Decontamination Process

Question 1

How are instruments transported to the LDU

Answer 1

in a box

Question 2

What requirements should the instrument transport box meet

Answer 2

o Rigid sided
o Leak proof
o Tight fitting lid
o Colour coded

Question 3

Where should the instrument transport box be placed

Answer 3

positioned in an agreed, set down area, which might be the same spot as the unload area

Question 4

What PPE should be donned prior to the cleaning process

Answer 4

o Gloves - rubber gloves + heavy duty gloves
o An apron/gown
o A face shield

Question 5

Is manual cleaning/ultrasonic use a must?

Answer 5

No, not necessary
can be useful for removal of debris prior to processing in a washer disinfector, particularly from instruments with hinges/intricate parts

Question 6

What does manual cleaning consist of

Answer 6

o Manually scrub to remove contamination
o Must take place below surface of the water
o Long handled, soft bristled, non-metallic brush
o Chemicals must be dosed based open the manufacturers instructions
o Do not exceed recommended temperature

Question 7

What does the ultrasonic consist of

Answer 7

o Uses sound waves at a very high frequency to produce bubbles that implode and have a scouring effect against the hard surface of the instruments

Question 8

Is the washer/disinfector a must?

Answer 8

Yes, it is a legal requirement

Question 9

What are the 5 stages of the washer/disinfector

Answer 9

• flush/prewash
• mainwash
• rinse
• thermal disinfection
• drying

Question 10

What is the flush/prewash

Answer 10

this stage saturates the contaminated instrumentation (<35 degrees)

Question 11

What is the mainwash

Answer 11

this stage is supplemented by detergent to remove contamination more effectively. This is when proteins or prions are removed (temperature dependent on chemical used for process)

Question 12

What is the rinse

Answer 12

this stage removes any remaining residue, biological or chemical before disinfection (less than <65 degrees)

Question 13

What is the thermal disinfection

Answer 13

this stage is actively killing microorganisms with the use of heated water (90-95 degrees for a minimum of 1 minute (minimum contact rate is 12 seconds))

Question 14

What is the drying stage

Answer 14

this stage removes any remaining moisture from the instruments before sterilisation (generally 90-110 degrees but no specified temperature)

Question 15

What is the inspection stage

Answer 15

o Inspect using illuminated magnifier
o Manual washing/ultrasonic if biological matter still present

Question 16

What temperature must the steriliser achieve

Answer 16

must achieve 134-137 degrees for 3 minutes

Question 17

What are the 3 types of steriliser

Answer 17

type N, B, S

Question 18

What are the features of a type N sterilizer

Answer 18

o Not favourable for high quality sterilisation
o Can’t process wrapped instruments
o Can’t process channelled/lumened instruments
o Items may not be sterile at point of use

Question 19

What are the features of a type B sterilizer

Answer 19

o Can process wrapped, channelled and lumened instruments
o Can process porous items e.g swabs
o Has drying stage to remove moisture

Question 20

What are the features of a type S sterilizer

Answer 20

o Washes/lubricates hand pieces as well as sterilizing them
o Does not process wrapped instruments