INFECTION CONTROL - decontamination Flashcards

1
Q

what is decontamination?

A

the process of cleaning, rinsing, disinfection, drying, inspection, and sterilisation

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2
Q

what guidance documents are used for detcontamination?

A

Health Protection Scotland (HPS)
www.scottishdental.org
Scottish Health Technical Memoranda (SHTM)
Scottish Health Technical Note (SHTN)

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3
Q

what does disinfecting alone not get rid of?

A

bacterial spored
you must sterilise too

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4
Q

what defines an instrument as sterile?

A

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

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5
Q

what are the top 3 most resistant microorganisms?

A

prions
bacterial spores
mycobacteria

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6
Q

what are the least 3 resistant types of microorganisms?

A

large non-enveloped viruses
gram-positive bacteria
lipid enveloped viruses

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7
Q

what is the criteria for local decontamination unit users?

A

fully vaccinated against Hep B
trained in the standards of infection prevention and control
can perform periodic testing of equipment and maintain accurate records

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8
Q

what is COSHH?

A

control of substances hazardous to health

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9
Q

what are substances hazardous to health?

A

biological agents - bacteria, viruses, fungi
chemicals
fumes
dust
vapours

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10
Q

what temperature should water be for manual cleaning?

A

30-35 degrees Celsius (should not exceed 45 as prions can start to coagulate and fix to instrument surfaces making cleaning more difficult)

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11
Q

what are features of an ultrasonic cleaner?

A
  • 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
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12
Q

what must you do prior to using the ultrasonic cleaner?

A

run first cycle empty to de-gas the solution

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13
Q

what dental instruments can not be cleaned in the ultrasonic?

A

dental handpieces

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14
Q

what temperature does the ultrasonic cleaner normally work at?

A

25-35 degrees Celsius

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15
Q

how often should solution in the ultrasonic cleaner be changed?

A

every 4 hours or if visible contaminated

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16
Q

what are the daily tests for the ultrasonic cleaner?

A

automatic control test
inspection of instruments

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17
Q

what are the weekly tests for the ultrasonic cleaner?

A

foil ablation testing
cleaning efficacy testing

18
Q

what should be used to dry equipment after the cleaning process?

A

lint-free towels

19
Q

why should you not not leave cleaned instruments to air dry?

A

it will promote microbial growth and or corrosion of the instruments

20
Q

what are the main benefits of the washer-disinfector?

A

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

21
Q

what is the preferred method for the cleaning of dental instruments?

A

washer-disinfector

22
Q

what are the 5 stages of the washer-disinfector?

A

pre-wash
wash
rinse
thermal disinfection
drying

23
Q

what is required to do daily for the washer disinfector?

A

check the spray nozzles for blockages
ensure spray arms are freely rotating
check door seals
remove and clean strainers and filters

24
Q

what are the types of tests done on the washer-disinfector?

A

efficacy testing (daily/ weekly)
automatic control-test (daily/ weekly)
chemical test (quarterly/ annually)

25
Q

why are instruments packaged after sterilisation?

A
  • prevent recontamination and sterilisation
26
Q

pre-sterilisation packaging material requirements?

A
  • be made of non-shredding material
  • only a single layer of wrapping material used
  • allow placement of adhesive labelling
27
Q

what should a package label contain?

A

contents - sterile or not
name of department/ clinic
instrument identifier
sterilisation cycle number
steriliser number
method of sterilisation - steam

28
Q

what are the 3 methods of sterilisation?

A

heat
chemicals
radiation

29
Q

what is sterilisation?

A

destruction/ removal of all living organisms and spores

30
Q

why is effective cleaning essential prior to steam sterilisation?

A

prion proteins are not fully deactivated by sterilisation
any deposits left on instruments like blood, bone or cement will prevent penetration of steam

31
Q

what could prevent sterilisation steam not penetrating all surfaces?

A

instruments not being fully dried prior to sterilisation

32
Q

with steam sterilisation, what temperature and pressure hold is required to kill microorganisms?

A

134-137 degree celcius for a min of 3 mins at 2.1-2.25 gauge pressure

33
Q

what are the 3 types of sterilisation cycles?

A

type B - vacuumed
type N - non-vacuum
type S - not all compatible with sterilisation of wrapped/ hollow items

34
Q

what is the preferred method of steam sterilisation?

A

type B (vacuumed)

35
Q

what properties should the water in the steriliser have?

A

low mineral, pathogen and endotoxin free

36
Q

how often is the steriliser checked?

A

beginning of each day

37
Q

what are the 2 types of traceability?

A

through the decontamination process
directly to the patient

38
Q

is dentistry classed as low or high risk regarding the transmission of vCJD?

A

low risk (but high risk for bloodborne viruses)

39
Q

how are dental instruments traced?

A

through the decontamination process

40
Q

what is FIFO?

A

first in first out system to allow for stock rotation