Judgement Day

Question 1

What are AWD

Answer 1

automatic washer disinfector

Question 2

What is the legal requirement

Answer 2

for us to operate a WD and process our contaminated instruments through one

Question 3

What i the chamber

Answer 3

background where process takes places

Question 4

What is the load carrier

Answer 4

where we position our instruments

Question 5

What are the pros and cons of manually washing instruments

Answer 5

there is potential for human error
there can be a variance of efficacy depending on the oerpator - if u have different individuals carrying out processes, you may not all be doing it the same way
they do have a significantly larger mechanical force but that means u need to have an operator manually cleaning

Question 6

What are the 5 core stages

Answer 6

flush/prewash
main wash
rinse
thermal disinfection
drying

Question 7

What is the flush/prewatch

Answer 7

this stage saturates the contaminated instrumentation

Question 8

What is the main wash

Answer 8

this stage is supplemented by detergent to more effetely remove contamination

Question 9

What is the rinse

Answer 9

this stage removes any remaining reside, biological or chemical before disinfection

Question 10

What is the thermal disinfection

Answer 10

this stage is actively killing microorganisms with the use of heated water

Question 11

What is the drying

Answer 11

this stage removes any remaining moisture from the instruments before sterilization

Question 12

What is the sump

Answer 12

there is fresh water used for each individual stage that fills the sump and is then circulated throughout the chamber

Question 13

What may be an additional stage

Answer 13

enzyme wash where there is use of different chemicals alongside main wash detergent

Question 14

Why is the flush/prewash, main wash rinse so important

Answer 14

more contamination is removed from the surface of the instruments and removed from the machine with the water changes

this is our only opportunity to remove proteins or prions
they must be removed during the wash stages

Question 15

Why is this stage the only opportunity to remove proteins or prions

Answer 15

they cannot be deactivated through disinfection or sterilization

high temperatures can make them adhere to the surface of instruments making them difficult to remove

they can survive higher temperatures for longer periods of time than temperatures and times of standard sterilization processes

they would also be removed if we were manually washing

Question 16

Describe the temperature for the flush/prewash stage

Answer 16

less than 25 degrees in relation to coagulation of proteins as breaching this will cause them to coagulate

Question 17

What is the temperature for the main wash

Answer 17

temperature dependent on the chemical used for process

Question 18

What is the temperature for the rinse

Answer 18

less than <65 degrees

Question 19

What is the temperature for the thermal disinfection

Answer 19

must be between 90-95 degrees for minimum of 1 minute

Question 20

What is the temperature for the drying stage

Answer 20

no specified temp but generally 90-110

Question 21

How are these temperatures and times decided

Answer 21

stage times, chemical volume and ash temperatures are established during the validation of the equipment by a competent person

Question 22

Who is the competent person

Answer 22

someone who is occupationally capable of carrying out this work to a standard that is required

for chemicals, the expected temp will be stated on the bottle and the engineer would decide on the temperature and then start to operate the cycle at that point to establish how well it is removing the contamination from the surface of instruments

Question 23

What stage’s temp never changes

Answer 23

thermal disinfection stage

Question 24

What is the first step in the decontamination process

Answer 24

use of WD

Question 25

Why is WD first

Answer 25

why bother manually cleaning when washer can do it

there is fresh water for each stage so not only removes contamination from instrument but removes it from machine entirely

the thermal disinfection stage makes the instrumentation safe for staff to handle so that a thorough inspection can take placed and then the instruments can be packaged for sterilization

Question 26

What is inspection

Answer 26

instruments are inspected for damage and present contamination

Question 27

What is used for inspection

Answer 27

illuminated magnifier

Question 28

What is the further processing

Answer 28

this is when we incorporate manual cleaning after the inspection stage if we have identified the contamination present

manually scrubbing will generate a greater mechanical force

following manual cleaning everything must be reprocessed back through the WD because of the thermal disinfeciton stage

Question 29

What happens after WD stage is complete

Answer 29

we verify there is no contamination present and that the instruments are not damaged in any way

we are ready to prepare any equipment for sterilization process