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BDS4 > Decontamination and cleanliness champions > Flashcards

Decontamination and cleanliness champions Flashcards

1
Q

PPE-
You are working at a dental practice as a dentist, you arrive exceptionally early and saw 2 nurses getting of the bus in their uniforms.
1. Name 2 concerns you would raise with the nurses? (2)

A
  • Inform nurses that in adherence with infection control precautions should not wear uniform out with the practice
  • Make them aware that this also creates issues with practice and profession reputation as the nurses have uniform that shows where they work
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2
Q
  1. You decide to give the staff working in the practice a learning session on Personal Protective Equipment’s. Name 6 key learning outcome from a learning session?
A
  • Wear of PPE when carrying out procedures
  • Wear of PPE when cleaning (should be fresh)
  • Change PPE between patients (and cleaning)
  • Correct disposal of PPE after usage and soiling (is the orange stream waste)
  • Need for PPE during decontamination procedure
  • Protection the hands, face/eyes and body/clothing with PPE
  • Always protect the patient with the appropriate PPE- eye and body protection- glasses and apron
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3
Q
  1. In order to check is the staff are following instruction, how would you ensure is they have done it?
A
  • Clinical audit
  • Regular inspection
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4
Q

Cleanliness Champions-
1. List the stages in the chain of infection?

A
  • Infectious agent
  • Reservoir
  • Portal of exit
  • Mode of transmission
  • Portal of entry
  • Susceptible host
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5
Q
  1. List the sinner circle?
A
  • Chemicals
  • Temperature
  • Energy
  • Time
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6
Q
  1. Name the 10 standard infection control procedures?
A
  • Patient placement and assessment of risk
  • Hand hygiene
  • Respiratory and cough etiquette
  • Safe management of care equipment
  • Safe management of care environment
  • Safe management of linen
  • Safe management of blood and bodily fluid spillages
  • Safe disposal of waste including sharps
  • Occupation safety- prevention and exposure management including sharps
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7
Q
  1. Name and concentration of chlorine releasing chemical used to clean a blood spill?
A
  • Sodium hypochlorite 10,000ppm
  • Sodium dichloroisocyanurate
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8
Q
  1. How long is 10,000ppm sodium hypochlorite applied for on blood spillages?
A
  • 5 minutes
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9
Q
  1. What are the different clinical waste stream and give an example of what would be disposed of in each?
A
  • Black- domestic waste- hand towels
  • Orange- low risk- PPE
  • Yellow- hazardous waste- teeth, sharp, needles
  • Red- special waste (chemicals)- amalgam
  • Brown – confidential
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10
Q
  1. Tooth with extracted amalgam- what stream should it go into?
A
  • Red stream special hazardous waste
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11
Q
  1. What document is a GDP required to keep for waste disposal? How long for and what should it include?
A
  • Waste consignment note
  • 3 years
  • Should include description of waste, quantity of waste, destination of waste, origin of waste and transport modality of waste
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12
Q
  1. What are the principles of waste disposal?
A
  • Segregation
  • Storage
  • Disposal
  • Document
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13
Q

Decontamination Cycle-
1. Name the steps of the decontamination cycle?

A
  • Acquisition
  • Cleaning
  • Disinfection
  • Inspection
  • Disposal or
  • Packaging
  • Sterilisation
  • Transport
  • Storage
  • Use Transport
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14
Q
  1. Name 4 legislation for decontamination?
A
  • The health and safety for work act 1974
  • The medical device directive 2007
  • Consumer protection act
  • The national health serves (Scotland) regulations 2010
  • COSHH- control of substances hazardous to health
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15
Q

Cleaning-
1. Why is cleaning an important prerequisite before disinfection and sterilising? (4)

