dirty to sterile Flashcards
Operator
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)
user
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
main responsibilities of the USER (6)
- 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)
Manager
defined as the person who is ultimately accountable for the operation of the LDU
usually dental practitioner
decontamination
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
role of LDU
Local decontamination unit within a dental practice
to decontaminate reusable medical devices
decontamination cycle/ lifecyle of RMD
sinner circle
chemicals
temperature
energy
time
policy
an overall statement of intent or is a set of rules or requirements to be followed to achieve a given process/outcome
procedure
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
objective
landmark event in pursuit of overall intent (usually subject to regular review and amendment)
work instruction
specific steps needed to carry out the procedures
HOW to do something
work flow
dirty to clean. Linear flow
clean, inspect, package, sterilisation
3 pieces of legislation realted to LDU running
- health and safety at work act
- consumer protection act
- medical device directive
what to do on entering and leaving LDU
hand hygiene
non immersion manual washing
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
immersion manual washing
most instruments - see manufacturer’s instructions
wash temperature is of particular importance when using enzymatic detergents - follow manufacturer’s instructions
2 types of manual washing
immersive
non-immersive
when to be particularly mindful of wash temperaure
when using an enzymatic detergent
manual washing
remember
- PPE
- full face visor, gown, thick marigold type gloves
- follow work instructions
- detergent
- should be neutral enzymatic
- correct concentration prep
- water temp
- 30-35oC
- no metal brushes (plastic only)
- rinse/immerse instruments in purified water (not handpieces) after cleaning and the dry
e.g. non immersion equipment
lumened or cannulated e.g. handpieces
e.g. detergent for manual washing
neutral enzymatic (endozyme AW plus)
30ml to 8 litres water
water temperature for manual washing
30-35oC
tools for manual washing
plastic only brushes (no metal)
ultrasonic cleaner
remember
- 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
role of purge (de-gas) US cycle
no instruments
done first
remove air/oxygen from water
why should handpieces not be placed in US
should not be immersed in water (channelled/lumened)
ultrasonic activity will damage the high speed turbine
detergents for ultrasonic
neutral (pH 7) or enzymatic (sonozyme)
25ml measured dose (sachet)
how often to drain and fill US
at least twice a day (4 hourly intervals)
more often if water visibly soiled
how to leave US overnight
always drain, clean and dry at end of day
refil next morning
tests for US
daily test - log book
weekly test - inc daily test plus cleaning efficacy tet (protein test strip), staple result with printout in log book
washer disinfector
remember
- 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)
housekeeping duties for washer disinfector
clean filter
clean door and seal
check detergent level
check printer for paper
daily automatic control test
washer disinfector
first run with instruments
fill in daily test sheet in log book and staple printout
why does thermal disinfection in washer disnfector use RO/purified water
prevent depositing of minerals on instruments and washer disinfector
weekly test for washer disinfector
daily test plus
cleaning effiicacy test (protein test stip) and staple result along with printout into log book (weekly automatic control test)
what to do after all types of cleaning carried out
insepct instruments under lit magnifier
3 types sterilisers
type N
type B
type S
type N steriliser
Normal
non vaccum, passive air removal
type B steriliser
better
vacuum, acitve air removal
type S steriliser
special
only use according to manufacturer’s instructions
sterility
an instrument is sterile if the probabiliy that there are viable microbes on the instrument is equal to 1 in a million
sterilisers
remember
- 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
e..g purified water
reverse-osmosis water (RO)
de-ionised
distilled
sterile water
used for irrigation in sterilisation
house keeping for sterilisers
wipe door seal and chamber
check door safety devices
drain and refill daily
(Type N check printer for paper)
type B can process
packaged instruments
lumened or cannulated instruments
type N tests
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
type B tests
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
sterilising temperature
134-135oC
2.05 to 2.3 bar for minimum 3 mins
(common terminology 134oC, 2.25 bar for min 3 mins)
