pressure on the hard surfaces of the instrument to remove contamination
What is the operating temperature for an ultrasonic bath?
20-35 degrees
What type of water is used in the ultrasonic bath?
Tap water
What should you do before using the USB?
A degas cycle must be ran , this is by running a standard production cycle with the chamber empty (except from the load carrier)
Why do we need to degas the USB?
- To remove any air bubbles which will effect the efficacy of the equipment and prevent proper cleaning of instrumentation
After manual cleaning and USB and rinsing the instrument in the rinsing sink, what is the next step?
Washer disinfector to be thermally disinfected
What is the first Stage in the decontamination cycle?
The use of the washer disinfector
What is the advantage of the manually washing over the washer disinfector?
Scrubbing produce more force than the washer disinfector could
5 disadvantages of ultrasonic bath and manual cleaning?
- Risk of aerosol production
- Risk of contaminating the surrounding environment
- Risk of human error
- Risk of sharps injuries
- USB may damage instruments
Where are instrument positioned in the AWD?
in the load carrier
2 advantages of USB
- removes hard to reach contamination
- Automated process
What are the 5 stages of the washer disinfector and what happens in each stage?
- Pre-wash - removes gross contamination
- Main wash - remove biological matter using detergent
- Rinse - removes any residue of biological matter or chemicals
- Thermal disinfection - kills microorganisms using heated water
- Drying - removes any remaining moisture from surface of instrument using hot air
Why is it important to remove proteins or prions during the prewash and wash and rinse stages of the washer disinfector?
- High temperature make them adhere to instrument surface
- They can survive higher temperatures for longer periods of time
Flush/ prewash temperature?
Less than 35
Main wash temperature?
Depends on chemical used
Rinsing temperature for WD?
Less than 65
Temperature and time for thermal disinfection?
90-95 degrees for minimum of 1 minute
3 advantages of washer disinfector?
- Can remove all contamination
- Consistency - the same process every time
- Automated process so produce printable record for each cycle (traceability)
- Facilitate thorough inspection as handling of instruments safe for stafff
When would you the daily checks of the WD?
Before instruments can be processed through it
What are the 6 daily checks of the washer disinfector?
- Check spray arms spin freely
- Check that spray jets are not blocked
- Make sure filter is free of debris
- Check door seal condition and wipe
- Check there is suitable amount of chemical in the reservoir
- Record the disinfection temperature of the first cycle
Explain Type N steriliser?
- heats water in the chamber to produce steam which passively removes air from the chamber (this can still leave some air within the chamber)
- you can only process unwrapped and non lumened instruments in this sterliser
What is the disadvantage of Type N?
Air is still present in the chamber meaning anything in contact with air will not be sterilised at the same temperature as steam
Describe how type B steriliser work?
- All air is removed from the chamber
- This creates a a negative pressure which allows the steam to rush into the chamber contacting all the instrument surfaces
- it can penetrate wrapping and sterilise the instruments inside
What daily tests are specific to type B steriliser?
- Steam penetration test using Bowie Dick pack or Helix
What does the sinner cycle consist of ? and what does it refer to ?
- Energy
- Chemicals
- Time
- Temperature
- the 4 elements required for successful cleaning process
Sinner cycle for different stages
What does the life cycle diagram represent?
The mandatory stages that must be carries out when processing instruments
Why is a flowline chart important in the LFU?
It shows how you should manage the path of your instrumentation through the LDU to minimise cross-contamination
What type of test is this graph from?
Quarterly test
