LDU competency

Question 1

What are the 9 steps of the lifecycle of reusable instruments missing from this picture?

Answer 1

Question 2

Define disinfection

Answer 2

as opposed to sterilisation, disinfection is intended to reduce the number of viable micro organisms and may not necessarily inactivate certain viruses and bacterial spores.

Usually achieved by automated washing process (thermal, preferred) or chemically.

Disinfection is required for contaminated equipment prior to handling and inspection, before packaging and sterilisation

Question 3

In the LDU, what is meant by packaging?

Answer 3

The materials used should be compliant with the relevant European standards (BS EN 868)

The method employed should be documented

Question 4

What needs to be taken into considerations re sterilisation?

Answer 4

The process used ie steam

The type of cycle ie vacuum vs non vacuum

Relevant parameters ie 134-137 degrees for min holding time of 3 minutes

Only vacuum sterilisers will reliably sterilise wrapped and hollow devices

Question 5

What is a policy?

Answer 5

Describe the aim of a particular process.

Should be available for all parts of the decon cycle

Question 6

What is a procedure in decon

Answer 6

Describe how to achieve compliance with policy.

Define, document and control all stages of decon process

Question 7

Define operator

Answer 7

Any person with the authority to operate a washer disinfector and steriliser, including the noting of instrument readings, replacing consumables and simple housekeeping.

Question 8

Define user

Answer 8

The person designated by the practice owner/manager responsible for the decontamination equipment.

Question 9

What are the duties of the user?

Answer 9

. to certify that the manual wash facilities, ultrasonic bath, AWD and sterilizer are fit for use;

b. to hold all documentation relating to the manual wash facilities, ultrasonic bath, AWD and sterilizer, including the names of other key personnel;
c. to ensure that the ultrasonic bath, AWD and sterilizer are subject to periodic testing and maintenance;
d. to appoint operators where required and ensure that they are adequately trained and training records completed and reviewed periodically;
e. to maintain production records;
f. to establish procedures for sterile instrument release.

Question 10

Define the manager

Answer 10

The person ultimately accountable for the operation of the dentla premisis (manager, owner etc)

Question 11

What are the responsibilities of the LDU manager?

Answer 11

a. to ensure that decontamination is carried out in compliance with the with the policy of the UK health departments; law and
b. to ensure that all personnel connected with decontamination, whether NHS employees or contract personnel, are suitably qualified and trained for their responsibilities;
c. to ensure that purchased ultrasonic baths, AWD’s and sterilizers conform to legal requirements, the minimum specifications set out in British and European standards, and any additional requirements of the UK health departments;
d. to ensure that ultrasonic baths, AWD’s and sterilizers are installed correctly and safely with regard to proper functioning, safety of personnel and environmental protection;
e. to ensure that newly installed ultrasonic baths, AWD’s and sterilizers are subject to a documented scheme of validation comprising installation checks and tests, commissioning tests and performance qualification tests before they are put into service;
f. to ensure that ultrasonic baths, AWD’s and sterilizers are subject to a documented scheme of periodic tests at yearly, quarterly, weekly and (in some cases) daily intervals in accordance with manufacturer’s instructions;
g. to ensure that ultrasonic baths, AWD’s and sterilizers are subject to a documented scheme of preventative maintenance;
h. to ensure that procedures for production, quality control and safe working are documented and adhered to in the light of statutory requirements and accepted best practice;
j. to ensure that procedures for dealing with malfunctions, accidents and dangerous occurrences are documented and adhered to.

Question 12

Who is the authorising engineer (decontamination)

Answer 12

the person designated by HFS to advise on decontamination procedures

Question 13

Who is a competent person (decontamination)?

Answer 13

a person designated to carry out maintenence, validation and periodic testing of washer disinfectors and sterilisers

It is recommended that no one CP carry out all 3 quarterly tests

Question 14

What is the sinners circle?

Answer 14

Time. Temperature. Chemicals. Energy

Question 15

What are the 5 stages of a WD cycle?

Answer 15

1. Flush: removing gross contamination from the items in the load with water at a temperature not exceeding 35°C.
2. Wash: removing any remaining soil by washing with water, water and detergent, or water and enzymatic cleaner. Several sub-stages may be used consecutively to provide a combination of treatments; physical removal of the soil by the action of water jets.
3. Rinse: removing any residual detergent or enzymic cleaner. This stage may be combined with the thermal disinfection stage which follows;
4. Disinfection: raising the temperature of the load to the preset temperature (using hot water) and maintaining the temperature for the required disinfection holding time.
5. Drying: purging the load and chamber with heated air to remove residual moisture.