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decontamination 3BDS > decontamination revision lecture > Flashcards

decontamination revision lecture Flashcards

1
Q

define decontamination

A

a combination of processes including cleaning, disinfection and sterilisation which, together, render a reusable medical device free from contaminants and safe for reuse

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2
Q

what are the most resistant types of bacteria?

A

prions and endospores of bacteria (prions more so)

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3
Q

name 5 types of SICP

A

hand hygiene, PPE, safe disposal of waste and sharps, environmental cleanliness and occupational exposure management

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4
Q

what is the purpose of SICPs?

A

to protect yourself and others

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5
Q

What is COSHH and what is its purpose?

A

Control of Substances Hazardous to Health, purpose is to protect yourself and others

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6
Q

give 3 statements from COSHH

A

employers must:
assess health risks from hazardous substances in the workplace
prevent employees from being exposed to hazardous substances or, if unavoidable, control their risk
prepare procedures to deal with any incidents

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7
Q

what must a practitioners policy for acquiring medical devices include?

A

review of manufacturer’s instructions and decontamination processes before purchase

documented specifications for the device

requirement for medical devices purchased to have the appropriate CE mark

requirement for new devices to meet current standards and be acceptable to both practitioners and decontamination staff

requirement for the correct medical devices to be purchased that can withstand repeated exposures to decontamination processes

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8
Q

what is the purpose of a batch code?

A

allows faulty devices to be traced back to a batch for recall

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9
Q

what is the purpose of a serial number?

A

it is a device’s unique identifier

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10
Q

when may single use instruments be favoured?

A

when there is a high risk of infection, when a reusable item is difficult to clean or when it is more economical or practical

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11
Q

what is the manufacturer’s device directive?

A

defines the info manufacturers are required to provide for users of their products

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12
Q

what does a CE mark indicate?

A

that a medical device satisfies the requirements of the MDD, making it fit for use

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13
Q

what is the first stage of the decontamination process?

A

cleaning

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14
Q

what is the aim of cleaning?

A

to remove all physical contamination as debris may interfere with sterilisation, increase the risk of infection for staff handling the instruments or damage the surface of the instruments therefore affecting the functionality of the device

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15
Q

why is automated cleaning favoured?

A

it is reproducible and more effective

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16
Q

why are 3 sinks required for manual cleaning?

A

sinks for washing, rinsing and hand washing must be kept separate

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17
Q

why should CHx or hibiscrub not be used for cleaning of steel instruments?

A

these agents make proteins stick to steel

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18
Q

what kind of brush should be used for manual cleaning?

A

long handled, soft bristle brush, not metal

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19
Q

what do enzymatic detergents do?

A

they contain molecules which break down proteins, fats and starch

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20
Q

why should instruments be immersed in water rather than run under a tap?

A

to prevent aerosols

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21
Q

what type of lid should an ultrasonic cleaner have?

A

an interlocking lid to prevent aerosols and opening mid-cycle

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22
Q

what other features should an ultrasonic cleaner have?

A

chamber tap drain, time and temperature controls, printer

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23
Q

how often should washing solution be changed in an ultrasonic cleaner?

A

every 4 hours or more frequently if contaminated

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24
Q

what tests can be run on an ultrasonic cleaner to check its effectiveness?

A

foil ablation test and residual soil test

25
Q

describe the principle of a foil ablation test

A

determines the pattern of erosion on aluminium foil strips suspended in the cleaner

26
Q

what is the second stage of decontamination?

A

disinfection

27
Q

define disinfection

A

carried out after all visible soil has been removed and aims to reduce the number of viable microorganisms on a device

28
Q

why are washer-disinfectors favoured?

A

they are automated and validated, they require minimal human contact, reduce the risk of sharps injuries and are reproducible

29
Q

what are the 5 stages of washer-disinfection?

A

flush, wash, rinse, thermal disinfection, dry

30
Q

what is an automatic control test for washer-disinfectors?

