INFECTION CONTROL - decontamination Flashcards
what is decontamination?
the process of cleaning, rinsing, disinfection, drying, inspection, and sterilisation
what guidance documents are used for detcontamination?
Health Protection Scotland (HPS)
www.scottishdental.org
Scottish Health Technical Memoranda (SHTM)
Scottish Health Technical Note (SHTN)
what does disinfecting alone not get rid of?
bacterial spored
you must sterilise too
what defines an instrument as sterile?
when the probability of a viable microorganism being present in or on a device following a validated sterilisation process is less than one in a million
what are the top 3 most resistant microorganisms?
prions
bacterial spores
mycobacteria
what are the least 3 resistant types of microorganisms?
large non-enveloped viruses
gram-positive bacteria
lipid enveloped viruses
what is the criteria for local decontamination unit users?
fully vaccinated against Hep B
trained in the standards of infection prevention and control
can perform periodic testing of equipment and maintain accurate records
what is COSHH?
control of substances hazardous to health
what are substances hazardous to health?
biological agents - bacteria, viruses, fungi
chemicals
fumes
dust
vapours
what temperature should water be for manual cleaning?
30-35 degrees Celsius (should not exceed 45 as prions can start to coagulate and fix to instrument surfaces making cleaning more difficult)
what are features of an ultrasonic cleaner?
- interlocking lid to prevent operation with lid open and aerosols
- suspended baskets for instruments
- drain-tap to enable chamber being emptied
- control of process variables such as temperature and time (6-10 min cycle)
- a datalogger to give a retainable record of each cyc;e
what must you do prior to using the ultrasonic cleaner?
run first cycle empty to de-gas the solution
what dental instruments can not be cleaned in the ultrasonic?
dental handpieces
what temperature does the ultrasonic cleaner normally work at?
25-35 degrees Celsius
how often should solution in the ultrasonic cleaner be changed?
every 4 hours or if visible contaminated
what are the daily tests for the ultrasonic cleaner?
automatic control test
inspection of instruments
what are the weekly tests for the ultrasonic cleaner?
foil ablation testing
cleaning efficacy testing
what should be used to dry equipment after the cleaning process?
lint-free towels
why should you not not leave cleaned instruments to air dry?
it will promote microbial growth and or corrosion of the instruments
what are the main benefits of the washer-disinfector?
automated process
reduces risk of sharps injuries
minimal human contact with instruments
cleaning cycle is reproducible
disinfects as well as cleans
has a drying cycle
what is the preferred method for the cleaning of dental instruments?
washer-disinfector
what are the 5 stages of the washer-disinfector?
pre-wash
wash
rinse
thermal disinfection
drying
what is required to do daily for the washer disinfector?
check the spray nozzles for blockages
ensure spray arms are freely rotating
check door seals
remove and clean strainers and filters
what are the types of tests done on the washer-disinfector?
efficacy testing (daily/ weekly)
automatic control-test (daily/ weekly)
chemical test (quarterly/ annually)
why are instruments packaged after sterilisation?
- prevent recontamination and sterilisation
pre-sterilisation packaging material requirements?
- be made of non-shredding material
- only a single layer of wrapping material used
- allow placement of adhesive labelling
what should a package label contain?
contents - sterile or not
name of department/ clinic
instrument identifier
sterilisation cycle number
steriliser number
method of sterilisation - steam
what are the 3 methods of sterilisation?
heat
chemicals
radiation
what is sterilisation?
destruction/ removal of all living organisms and spores
why is effective cleaning essential prior to steam sterilisation?
prion proteins are not fully deactivated by sterilisation
any deposits left on instruments like blood, bone or cement will prevent penetration of steam
what could prevent sterilisation steam not penetrating all surfaces?
instruments not being fully dried prior to sterilisation
with steam sterilisation, what temperature and pressure hold is required to kill microorganisms?
134-137 degree celcius for a min of 3 mins at 2.1-2.25 gauge pressure
what are the 3 types of sterilisation cycles?
type B - vacuumed
type N - non-vacuum
type S - not all compatible with sterilisation of wrapped/ hollow items
what is the preferred method of steam sterilisation?
type B (vacuumed)
what properties should the water in the steriliser have?
low mineral, pathogen and endotoxin free
how often is the steriliser checked?
beginning of each day
what are the 2 types of traceability?
through the decontamination process
directly to the patient
is dentistry classed as low or high risk regarding the transmission of vCJD?
low risk (but high risk for bloodborne viruses)
how are dental instruments traced?
through the decontamination process
what is FIFO?
first in first out system to allow for stock rotation
