manual washing and cleaning

Question 1

when is prion removed

Answer 1

• Prion is only removed during the washing process

○ It is not deactivated during sterilisation and can survive higher temperatures than our standard process achieves

Question 2

what is involved in manual cleaning

Answer 2

We are removing bodily fluids and organic matter that has adhered to the surface of the instrumentation during the procedure that it was used for

Question 3

what is appropriate PPE to wear for cleaning instruments

Answer 3

• An apron / gown to cover our person
• A face shield to protect from splashing our face and eyes
• Rubber gloves (nitrile) and heavy duty rubber gloves (over the top of the rubber gloves) on our hands

Question 4

can you use the same sink for handwashing, rinsing and manual washing

Answer 4

We must have a dedicated sink for the purpose of manually washing and also a separate sink for rinsing
These cannot be the same sink used for hand washing

Question 5

what temperature must the water not be exceeded during the manual cleaning stage

Answer 5

The water must not exceed 35˚C as this might cause proteins to coagulate making them more difficult to remove

Question 6

what detergent is used during the manual cleaning stage and why

Answer 6

We use a chemical detergent during this process, generally enzymatic or pH neutral, to improve the cleaning process and help remove any contamination present

Question 7

what recommendations should we follow to successfully clean the instruments

Answer 7

• The chemicals must be dosed based upon the manufacturers instructions (MI), for correct concentration
○ This is generally in ml/L
○ Eg 5 millilitres per 1 Litre of water

• If we have our sink filled with 12L of water at a temperature no greater than 35˚C, we would need to dose 60ml of chemical for the correct concentration
○ 5 x 12 = 60

It is essential we do not exceed the recommended temperature as this may damage to efficacy of the chemical, especially if we are using enzymatic as this is temperature sensitive

Question 8

how should contamination be removed from the instruments

Answer 8

We manually scrub the instruments to remove contamination, this must take place below the surface of the water
We would generally use long handled, soft bristled, non-metallic brush, that can be processed through a thermal washing cycle, for this purpose

Question 9

why do we scrub the instruments below the surface of the water

Answer 9

1. We need contact with the water and detergent
2. While carrying out the process we want to minimise splashing
3. Scrubbing above the water causes aerosols to be produced

Question 10

what does physically scrubbing do

Answer 10

Physically scrubbing has removed the ‘gross contamination’ from the surface of the instruments

Question 11

what does the use of ultasonic do

Answer 11

The use of the ultrasonic bolsters the process by getting right into the textured surfaces and joints of the instruments
It is a ferocious process that uses soundwaves, at a very high frequency, to produce bubbles that implode and have a scouring effect against the hard surface of the instruments

Question 12

what process is referred to as cavitation

Answer 12

Ultrasonic cleaning
• As the sound waves pass through the water they cause microbubbles to be formed
• The fluctuation in pressures the sound waves induce, causes the bubbles to rapidly expand and then collapse

The process is referred to as cavitation

Question 13

what is the operating temperature of an ultrasonic bath

Answer 13

The operating temperature is set between 20-30˚C

Question 14

what is added to the water in the chamber of the ultrasonic bath

Answer 14

Chemical must be added to the water in the chamber, at the concentration recommended by the chemical manufacturer

Question 15

how long does the cycle of the ultrasonic bath take

Answer 15

The cycle must be ran for a specified period of time that has been established to effectively remove contamination

Question 16

what should be recored in the equipment log book

Answer 16

• The values previously mentioned must be recorded in our equipment log-book
• Record keeping is an essential part of our decontamination process

• You will be audited on it, in practice
○ Date 
○ Cycle number
○ Detergent added: yes / no
○ Temperature: \_\_˚C
○ Time (how long it ran for)

Question 17

what happens to instruments after they have been washed and processed in the ultrasonic bath

Answer 17

they should be rinsed in a separate ‘rinse’ sink to remove any remaining residue from the previous stages§

Question 18

what is the most basic step in the cleaning process of the decontamination cycle

Answer 18

Manual and ultrasonic are the most basic step in the cleaning process of the decontamination cycle

they are not the first stages of the cleaning cycle

Question 19

what is the first stage of the cleaning cycle

Answer 19

the first stage is the use of the washer-disinfector

Question 20

what are the reasons for manual washing

Answer 20

• Manually scrubbing with a brush exerts a greater force than the washer-disinfector is capable of producing
• Some pieces of equipment must only be manually washed, in line with manufacturers recommendations
• Ultrasonic baths have a ferocious process that is very good at removing contamination

Question 21

what are the reasons against manual washing

Answer 21

• A member of staff is required to be present for the entire process
• There is a risk of aerosol production
• There is a risk of contaminating the surrounding environment
• There is the potential for inconsistency in the process due to human error
• There is a high risk of sharps injuries for members of staff carrying out the process

• Ultrasonics have a ferocious process which has the potential to damage some equipment
There are no automatic water changes in an ultrasonic bath

Question 22

sorry these flashcards might be rubbish i dont really understand all this hahahhhhaha

Answer 22

xoxo lp