Infection Control Flashcards
Good infection control
*it’s all about reducing transmission of infection
No food or drinks in clinical area
No jewellery/watches/bracelets/piercings (or covered)
Know good hand hygiene
Don’t wear gloves or mask into different clinical areas
Don’t handle notes or drawer handles with gloves on
Put the bib and glasses on the patient before you put on your ppe
Always re-sheath safety needles after use
Performs alcohol-based rub after doffing ppe and before leaving room
Then, performs alcohol based hand rub again prior to putting gloves back on and treating the patient
Aerosol generating procedures always require high volume aspiration *no bbv transmission evidence via Aerosol
Instruments used to place dental cements should be wiped clean immediately (before setting on the instrument surface)
Peform hand hygiene after removing PPE too (ie. Prior to seeing next patient)
Cleaning the station:
Top to bottom
Light
Chair
Spatoon
Then, with a different wipe do the bracket table and cables then the countertops
*think. Have I cleaned all the potentially contaminated surfaces
Single Use instruments into waste
or
LDU instruments (with tag into box)
LDU operation
Soiled instruments are first put into a cold water bath (except handpieces)
Then, either an automated washer-disinfector OR an ultrasonic bath (not for handpieces)
UB needs detergent and the instruments need rinsed in a separate bath afterwards
Then check for gross debris
If there is anything, go back to start of cleaning cycle
(Use light! Turn it on)
Steam sterilisation next. Non vacuum steriliser means not packaged
Vacuum steriliser means packaged
Used instruments should be in a clearly defined area
Clean instruments should go to another area and then immediately to storage
LDU facilitates
Automated (validated) cleaning
Thermal disinfection
Sterilisation
Prior to checking instruments for gross contamination in preparation for sterilisation
They must be dried and under good lighting
*if not dry, a lint free cloth can be used (not air dry)
Packaging must be compliant with what European standards
BS EN 868
Vacuum type B parameters
134-137°C for a minimum holding time of 3 minutes
Sterilise wrapped items that are hollow
Transport boxes (to and from)
Different color
Clean
Solid walled
Rigid
Durable
Leak-proof containers
Tight fitting lid - to protect instruments from damage and staff from injury
One for clean, one for dirty
Storage area requirements
Clean
Dry
Well ventilated
Secure
First in- first out policy
Labelling of equipment following the same BS EN 868 series
The 3 areas in the LDU
Dirty area (cleaning of used devices)
IAP area (Inspection, assembly, packing)
Clean area (sterilisation and post-sterilisation storage of devices)
Who is responsible for the decontamination of re-usable devices
Decontamination manager
Where to find main responsibilities of those involved with the LDU
Scottish health technical memorandum (SHTM 01-05 Part A)
*part B refers to periodic testing requirements
LDU operator
The person with the authority to operate decontamination equipment in processing of reusable medical devices
LDU user
Responsible for the management of the LDU process. Ensures all documentation is correct and machines are fit for use and operators are adequately trained
AED role
Authorising engineer decontamination: provides advice related to LDU and reviews the documentation on validation, revalidation and yearly tests
CPD role
Competent person decontamination: maintains, repairs and validates the equipment
Keeps the equipment up to date with relevant European standards
SHTM 01-05 Part B
Who needs to be educated on LDU use and maintenance
Any staff that manage, supervise or use the LDU
When would you use manual cleaning
Only in the event the AWD is unavailable
*procedure must be documented alongside details of items processed.
AWD Cycle stages
Flush - removes gross contamination with water (not above 35°C)
Wash - removed remaining gross contamination with water jets
Rinse - removes any detergent
Thermal disinfection - used for pre-assigned time
Drying - heated air
For a device to be considered sterile
It has undergone:
134-137°c at 2.25 bar for a minimum of 3 minutes
These are all devices used for invasive (spalding classification) dental procedures (pretty much all)
It cannot be wet or packaging ripped upon removal
types of water you can use for irrigation
Sterile water first
Reverse osmosis water second
Distilled or de-ionised water last
LDU design layout should be compliant with what regulation
SHPN 13 part 2
Type B steriliser
Vacuum steriliser
Active air removal
Wrapped or non-wrapped solid items
Wrapped or non-wrapped hollow items
Porous loads
Drain water reservoir and chamber daily
AWD checks
Check Daily: the cycle used, the time of use, detergent levels, spray arm for free rotation and spray nozzles for blockages, remove and clean strainers and filters
Check weekly: perform safety checks (door seals and door interlocks) and cleaning efficacy test (by residual soil detection)
Quarterly and annual tests: performed by CPD
*guidance found at SHTM 01-05 Part C
Steriliser daily checks
Check Time, temperature and pressure
Do a steam penetration test
*changes color, completely
Weekly tests: examine door seal for signs of deterioration or leaks
Air leakage test
Steam penetration test
Automatic air detection system function test
Quarterly and annual checks and tests: SHTM 01-05 Part C
*performed by CPD
PAT Testing
For electrical equipment, to ensure its safe to use, done at regular intervals by a competent person
