from dirty to sterile Flashcards
define operator
○ 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
define user
Defined as 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
what are the main responsibilities of the user
○ 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 maintained records of training
○ To maintain sufficient records of decontamination equipment and procedures
○ To establish procedures for parametric release (ensure that instruments have been sterilised)
define manager
These are defined as the person who is ultimately accountable for the operation of the LDU, this is usually the dental practitioner
define decontamination
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
what is LDU
Local Decontamination Unit within a Dental Practice
what is the role of the LDU
decontaminate reusable medical devices
explain the decontamination life cycle of a re-usable instrument
- acquisition
- purchase
- load - cleaning
- disinfection
- inspection
- disposal if necssary
- scrap
- return to lender - packaging
- sterilisation
- transport
- storage
- use
- transport
what is in the sinner circle
- chemicals
- temperature
- time
- energy
what is a policy
A policy is an overall statement of intent or is a set of rules or requirements to be followed to achieve a given process / outcome
what is a procedure
• A procedure is guidelines of major methods to be used to meet the policies as defined by the company / practice
○ Procedures tell you who does what and when
○ Who = usually refers to department but in a dental practice setting my just refer to staff members or grade (dental nurse / practice manager)
○ When = in what sequence, not clock time
what is an objective
An objective is a landmark event in pursuit of overall intent
(usually subject to regular review and amendment)
what are work instructions
Work instruction are specific steps needed to carry out the procedures
= instructions tell you how to do something
what legislation is associated with decontamination
health and safety at work act
consumer protection act
medical device directive
what do you need to remember when entering or leaving LDU
Remember hand hygiene when entering or leaving LDU
what are the 2 types of manual washing
- non-immersion
- immersion
what is non-immersion manual washing
§ This type of manual cleaning is appropriate for certain equipment where items will become compromised by soaking in aqueous solution eg electrical and electronic equipment, Lumened or cannulated such as handpieces
§ These items should be cleaned in accordance with manufacturer’s instructions
what is immersion manual washing
§ Most instruments
§ See manufacturers instructions
§ The wash temperature is of particular importance when using enzymatic detergents
§ Follow manufacturer’s instructions
what PPE is needed for manual washing
§ Full face visor
§ Gown
§ Marigold type gloves
what detergent is used for manual washing
§ Neutral enzymatic
§ Eg endozyme AW plus
§ 30ml to 8L water
what is the water temp for manual washing
Water temp: 30-35˚C
what brushes are used for manual cleaning
No metal brushes (plastic only)
what should be done after manual washing
Rinse / immerse instruments in purified water after cleaning and then dry
(not handpieces)
how do you run an ultrasonic cleaner
○ Follow work instructions
○ Always run a purge cycle (de-gas) after filling (no instruments) to remove air / oxygen from water
○ First run with instruments will be daily test cycle
○ Carry out daily test
§ Fill in daily test sheet in log book and staple printout
how should you load an ultrasonic cleaner
○ Take care when loading
§ No overlapping or shadowing of instruments
○ Hinged instruments open
§ Eg forceps
can you put handpieces in the ultrasonic cleaner
never place handpieces in the ultrasonic cleaner as they should not be immersed in water and ultrasonic activity will damage the high speed turbine
what detergent is used for an ultrasonic cleaner
§ Use neutral (pH 7) or enzymatic (we use sonozyme)
§ 25ml measured dose (sachet)
what should be done at least twice a day with an ultrasonic cleaner
Always drain and fill at least twice a day (4 hourly intervals) or more frequently if water is visibly soiled
what should be done at the end of every day with an ultrasonic cleaner
Always drain, clean and dry at the end of the day and refill next morning
what does a weekly test include for an ultrasonic cleaner
Weekly test includes daily test plus cleaning efficacy test (protein test strip) and staple result along with printout into log book
what are the housekeeping duties for washer disinfects
§ Clean filter
§ Clean door and seal
§ Check detergent level
§ Check printer for paper
what detergent is used for washer disinfects
Neutral (pH 7) enzyme
what test should be run for a washer disinfects
§ Daily automatic control test
○ Carry out daily test
Fill in daily test sheet in log book and staple printout
○ First run with instruments will be daily test cycle
○ 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
what does the thermal disinfection rinse use
Thermal disinfection rinse uses RO water to prevent the depositing of minerals on instruments and the washer disinfector
how should you load a washer disinfects
○ Take care when loading
§ No overlapping or shadowing of instruments
§ Hinged instruments open (forceps)
what should be done after all types of cleaning
Following all types of cleaning inspect instruments for cleanliness using task lighting and under magnification (lit magnifier)
what are the types of sterilisers
type N
type B
type S
what is a type N sterilise
§ Normal
§ Non-vacuum
§ Passive air removal
what is a type B steriliser
§ Better
§ Vacuum
§ Active air removal
what is a type S steriliser
§ Special
§ Only use according to manufacturers instructions
when is an instrument sterile
An instrument is sterile if the probability that there are viable microbes on the instrument is equal to 1 in a million
what are housekeeping duties for a steriliser
§ Wipe door seal and chamber
§ Check door safety devices
§ Drain and refill daily
§ (type N) check printer for paper
what water is used for a steriliser
§ Use purified water eg reverse osmosis (RO)
§ De-ionised, distilled or sterile water for irrigation
what steriliser can packaged instruments be used in
type B only
lumped or cannulated instruments are only suitable for use in what steriliser
type B only
what tests need to be done for type N sterilisers
○ Carry out daily test (type N)
§ Check print out and sign
§ Staple into logbook
§ Carry out weekly test
§ Weekly test includes daily test plus steam penetration test (chemical test strip) and staple result along with checked and signed printout into log book
what tests need to be done for type B sterilisers
○ Carry out daily test (type B)
§ Daily test includes:
□ Steam penetration test (chemical test strip)
□ Empty chamber
□ Helix or Bowie Dick
§ Staple result along with checked and signed printout into log book
§ Chemical indicators colour change from yellow to blue
○ Weekly test (type B) § Do the daily test § Plus the vacuum leak test § Plus the air detector function test § Enter results in log book § This would usually be for the user / manager to carry out but could be delegated
what is the sterilising temperature for sterilisers
○ Sterilising temperature: 134-137˚C
§ 2.05 to 2.3 bar for the minimum of 3 minutes
Common terminology used is, 134˚C, 2,25 bar for minimum 3 minutes
