Dirty to Sterile (main points)

Question 1

Who is the operator/what do they do?

Answer 1

The person with the authority 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

What is the user defined as? Who might this be?

Answer 2

the person responsible for the day-to-day management of the equipment.

In an LDU this may also be the dental practitioner, a senior dental nurse or practice manager

Question 3

What are the main responsibilities of the user?

Answer 3

• To certify that the equipment is fit for use
• To hold all documentation relating to decontamination equipment; including the names of other key personnel, such as the Authorising Engineer. •
• To ensure that the equipment is subject to periodic testing and maintenance.
• to appoint operators where required and ensure they are adequately trained and maintain records of training
• To maintain sufficient records of decontamination equipment and procedures
• To establish procedures for parametric release (ensure that the instruments have been steralised)

Question 4

Who is the manager?

Answer 4

These are defined as the person who is ultimately accountable for the operation of the LDU. This is usually the dental practitioner.

Question 5

What is the definition of decontamination?

Answer 5

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 patients”

Question 6

What is the role of a local decontamination unit (LDU)?

Answer 6

to decontaminate reusable medical devices

Question 7

Describe the decontamination cycle diagram.

Answer 7

Question 8

What is sinner circle?

Answer 8

Question 9

What is a 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

What is a procedure?

Answer 10

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

• Or put more simply procedures tell you WHO does WHAT & WHEN

Note: WHO usually refers to department but in a dental practice setting may just refer to staff members or grade (dental nurse/ practice manager) and WHEN means in what sequence – not clock time!

Question 11

What is an objective?

Answer 11

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

Question 12

What is work instruction?

Answer 12

are specific steps needed to carry out the procedures

(tells you HOW to do something)

Question 13

What legislation is relevant to decontamination?

Answer 13

health and safety at work act

consumer protection act

medical device directive

Question 14

What are the 4 basic steps in decontamination?

Answer 14

clean

inspect

package

sterilisation

Question 15

What are the 2 diff methods of manual cleaning?

Answer 15

non-immersion

immersion

Question 16

When is non-immersion manual cleaning used?

Answer 16

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

What instruments are manually cleaned by immersion?

Answer 17

most instruments but see manufacturers instructions

Question 18

The temperature of the water when manually cleaning is especially important when what?

Answer 18

using enzymatic detergents (follow manufacturer’s instructions)

Question 19

What is the PPE for manual washing?

Answer 19

Full Face Visor, Gown, Marigold type Gloves.

Question 20

What brushes are used for manual cleaning?

Answer 20

plastic brushes (no metal)

Question 21

What is the water temp and detergent conc for manual washing and cleaning?

Answer 21

water temp 30-35 degrees celsius

Detergent - should be a neutral enzymatic: 30ml to 8litres water

Question 22

After manual washing and cleaning, what should be done to the instruments before drying?

Answer 22

Rinse/immerse instruments in purified water ( not handpieces) after cleaning and then dry

Question 23

What should never be placed in an ultrasonic cleaner? Why?

Answer 23

handpieces

as they should not be immersed in water and the ultrasonic activity will damage the high speed turbine.

Question 24

What detergent is used in wahser disinfector?

Answer 24

Neutra (pH7) enzyme

Question 25

What tests are required for ultrasonic?

Answer 25

Carry out weekly test. Weekly test includes daily test plus cleaning efficacy test (protein test strip) and staple result along with printout into log book.

Question 26

What tests are required for washer disinfectore?

Answer 26

Carry out daily test. Fill in daily test sheet in log book and staple printout

Carry out weekly test. Weekly test includes daily test plus cleaning efficacy test (protein test strip) and staple result along with printout into log book. (Weekly Automatic Control Test)

Question 27

What are the 3 diff types of sterlisers and basic description.

Answer 27

Type B (Better) vacuum, active air removal •

Type S (Special) only use according to manufacturers instructions

Type N (Normal) non vacuum, passive air removal

Question 28

What makes something sterile? (defintion)

Answer 28

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