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BDS2 - BAMS > dish the dirt - environmental surfaces, transmission and cleaning > Flashcards

dish the dirt - environmental surfaces, transmission and cleaning Flashcards

1
Q

what are the 6 links in the chain of infection

A
  • infectious agent
  • reservoirs
  • portal of exit
  • means of transmission
  • portal of entry
  • susceptible host
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2
Q

what is most contamination cause by

A
  • from scaling followed by cavity preparations
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3
Q

in a study what was the number of oral streptococci found

A
  • in saliva = 67,000,000 cfu/ml
  • in air = 3,700 cfu/ml
  • on surface = 8,700 cfu/ml
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4
Q

in a study how much blood was found following treatment

A
  • 3 in 1 syringe = 40%
  • tap handles = 20%
  • light handle = 18%
  • operating cart handle = 10%
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5
Q

in a study how much blood was found after cleaning

A
  • 3 in 1 syringe = 10%
  • tap handles = 4%
  • light handle = 18% (probably missed)
  • operating cart handle = 2%
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6
Q

what is the Spaulding classification

A
  • critical = high risk
  • semi critical = medium risk
  • non-critical = low risk
  • minimal risk
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7
Q

what is critical risk Spaulding classification

A
  • items in contact with normally sterile body sites

- forceps, periodontal scaler

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8
Q

what is semi critical risk Spaulding classification

A
  • items in contact with intact mucous membranes

- dental handpiece, mirror

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9
Q

what is non critical Spaulding classification

A
  • items in contact with intact skin

- light cure

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10
Q

what is minimal risk Spaulding classification

A
  • items not normally in contact with intact skin

- dental chair

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11
Q

what is low risk equipment done with

A
  • items in contact with intact skin

- decontamination process = cleaned of chemical disinfected

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12
Q

what is minimal risk equipment done with

A
  • items not normally in contact with intact skin

- cleaned = chemically disinfected in risk assessed circumstances

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13
Q

what are house-keeping surfaces

A
  • non critical environmental surfaces
  • not directly touched during dental treatment and carry lowest risk of disease transmission
  • walls, floors, sinks
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14
Q

what are clinical contact surfaces

A
  • non-critical environmental surfaces
  • contaminated from patient materials wither by direct spray or splatter generated during dental procedures
  • OR by contact with gloved hand of health care professionals
  • bracket table, drawer handles, light, computer
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15
Q

where is MRSA most often found in dental environment

A
  • 3 in 1 surging

- dental chair

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16
Q

what is an antibiogram

A
  • overall profile or antimicrobial susceptibility testing results of a specific microorganism to a battery of antimicrobial drugs
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17
Q

what is the most common mode of transmission

A
  • hands of healthcare workers

- can be reduced 50% if appropriate hand hygiene is carried out

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18
Q

how long does influenza survive on steel and plastic

A
  • 24-48 hours
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19
Q

how long does influenza virus survive on cloth, paper and tissue

A
  • <8-12 hours
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20
Q

how can transmission of influenza occur

A
  • steel to hands over 24 hours

- paper tissue to hands for 15 mins

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21
Q

how long does influenza virus survive on hands

A
  • approx 5 mins
22
Q

where has influenza been isolated from

A
  • cloths, keyboards, light switches, toys, phones, taps, remotes
23
Q

how many times an hour do you touch your hair

24
Q

how many times an hour do you touch you ear

25
Q

how many times an hour do you touch your eyes

26
Q

how many time an hour do you touch your nose

27
Q

how many time an hour do you touch you mouth

28
Q

how many times an hour do you touch your cheek

29
Q

how many times an hour do you touch your neck

30
Q

how many times an hour do you touch your chin

31
Q

how long do droplet nuclei remain suspended in the air

A
  • long time
  • droplets that are propelled a distance of <1m through the air and are deposited on the nasal or oral mucosa of new host or in their immediate environment do not remain in the air
32
Q

what must you think about in terms of preventing a reservoir

A
  • surface design = declutter
  • surface material
  • cleaning
  • disinfectant v detergent wipes
33
Q

how can recontamination reduced

A
  • there should be no exposed instruments near a patient, only instruments being used on that patient should be available
34
Q

what is the definition of cleaning

A
  • the physical removal of contamination
35
Q

what are issue with surface cleaning

A
  • body fluids form surface films = facilitate bug attachments
  • charged organic soils more difficult to remove and protect bugs from dehydration
36
Q

why is visual assessment of cleanliness not good

A
  • visual clean can mean large numbers of bugs and residues still
37
Q

what is not good about cleaning process

A
  • has potential to recontaminate surfaces with organic soil and microbes
  • e.g. buckets and mops and solutions
38
Q

what’s the definition of detergent

A
  • a group of synthetic organic water soluble agents that have a wetting agent emulsifying and soil holding properties
39
Q

what is the issue with detergents

A
  • no standard for efficacy
40
Q

what is the EU regulation for detergent

A
  • biodegradability
  • specific labelling requirements
  • provision of data
  • restriction on phosphates
41
Q

what is the definition of disinfection

A
  • a process for the removal or destruction of microbes not usually including bacterial spores
  • quantitative definition = ability to produce a 5 log reduction in a defined bacterial population
42
Q

what does a high level disinfectant do

A
  • kills all microbes but not large numbers of bacterial spores
  • usually require longer contact time (hours) = no good for use in practice
43
Q

what does a low level disinfectant do

A
  • kill most vegetative bacteria, some fungi and some viruses in a practical period of time
  • under 10 mins
  • better for use in a practice
44
Q

what are the standards for disinfectants

A
  • a series of european standards with criteria for testing under controlled conditions
  • many factors compromise their efficacy = organic matter, when dried or coagulated matter, time of exposure, coverage of large or irregular areas
45
Q

what is efficacy of disinfectants influenced by

A
  • there can be a short exposure time to the disinfectant
  • incomplete coverage with large surface area
  • other factors can interfere = surface properties etc
46
Q

what is the portal of entry prevented by

A
  • PPE
  • must be worn for all chair side staff
  • protects against splashes and splatter
47
Q

what is the portal of exit prevented by

A
  • aerosol control
  • high volume aspiration
  • rubber dam
48
Q

what is mode of transmission prevented by

A
  • hand hygiene
49
Q

what is the flu vaccine programme in Scotland

A
  • > 65years old, pregnancy, chronic health conditions and HCW’s
  • offered to children 2-5 years old Nasal Spray
50
Q

how can the susceptible host be protected

A
  • vaccinations

BDS2 - BAMS (18 decks)

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