LDU Flashcards
List reasons for cleaning (3)
- Medicolegal requirement
- Remove biological matter - functionality
- Minimise cross contamination
Features of a decon box (5)
- Tight fitting lid
- Leakproof
- Durable
- Rigid sided
- Colour coded
Describe steps of LDU (8)
- Hand hygiene + PPE
- Dispose of disposable/reusable items into transport box
- Set dirty instruments in to dirty instrument area
- AWD daily checks + loading
- AWD cycle
- Inspection - reprocess if dirty
- Manually clean + US (OLD NOTES)
- Steriliser
- Position in clean instrument cool down area then clean box
List daily checks for AWD
Check spray arms/jets free from blockage
Check door seal
Check filter
Check chemical level
Check load carrier
AWD loading requirements
Utilise basket furniture
No overlapping/shadowing
Hinged instruments open at hinge
Assemblies dissembled
Describe the AWD cycle (5)
- Flush - remove easy debris (30-35)
- Wash - remove hard debris (biological matter)
- Rinse - remove detergent/cleaner (<65)
- Disinfection - 90-95 degrees for 1 min
- Dry - hot air in chamber to remove excess moisture (90-110)
What to check under inspection?
Illuminated magnifier to check for residual contamination, functionality of instruments, damage/corrosion
Requirements of manual cleaning
PPE (apron, visor, rubber gloves, heavy duty gloves)
Dedicated cleaning sink
Water <35 + chemical detergent (enzymatic or pH neutral)
Long handled soft bristle brush scrub below water to decrease spread of contaminants
Use overflow plug in
What are the 2 methods for manual cleaning
Immersion
Non immersion - handpieces
What are the issues with manual cleaning (4)
- Splashing
- Cross contamination
- Sharps injuries
- Human error
Ultrasonic loading requirements
Utilise basket furniture
No overlapping/shadowing
Hinged instruments open at hinge
Assemblies disassembled
Ultrasonic checks
Degas to remove o2 - o2 inhibits cavitation
Check chemical level
What has to be done after use of US?
Rinse in separate sink
Reprocess through AWD disinfection
Change PPE between
Inspection
Sterilisation
Why do we lubricate joints/hinges before sterilisation?
Prevent corrosion
Temp + pressure gauge for sterilisation
134-137
2.05-2.35 pressure gauge
3.05-3.35 pressure absolute
Type B steriliser
B for better
Vacuum capable - active air removal
Channeled, wrapped, lumened, porous, cannulated instruments
Type B steriliser disadvantages
Additional periodic testing required
Type N steriliser
Non vacuum - gravity displacement - passive air removal
No wrapped, channeled, lumened instruments only rigid
Backup cleaning method if AWD is not available
Ultrasonic
Why do we not let instruments air dry
Trapped moisture –> corrosion/microbial growth
What type of water do we use
Sterile or reverse osmosis
How do you clean handpieces
AWD + Type B steriliser
Can’t go in US
Cant go in Type N steriliser
only non immersion manual wash
What are the conditions for storing instruments?
Clean, dry, organised
What is the protocol for dirty instruments with contamination stuck on it
US - indication for stubborn contamination
What are indications for manual wash?
AWD failure/servicing
AWD weekly tests
Cleaning efficacy test
- Test for residual protein detection on instruments
ACT
- Ensures AWD continues to function correctly
- Check temp/time within disinfection range, door cant be opened during cycle time
AWD daily checks
Door seal for damage
Load carrier for damage
Chamber for debris
Fill + drain water daily
Sprays arms/jets free from blockage
Check filter
Check door seal
Check chemical level
Check load carrier
Cleaning efficacy test visually (daily)
US daily checks
Door seal for damage
Load carrier for damage
Chamber for debris
Fill + drain water daily
Cleaning efficacy test visually (daily)
US weekly checks
Cleaning efficacy test
- ability to remove test soil from instruments
ACT
Test for US activity
- Erosive pattern created on aluminium foil exposed in bath
Steriliser daily checks
Door seal for damage
Load carrier for damage
Chamber for debris
Fill + drain water daily
Steriliser weekly checks
ACT
- Run load and check printout ensure parameters within range (temp, pressure,hold time)
Daily type B steriliser tests
Steam Penetration (Bowie dick/Helix)
- Measures reach of pressure + temp for adequate sterilisation
- Shows steam penetrates rapidly + evenly
- 100% colour change required
Weekly type B steriliser tests
ACT
- Check air not leaking into steriliser
- Can impair steam penetration, prevent sterilisation, recontaminate damp load during drying phase
ADSFT
- Fitted to detect residual air that will prevent sterilisation
