dirty to sterile

Question 1

Operator

Answer 1

the person with the autority to operate decontamination equipment, this includes noting instrument readings, replenishment of detergent solutions and simple housekeeping duties (ensuring equipment is cleaned and ready to be used)

Question 2

user

Answer 2

defined as the person responsible for the day-to-day management of the equipment

in an LDU it may also be the dental practitioner, a senior dental nurse or practice manager

Question 3

main responsibilities of the USER (6)

Answer 3

• to certify the equipment is fit for use
• to hold all documentation relating to decontamination equipment; including names of other key personnel - such as Authorising Engineer
• to appoint operators where required and ensure they are adequately trained and maintain records of training
• to maintain sufficien records of decontamination equipment procedures
• to establish procedures for parametric release (ensure tha instruments have been sterilised)

Question 4

Manager

Answer 4

defined as the person who is ultimately accountable for the operation of the LDU

usually dental practitioner

Question 5

decontamination

Answer 5

is the combination of processes (including washing, disinfection and sterilisation) employed to make re-usable items safe for handling by users and for use on pts

Question 6

role of LDU

Answer 6

Local decontamination unit within a dental practice

to decontaminate reusable medical devices

Question 7

decontamination cycle/ lifecyle of RMD

Answer 7

Question 8

sinner circle

Answer 8

chemicals

temperature

energy

time

Question 9

policy

Answer 9

an overall statement of intent or is a set of rules or requirements to be followed to achieve a given process/outcome

Question 10

procedure

Answer 10

guidelines of major methods to be used to meet the policies as defined by the company/practice

tell you WHO does WHAT and WHEN

• who - department, staff member or grade (dental nurse/ practice manager)
• when - what sequence

Question 11

objective

Answer 11

landmark event in pursuit of overall intent (usually subject to regular review and amendment)

Question 12

work instruction

Answer 12

specific steps needed to carry out the procedures

HOW to do something

Question 13

work flow

Answer 13

dirty to clean. Linear flow

clean, inspect, package, sterilisation

Question 14

3 pieces of legislation realted to LDU running

Answer 14

• health and safety at work act
• consumer protection act
• medical device directive

Question 15

what to do on entering and leaving LDU

Answer 15

hand hygiene

Question 16

non immersion manual washing

Answer 16

approproriate for certain equipment where items will become compromised by soaking in aqueous solution e.g. electrical and electronic equipment

these items should be cleaned in accordance with manufacturer’s instructions

Question 17

immersion manual washing

Answer 17

most instruments - see manufacturer’s instructions

wash temperature is of particular importance when using enzymatic detergents - follow manufacturer’s instructions

Question 18

2 types of manual washing

Answer 18

immersive

non-immersive

Question 19

when to be particularly mindful of wash temperaure

Answer 19

when using an enzymatic detergent

Question 20

manual washing

remember

Answer 20

• PPE
  
  • full face visor, gown, thick marigold type gloves
• follow work instructions
• detergent
  
  • should be neutral enzymatic
  • correct concentration prep
• water temp
  
  • 30-35^oC
• no metal brushes (plastic only)
• rinse/immerse instruments in purified water (not handpieces) after cleaning and the dry

Question 21

e.g. non immersion equipment

Answer 21

lumened or cannulated e.g. handpieces

Question 22

e.g. detergent for manual washing

Answer 22

neutral enzymatic (endozyme AW plus)

30ml to 8 litres water

Question 23

water temperature for manual washing

Answer 23

30-35^oC

Question 24

tools for manual washing

Answer 24

plastic only brushes (no metal)

Question 25

ultrasonic cleaner remember

Answer 25

* follow work instructions * alwasy run a purge cycle (de-gas) after filling (no instruments) * first run with instruments will be a daily test cycle * fill in daily test sheet in log book and staple printout * take care when loading * no overlapping or shadowing * hinged instruments open (forceps) * rinse/immerse instruments after cleaning and then dry

Question 26

role of purge (de-gas) US cycle

Answer 26

no instruments done first remove air/oxygen from water

Question 27

why should handpieces not be placed in US

Answer 27

should not be immersed in water (channelled/lumened) ultrasonic activity will damage the high speed turbine

Question 28

detergents for ultrasonic

Answer 28

neutral (pH 7) or enzymatic (sonozyme) 25ml measured dose (sachet)

Question 29

how often to drain and fill US

Answer 29

at least twice a day (4 hourly intervals) more often if water visibly soiled

Question 30

how to leave US overnight

Answer 30

always drain, clean and dry at end of day refil next morning

Question 31

tests for US

Answer 31

daily test - log book weekly test - inc daily test plus cleaning efficacy tet (protein test strip), staple result with printout in log book

Question 32

washer disinfector remember

Answer 32

* follow work instructions * housekeeping duties * detergent - neutral or enzyme * first run with instruments - daily test cycle * record with printout * thermal disinfection rinse with purified water (RO water)

Question 33

housekeeping duties for washer disinfector

Answer 33

clean filter clean door and seal check detergent level check printer for paper

Question 34

daily automatic control test washer disinfector

Answer 34

first run with instruments fill in daily test sheet in log book and staple printout

Question 35

why does thermal disinfection in washer disnfector use RO/purified water

Answer 35

prevent depositing of minerals on instruments and washer disinfector

Question 36

weekly test for washer disinfector

Answer 36

daily test plus cleaning effiicacy test (protein test stip) and staple result along with printout into log book (weekly automatic control test)

Question 37

what to do after all types of cleaning carried out

Answer 37

insepct instruments under lit magnifier

Question 38

3 types sterilisers

Answer 38

type N type B type S

Question 39

type N steriliser

Answer 39

Normal non vaccum, passive air removal

Question 40

type B steriliser

Answer 40

better vacuum, acitve air removal

Question 41

type S steriliser

Answer 41

special only use according to manufacturer's instructions

Question 42

sterility

Answer 42

an instrument is sterile if the probabiliy that there are viable microbes on the instrument is equal to 1 in a million

Question 43

sterilisers remember

Answer 43

* follow work instructions * house keeping * water * purified water * first run with instruments is daily test cycle * fill in log book and staple printout * type B only * packaged instruments * lumened or cannulated instruments * take care when loading

Question 44

e..g purified water

Answer 44

reverse-osmosis water (RO) de-ionised distilled sterile water used for irrigation in sterilisation

Question 45

house keeping for sterilisers

Answer 45

wipe door seal and chamber check door safety devices drain and refill daily (Type N check printer for paper)

Question 46

type B can process

Answer 46

packaged instruments lumened or cannulated instruments

Question 47

type N tests

Answer 47

daily test - carry out, check printout sign, staple in logbook weekly test - daily test plus steam penetration test (chemical test strip), check and sign printout and staple into logbook

Question 48

type B tests

Answer 48

daily tests * steam penetration test (chemical strip test) empty chamber, helix or bowie dick * staple checked and signed printout in logbook weekly test * daily test plus vacuum leak test and the air detection function test * record as above usually carried out by user/mamager unless delegated

Question 49

sterilising temperature

Answer 49

134-135^oC 2.05 to 2.3 bar for minimum 3 mins (common terminology 134^oC, 2.25 bar for min 3 mins)