A
  • Functionality of the instrument- gets rid of biological debris which could clog instruments and impair their function or speed up destructive processes such as corrosion
  • Remove/reduce biological (organic) contamination- if devices are contaminated with previous patients materials this could result in infection spread and misdiagnosis (in biopsy devices)
  • Remove restorative materials- can adhere to instruments makes them more difficult to clean
  • Aid in disinfection and sterilisation
  • Legal requirement (under medical device’s direction
  • It acts to remove gross debris, organic material, restorative material, restore function and aid in disinfection and sterilisation
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16
Q
  1. Briefly describe manual washing- immersion and non-immersion?
A
  • General- use PPE (marigold gloves, gown, facemask and visor), use water 30-35° with 20ml detergent/8L water at pH7, immersion or non-immersion as appropriate, rinse with RO water and inspect with lit magnification
  • Immersion- Immerse device fully in water, use cleaning brush (non-metal) which has been cleaned (at least once a day) with enzymatic detergent diluted to appropriate concentration and temperature to clean gross contamination from device without removing from the water then dry using a sterile, dry, non-linting disposable towel
  • Non-Immersion- For lumened devices or those which would eb damaged or inhibit sterilisation using immersion technique, do not immerse the device in water but use a non-linting disposable wipe (and detergent) to clean then a fresh wipe to rinse before drying
17
Q
  1. Briefly describe ultrasonic bath?
A
  • Ultrasonic bath uses ultrasound (200-400kHz) to create micro-bubbles that cause cavitation when they implode the energy released from which helps to remove soil from the instrument
  • Useful as a pre-cleaner where contamination may be hard to reach
  • Must rain and refill chamber every 4hrs and perform a degass cycle before every use (to remove air as will prevent cavitation)
  • Disassemble or gully open devices before loading and ensure they are fully immersed so that all surfaces are exposed
  • NB. Should only be sued to remove gross contamination or difficult to remove contamination before placing in an AWD
18
Q
  1. What maintenance tests are carried out for an AWD?
A
  • Daily- wipe door seal and check no damage, check spray arm rotate freely, clear blockages from holes in spray arm and filters in the drain, check and clean filter, clean as necessary, automatic control test (run cycle and record all operating factors) with print out (compare to latest validation report) (done on first cycle of the day)
  • Weekly- daily tests plus cleaning efficacy test using protein test strip (test piece) and staple result into logbook
  • Quarterly & annual- carried out by authorised test personnel to produce validation report and ensure machine functions to original manufacturers specification
19
Q
  1. Why is it important to test washer disinfector and steriliser? (1)
A
  • To ensure machines are clean, working properly to reach relevant standards and guidance for decontamination for reusable medical devices
  • Also ensure validity and warranty of the machine and helps detect both procedural errors and equipment malfunctions
  • This is a medicolegal requirement
20
Q
  1. What are the 5 cycle stages of a washer disinfector and explain them?
A
  • Flush/pre-wash- <45° to remove gross decontamination and hydrate instrument
  • Wash- chemical introduced to machine and water heated to 40-65°- action of physical force of water, chemical action of detergents and thermal heat activates and facilitated action of detergents to remove any remining soil
  • Rinse- removes any chemical agents or detergents used in stages one and two
  • Disinfection- temperature increased to 90-95° for a minimum of one minute to allow thermal disinfection (acts to render device safe for handling by reducing the number of viable microorganisms that contaminate a device)
  • Dry- hot circulating air introduced to clear chamber and instrument/device of remaining moisture
21
Q

Sterilisation-
1. What are the three types of sterilisers?

A
  • S, B & N
22
Q
  1. What don’t you dry with a paper towel?
A
  • If you use paper towels they will shed particles that will clog the filters in the sterilisers and contaminate the device themselves
23
Q
  1. What are the differences between type N and B sterilisers? Why is b better?
A
  • Type N- non vacuum, cycle intended for sterilisation of non-wrapped solid products such as metallic items that aren’t lumened, involves passive air removal- air displaced passively from the chamber and load by gravity disapclement as stem is generated within the chamber, items aren’t wrapped and should be used immediately after processing, they have been sterilised but are not sterile
  • Type B- vacuum, cycle intended for sterilisation of wrapped solid, hollow and porous products, involves active air removal- vacuum pulp actively removes air from the chamber and load, products are vacuum packages and are sterile at the point of use and can be stored before use
  • Type B is better as can be used for hollow or lumened devices as well as sterile, active air removal, can tell if all the air has been removed via air detector present, device are pre-packaged and sterile at point of use
24
Q
  1. What temp, pressure and time is sterilisation carried out at?
A
  • 134-137° for 3 minutes, 2-2.3 barr
25
Q
  1. Give three types of sterilisers and compare their use?
A
  • N- normal- passive air removal so processes unwrapped items and no lumened devices
  • B- better- active air removal so processed wrapped items and lumened devices as required (sterile at point of use)
  • S- special- use in accordance with manufacturers instruction
26
Q
  1. What maintenance and tests are carried out for sterilisers?
A
  • Daily- wipe clean door seal and chamber and check for damage, check door safety device, drain and refill (change water), check for printer paper, automatic control test bowie dick or helix test to check for steam penetration (chemical colour from yellow to blue if proper penetration and sterilised)
  • Weekly- as for daily plus vacuum/air leak test to check for integrity of chamber to see if any air is entering the chamber during sterilisation, air detector function test to check if sterilisation fails if air enters
  • Quarterly & annual- carried out by authorised test personnel to produce validation report and ensure machine functions to original manufacturers specification
27
Q

Decontamination Personnel & Water-
1. Name 4 key personnel involved in the decontamination process and give a description of each of their roles?

A
  • Manger- person accountable for the operation of the premises (owner or occupier and also the employer)
  • User- person responsible for the day to day management of the LDU (appoints operators, makes sure they are trained, makes sure equipment is tested and maintained, keeps record, maintains correct documentation)
  • Operator- trained in the operation of all equipment and practices (conducts daily & weekly tests, takes instrument readings, replenishes consumables, simple housekeeping)
  • Competent person- person qualified to conduct validation of equipment (periodic testing and validation work, advising on operational procedures, producing testing reports)
28
Q
  1. What type of water is used for the final rinse cycle and why is this used as opposed to mains water?
A
  • Reverse osmosis demineralised water
  • Used as it is one of the recommended waters low in mineral content and is the only one capable of making water in high enough volumes quickly enough to keep up with the water disinfector
  • Mains water contains a higher mineral content which if left on the instruments can lead to the formation of limescale
29
Q

Handpiece Faults-
1. Give 5 common reasons for handpiece faults?

A
  • Incorrect compressor settings and lack of maintenance
  • Damage or oversized bur fitted (which damaged the chuck)
  • Incorrect instrument use
  • Poor or inadequate cleaning (including incorrect processing)
  • Incorrect or inadequate lubrication

BDS4 (24 decks)

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