decontamination need to know Flashcards
what are the 2 types of manual washing?
immersion
non-immersion
what instruments are suitable for immersion manual washing?
probe
dental mirror
(most instruments)
what instruments are suitable for non-immersion manual washing?
handpieces
other electrical/electronic devices
Q
what PPE is required for manual washing and why?
gloves- protect hands from detergent (irritant) and contaminated substances
mask- prtect against aerosol from washing of contaminated instruments
full face visor- protect against splash back of contaminated/detergent filled water
plastic disposable apron- protect clothes and other parts of body from splashes during water
why do we degas the ultrasonic?
oxygen/air inhibits cavitation and resulting bubbles have lower intensity when imploded
this would reduce efficiency of the machine in cleaning
how often do you degas the ultrasonic?
necessary before every cleaning cycle, after filling the machine with clean water but before loading instruments
why can handpieces not be placed in the ultrasonic?
handpeices should not be immersed in water
ultrasonic activity can damage the high-speed turbine
why is demileralised water used in the steriliser?
minerals, endotoxins etc. present in normal water would coat the surface of the instruments, making them not sterile
name 3 regulations for waste disposal
the controlled waste regulations 2012
the hazardous waste directive 2011
the environmental protection act 1990
what procedures can be put in place to keep an amalgam container safe?
spill proof container
leak proof container
mercury vapour suppressant in lid
red lid and white body to distinguish from other containers
what chemical would you use to clean blood?
sodium hypochlorite
sodium dichloro-iso-cyanurate
what concentration of sodium hypochlorite would you use for a blood spillage?
10,000ppm
what is the active agent used for blood spillage?
chlorine/chloride
how do you decomtaminate an impression?
rinse under cold running water
place in perform for 10 minutes
remove and rinse under cold water
place damp gauze on impression
place into sealable labelled bag
how long do you keep waste disposal records for?
3 years
what are the different types of waste disposal stream?
- black stream
- orange stream bag
- orange stream bin
- blue stream bin
- red stream waste
what is the main way to reduce healthcare associated infections?
use of the standard infection control precautions (SICPs)
name the SICPs
- patient placement/assessment for infection risk
- hand hygiene
- respiratory and cough etiquette
- PPE
- 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
- occupational safety- prevention and exposure management
what is the chain of infection?
- infectious agent
- reservoir
- portal of exit
- mode of transmission
- portal of entry
- susceptible host
give methods of breaking the chain of infection
- cleaning
- disinfecting
- sterilising
- SICPs
how can clinical waste be made safe before landfill?
- heat disinfetion
- incineratin
what is the licence regarding disposal of amalgam?
the consignment note
what factors increase the risk of food poisoning in a care home?
- food touched by someone who is ill
- food touched by a carer who has looked after a sick resident
- food not stored correctly in fridge
- weakened immunity of the elderly
what advice could be given to carers when performing oral hygiene on the elderly to stop cross infection?
- ensure hand hygiene is carried out before and after helping the pt
- PPE
- educate on cough etiquette and hand hygiene
define sterile
an object free from all microorganisms
define sterilised
when an object has went through a process of becoming free from bacteria and all other living microorgansism
what is sterilisation?
the use of physical or chemical procedures to destroy all microorganisms including large numbers of resistant bacterial spores
describe steam sterilsation
- process used to render reusable instruments free from viable microorganisms
- does not destroy prions
- the result of direct contact of medical devices with saturated steam in the absence of air
what is validation?
- reviewing that the practice is safe
- related to regulations 12 and 15
- essential to ensure equipment performs to an optimum standard
- should be done in accordance to manufacturers instructions
what is the sinner circle?
shows components essential for adequate cleaning
* chemicals
* temperature
* time
* energy (mechanical force)
what is disinfection?
- destruction of pathogenic and other kinds of microorganism by physical or chemical means
- achieved by thermal disinfection
- destroys most recognised pathogenic microorganisms but not bacterial spores
what is removed by degassing?
air/oxygen
what are the principles of waste disposal?
- segregation
- storage
- disposal
- documentation
give legislation for the decontamination of instruments
health and safety at work act 1974
the medical device regulations 2017
what si the standard that everyone must achieve for decontamination?
BS EN standards
what standard from BS EN relates to sterilisation?
285
13060
what guidance is there for decontamination?
SHTM01
part c- sterilsation
part d- automated cleaning and disinfection
explain the spoulding classification and how they are cleaned
- critical- penetrates sterile tissue
must be sterile - semi-critical- contacts non intact skin/mucous membranes
sterile preffered, high disinfaction accepted - non-critical- contacts intact skin/mucous membrane
disinfection/clean
why is it important for instruments to be sterile?
- reduce infection transmission
- high quality care
- meet legislative and professional standards
what type fo detergent is used in manual cleaning?
enzymatic detergent
or
pH neutal
what is immergen better than non immersion?
minimises splashing
minimises aerosol production
what detergent is used in the ultrasonic cleaner?
ezymatic or neutral pH
what type of water is used in the ultra sonic?
tap water acceptable
what must be included in records for ultasonic use?
- date
- time
- cycle number
- detergent added
- operator name
describe the load requirements for the ultrasonic
- hinge instruments open
- no overlapping/shadowing
- all assemblies unassembled
- load carrier must be used
what type of detergent is used in the AWD?
high or low alkaline detergent
what are the 5 stages of the washer disinfector?
flush/pre-wash
main wash
rinse
thermal dinsinfection
drying
what must occur between all stages of the washer disinfector
water change to remove contamination
when must prions be removed and why?
before high temperature is added
they adhere to the surface of the instruments
what happens during the flush stage
saturates and removes decontamination
<35degrees
what happens during the main wash?
deterghent added to remove biological matter
temp is chemical dependent
what happens during the rinse stage?
removes remaining residue
<65degrees
what happens during thermal disinfection stage?
kills microorganisms
occurs between 90-95 degrees for at least a minute
what occurs during the drying stage
hot air removes moisture
at least 100degrees
give daily checks for AWD
- record disinfection of first daily cycle
- check condition of the door seal
- check chemical levels in reservoir
- check spray arms spin freely
- check that spray jets are not blocked
what type of water is used in steriliser?
purified
name 3 types of sterilser
N
B
S
describe the type N sterilser
cannot process wrapped instruments
explain the type B sterilser
vacuum created
****
can process wrapped instruments - makes things sterile
explain the type S sterilser
specialised
can only be used for certain equipment
cannot process a wrapped instrument
has a vaccuum
what temp does sterilsation occur at?
134-137 for at least 3 minutes
what are daily tests for the steriliser?
- stem penetration test
- bowie dick or helix
- check the door seal
- fill feed water reservoir
- drain the used water