A

a cycle run before use to ensure everything is operating correctly

31
Q

why is thermal disinfection preferred over chemical disinfection?

A

it leaves no harmful residue and some chemicals may have a weakening effect on metals

32
Q

when is visual inspection carried out?

A

after washing and disinfection

33
Q

what must happen to a device that fails visual inspection?

A

sent to the start of the cleaning process, sent fro repair or disposed of and replaced

34
Q

how would you carry out visual inspection?

A

under an illuminated magnifier check for cleanliness, dryness, damage and functionality

35
Q

define functionality

A

all loving parts can move freely and any blades are aligned and sharp

36
Q

defines sterilisation

A

the destruction/removal o all living organisms and spores

37
Q

why is debris on the instruments detrimental to the sterilisation process?

A

they will prevent the stem from contacting all surfaces of the instrument, protect microorganisms, increase the risk of corrosion and prevent the instrument from functioning correctly

38
Q

if a washer-disinfector with a drying cycle is not available what is the alternative?

A

drying with low-linting paper towels

39
Q

why is drying before sterilisation necessary?

A

moisture may encourage the growth of microorganisms, contaminate the steam in the steriliser or cause corrosion of the instruments

40
Q

what is the difference between devices packaged before and after sterilisation?

A

those packaged prior to sterilisation can be labelled sterile afterwards but those packaged afterwards must be labelled sterilised but cannot be labelled sterile

41
Q

what are the requirements of pre-sterilisation packaging?

A

allows steam penetration, allows steam to circulate instruments, withstands sterilisation, prevents recontamination, maintains sterility, made of non-shedding material, allows placement of adhesive labelling

42
Q

what are the requirements of post-sterilisation packaging?

A

contains the instrument and keeps it clean during transport and storage

43
Q

what info should a label on a sterilised device offer?

A

whether contents are sterile or sterilised, cycle number, method of sterilisation, contents info including individual identifier and name of clinic

44
Q

can instruments be used for invasive procedures if packaged after sterilisation?

A

no, instruments must be sterile at point of use

45
Q

what type of microorganisms are not destroyed by sterilisation?

A

prions

46
Q

what is the recommended method of sterilisation for dentistry?

A

high temperature steam sterilisation

47
Q

define sterile

A

when the theoretical probability of a viable microorganism being present in or on a device following a validated sterilisation process is less than one in a million

48
Q

what are the three key factors for successful sterilisation?

A

high temperature, sufficient time and air removal

49
Q

what are the standard values for sterilisation in dentistry?

A

2.25 bar at 134-137 degrees C for 3 minutes

50
Q

what is a type B steriliser?

A

vacuum type, for packaged, solid, hollow and porous materials, with active air removal

51
Q

what is a type N steriliser?

A

downward displacement type, for unwrapped solid or lumened handpieces, with passive air removal

52
Q

what is a type S steriliser?

A

active air removal for wrapped or unwrapped instruments but rarely used in dentistry

53
Q

what are some advantages of steam sterilisation?

A

practical, cost-effective, non-toxic and readily controlled/monitored

54
Q

what is an FIFO system?

A

a first in first out system for storage of medical devices to allow for stock rotation

55
Q

what 3 qualities should steriliser water have?

A

low mineral, pathogen free, endotoxin free

56
Q

why an tap water not be used for sterilisation?

A

it is high mineral and would cause scaling of the heating element and chamber

57
Q

what should sterilisation records include?

A

details of daily ACT and steam penetration tests, details of each steriliser cycle and documented evidence that the steriliser was working correctly

58
Q

why is traceability important?

A

for defence against allegation of an HAI and for procedures with medium or high vCJD risk

59
Q

what would result from having no operational policies in place?

A

difficulty in providing evidence in a public health investigation that correct practice was followed after an adverse incident, loss of patient confidence and possible legal action

decontamination 3BDS (1 decks)

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