Decontaminate before its too late Flashcards

1
Q

5 things needed to ensure safe decon

A
  • We need a sufficient means of transporting contaminated and clean instrumentation
  • We need an automated, reproducible process for cleaning and disinfection
  • Our instruments need thoroughly inspected to ensure our process has taken place
  • We need to support the process with the use of other pieces of equipment
  • And that all our instrumentation must be processed through a steriliser
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2
Q

processing cycle/life cycle

A

Need equipment to carry stages out in line with requirements and standards

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3
Q

major factor in all stags of process cylce

A

time

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4
Q

how the period of time after the instruments are used influences the cycle

A
  • Any blood or biological matter still present can start to dry in and adhere to the surface of the instrument
  • There are products on the market such as sprays and sealed bags/packets for transport
    • But the best course of action is to have the shortest amount of time between use and processing
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5
Q

6 stages where time influences the processing cycle

A
  • How long since the instruments were used for a procedure
  • How long does my wash phase need to be for cleaning efficacy
  • How long is the WD cycle in total
  • What are the critical time/temperature settings for thermal disinfection
  • How long will the packaging and sterilisation process take
  • How long does my processing cycle take overall
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6
Q

5 major factors in the processing cycle

A
  • time
  • temperature
  • water
  • chemicals
  • energy
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7
Q

sinner circle

A
  • developed in the 1950’s by a man named Herbert Sinner

It shows the 4 key elements that are required for a Successful cleaning process

His work was based within a laundry, but the principles of the circle apply to all successful washing and cleaning processes

  • It is widely referenced If we decrease or increase any of the quarters we will impact what percentage they they play within the process
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8
Q

conductivity

A

As water travels from source to our facilities it picks up particulate along the way from hillsides, river banks & anything else it contacts

  • Minerals - calcium, potassium
  • Silicates - sand, glass, rock
  • Organics - vegetation, colloidal particle
  • Metals - iron, zinc, tin, mercury

The measure of this is called conductivity (a.k.a Total Dissolved Solids TDS)

e.g minerals, silicates, organics, metals

(µs)

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9
Q

conductivtiy measured in

A

unit = micro-siemens (µs)

using a conductivity metre

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10
Q

water used in sterilisation process

A

must be “pure water”

cannot be tap

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11
Q

“Pure water”

4 properties

A
  • Distilled
  • De-ionised
  • Reverse osmosis
  • Sterile

Pure water has had nearly all of the particulate filtered out or removed and has very low levels of bacterial and fungal presence

Conductivity = 4.3 µs

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12
Q

conductivity of pure water

A

Pure water has had nearly all of the particulate filtered out or removed and has very low levels of bacterial and fungal presence

Conductivity = 4.3 µs

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13
Q

detergents and disinfectants in processing cycle

A

don’t generally use chemical disinfectants for our process

there are a range of detergents used for different purposes

  • High and Low Alkaline detergent for enclosed processes (not designed to be in contact with skin as can be quite harsh)
  • Enzymatic detergent breaks protein down into smaller particles (generally used in the Ultrasonic but can be used for manually washing)
  • pH neutral detergent is less harmful to operators skin (generally used for manual washing as high chance of skin contact/handling)
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14
Q

how detergents work

A

chemical molecule within detergents is designed to have hydrophilic and hydrophobic ends

  • One end repels water and the other is attracted to it
    • The hydrophobic end never contacts water, because of the repulsion
      • This is where the contamination is drawn to and then flushed away as the hydrophilic end attaches to water molecules
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15
Q

how to know what detergents to use

A

need to be validated against the cycle

if changing chemical - needs re-validated

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16
Q

cycle times decided

A

Cycle times are established based on cleaning efficacy of the chemical during the validation or periodic testing of the machine

  • Manufacturers instructions should be followed for dosing volume and operating temperature of chosen detergent
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17
Q

‘energy’ in processing cycle

A

or ‘force’ that we are using for cleaning and contact

  • When manually cleaning we use a scrubbing brush
  • In the ultrasonic bath the force comes from high frequency sound waves causing cavitation
  • The washer-disinfector uses a high pressure (1-1.5 bar) water jet or spray
    • Note the WD is generally the least ferocious so we supplement the process with stronger chemicals
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18
Q

how are time and temperature of different processing cycles stages decided

A

cleaning stages the times are agreed at validation based upon the efficacy of the cycle (i.e. everything must be clean and free from contamination)

also established that temperatures are influenced by the chemical being used and that for primary stages it must be below 35 degrees (i.e. during the flush stage, manual washing or in the Ultrasonic)

Disinfection and sterilisation stages are different as the temperatures and times have already been established and must be achieved (i.e. the times and temperature for critical conditions are globally recognised)

  • Manufacturers recommendations 42-58oC
  • <35 oC prevents protein coagulating
  • Steam sterilisation 134-137 oC 3 minutes, minimum
  • Thermal disinfection 90-95 oC 1 minute, minimum
19
Q

manual cleaning

water

A

tap water

20
Q

ultrasonic cleaning

water

A

tap water

21
Q

washer-disinfector

water

A

cleaning stages can use standard tap water

thermal disinfector (still in WD) needs to be water at a conductivity lower than 30µs

22
Q

steam sterilisation

water

A

must be pure water

23
Q

manual cleaning

temperature

A

less than 35oC

24
Q

ultrasonic

temperature

A

less than 35oC

25
Q

washer disinfector

temperature

A

dependening on the chemical validated with process (<65oC)

thermal disinfector (still in WD) 90-95oC

26
Q

steam sterilisation

temperature

A

134-137oC

27
Q

thermal disinfector

water

A

Water to be at conductivity of lower than 30 µs

28
Q

thermal disinfector

part of

A

washer-disinfector

29
Q

thermal disinfector

temperture

A

90-95oC

30
Q

manual cleaning

time

A

dependent on operator allocation

31
Q

ultrasonic

time

A

dependent on the validated cylce time

(20 mins)

32
Q

washer-disinfector

time

A

dependent on the validated cycle time

(55 mins)

33
Q

thermal disinfector

time

A

must be a minimum hold time of 1min

34
Q

steam sterilisation

time

A

must be a minimum hold tie of 3 mins

35
Q

manual cleaning

chemicals

A

pH neutral or enzymatic detergent

36
Q

ultrasonic

chemicals

A

pH neutral or enzymatic detergent

37
Q

washer-disinfector

chemicals

A

low alkaline or high alkaline detergent

38
Q

thermal disinfector

chemicals

A

must be free from all chemicals

39
Q

steam sterilisation

chemicals

A

must be free from all chemicals

40
Q

manual cleaning

energy

A

scrubbing with brush

41
Q

ultrasonic

energy

A

ultrasonic sound waves

42
Q

washer-disinfector

energy

A

water jet/spray

43
Q

thermal disinfector

energy

A

water jet/spray

44
Q

steam sterilisation

energy

A

steam hear energy