Instrument Decontamination - Operator Level Flashcards
Why is the washer disinfector the first stage? Pros?
Consistency
Traceability - automated and recordable
Automated
Washes, disinfects and drys
What occurs at the cleaning stage
removal of all biological matter
- for functionality of instrument
- minimise contamination
- prevent failed biopsy
- to achieve steam contact
- legal requirement
Placed in an automated washer-disinfector
What occurs at sterilisation stage
Processed through steam steriliser - vacuum or non vacuum
- vacuum is best
What is a decontamination flow line?
Used in the dental school. This is a flow line of how instruments should be decontaminated.
What three things must be in place for manual cleaning?
When should it be done?
Dedicated sink around 12L of water for washing and then a separate sink for rinsing
Standard tap water at 30-35 degree
Chemical detergents, pH neutral 5ml per 1L of water
Only when instructed by instrument instructions
Or when automated cleaning is not available or it has failed to remove the decontamination
What two methods of manual cleaning is there?
Immersion or non immersion
Immersion = long handled soft bristled brush
Cloth = non immersion as dont want aerosols above water
What is the ultrasonic bath?
Secondary back up after washer-disinfector
Uses ultrasonic high frequency sound waves to produce bubbles that implode and have a scouring effect.
Can damage instruments so always verify manufacturers instructions
What is the process of cleaning
Washer disinfector
Manual / ultrasonic cleaning (if needed)
Rinsing
Back into washer disinfector
Pros / cons for manual/ultrasonic cleaning
Pros
- greater force than WD
- ultrasonic bath has ferocious process
- some instruments require this
Cons
- staff member present all the time
- risk of aerosol production
- Potential for human error
- risk of sharps
- only washes, no disinfection or drying
What are the stages of a washer disinfector? Briefly describe each
Prewash - remove gross contamination
Main wash - detergent supplemented to remove more biological matter
Rinse - removes cleaning residue
Thermal disinfection - kills MO’s with heated water
Drying - hot air removes moisture
Verify all contamination removed
Between each stage, water is automatically changed to remove proteins / contamination from the water
What checks must be done for the washer disinfector?
Check arms can rotate freely without obstruction
Check cleaning chemical is at sufficient level
Check no debris in the chamber from previous wash cycles
Why is steam used for sterilisation? What must be ensured when using steam?
Carries a large amount of energy
Non toxic
Can be re-condensed and re-used
Main ingredient is water, small amount can make lots of steam at high pressure in chamber
No waste except water
Must use purified water with no minerals, MOs or organics in it
What can be placed in each type of steriliser ?
Type N (steam expels air, sometimes pocket left over) - only rigid or solid steel instruments with no lumens, no wrapped instrumentation
Type B (vacuum created first) - can use lumened instruments and also porous items such as cotton wool swabs
Type S (also washes and lubes handpieces + pre vacuum like B) - only for equipment designed for this
Safety check is of sterilisers?
Check door seals intact
Verify chamber not damaged
Fill feed water daily
Drain reservoir daily
What are the ideal conditions for use and processing stages
After use, instruments should b processed as quickly as possible as biological matter can dry and stick stubbornly
What is sinners circle?
4 key elects required for successful cleaning
Energy
Chemicals
Time
Temperature
