Overview of Decontamination Cycle & Process Flashcards
Describe the ideal flow line of a single room LDU
- dirty
- wall mounted PPE
- wash hand basin
- dirty set down
- wash sink
- ultrasonic cleaner
- rinse sink
- RO water treatment
- washer disinfector
- clean
- inspection area
- magnifying inspection lamp
- dental handpiece cleaner lubricator
- packaging
- steriliser
- cooling and dispatch
- administration area
What is the purpose of a flow line in a single room LDU?
to minimise the potential for cross contamination
What are the 9 stages of the life cycle of a reusable dental instrument?
- cleaning
- disinfection
- inspection
- packaging
- sterilisation
- transport
- storage
- use
- transport
Provide examples of process verification
- steriliser tests
- Bowie Dick test
- steam penetration
- Helix test
- steam penetration
- chemical indicator
- steam penetration
- Bowie Dick test
- washer disinfector tests
- test soil
- cleaning efficacy
- residual protein test
- cleaning efficacy
- test soil
What information is included for an automatic control test of a washer disinfector?
- cycle number
- cycle selected
- disinfection hold temperature
- disinfection hold time
- cycle complete indication
- result of test
- certified fit for use
Describe the criteria a container must meet to be suitable to carry contaminated instrumentation
- durable
- leak proof
- rigid sided
- colour coded or clearly marked
- tight fitting lid
The first stage of the decontamination process is cleaning in the washer disinfector, what are the reasons for this?
- medico-legal requirement
- removal of biological matter
- can impact functionality
- minimises cross contamination
- e.g. misdiagnosis
- removal of biological substances
- can prevent steam contact
- reduces risk when handling instruments
How should load carriers be loaded with instruments?
- no overlapping or shadowing
- do not overload machine
- utilise the available load carrier
- all assemblies should be disassembled
- forceps should be open at the hinge
- restorative material must be removed
What daily testing should be carried out for a washer disinfector?
- check spray arms/jets
- check filter/strainer
- check door seal
- verify chemical level
- verify load carrier
- record cycle data
What are the 5 cycle specifics in a water disinfector?
- flush
- wash
- rinse
- thermal disinfection
- drying
What is the function of the flush stage of the washer-disinfector?
remove gross contamination
What is the function of the wash stage of the washer-disinfector?
remove biological matter
What is the function of the rinse stage of the washer-disinfector?
remove residue
What is the function of the thermal disinfection stage of the washer-disinfector?
90-95 degrees for 1 minute to reduce the number of viable organisms
What is the function of the drying stage of the washer difinfector?
remove excess moisture
What does inspection of instruments look for after cleaning in the washer disinfector?
- using an illuminated magnifier
- residual contamination
- functionality of instruments
- damage or corrosion
If on inspection an instrument is damaged or corroded what must be done?
- repaired
- disposed of
If on inspection an instrument is contaminated what must be done?
- reprocess
What are the two methods of manual cleaning?
- immersion
- solid instruments
- non-imerssion
- handpieces
What PPE must be work during manual cleaning?
- gloves
- heavy duty gloves
- apron
- face covering
What are the requirements of manual cleaning?
- chemicals
- <35 degrees
- under surface of water
- soft bristles brush
What are the issues associated with manual cleaning?
- splashing
- cross contamination
- sharps injuries
- human error
What is the capability of an ultrasonic bath?
can remove stubborn/dried in/gross contamination
What process do ultrasonic baths use to remove contamination?
cavitation
Describe the process of an ultrasonic bath
- bath filled to required level
- chemicals added as per manufacturers instructions
- run de-gas cycle
- load according to requirements
What instruments cannot be processed through an ultrasonic bath?
handpieces
What is the temperature and hold time for sterilisation?
134-137 degrees for 3 minutes
What are the pressure gauge and pressure absolute for sterilisers?
- pressure gauge
- 2.05-2.35
- pressure absolute
- 3.05-3.35
What are the daily checks that must be carried out for sterilisers?
- check load carrier and chamber
- check door seal
- fill feed water reservoir
- drain used water reservoir
- record cycle information
Describe a type N-steriliser and what can and cannot be processed in one
- non-vacuum steriliser
- gravity displacement
- cannot process
- wrapped items
- channeled or lumened devices
- can only process rigid instruments
- as instruments cannot be wrapped they are not sterile
- have ‘been sterilised’
Describe a type B-steriliser and what can be processed in one
- porous load or vacuum capable machine
- can process wrapped instruments
- can process channeled and lumened items
- wrapped instruments are sterile
What daily testing must be carried out for Type-B sterilisers?
- steam penetration test (adequate air removal)
- Bowie Dick
- Helix
What weekly testing must be carried out for Type-B sterilisers?
- air leakage test
- air detector function test
What is the function of an air leakage test?
- verifies integrity of the chamber
- ensures no leaks
- ensure door seal and valve closure
What is the function of an air detector function test?
verifies machines capability to recognise air in the chamber
Why is it important to remove air when sterilising in a Type-B steriliser?
air will always be at a lower temperature which can prevent the steriliser reaching the time/temperature kill rate required for sterilisation
Describe the criteria a container must meet to be suitable for transporting clean instruments
- durable
- leak proof
- rigid sided
- colour coded or clearly marked
- tight fitting lid
How is safety ensured at all stages of the decontamination process
- safe transportation of hazardous material
- use of PPE
- protect unwrapped instrumentation
- correctly mange single use equipment
- store sterile instruments correctly
What questions must be asked of staff at all stages of the decontamination process?
- are staff trained for each task and process?
- is staff training documented?
- is there a SOP in place?
- has correct PPE been provided?
- are there barriers to safe working
How should sterile instruments be stored to remain sterile?
- temperature controlled environment
- no fluctuations causing condensation
- unlikely to encounter aerosol contamination
- out of direct sunlight
- unlikely to be damaged
What records must be taken over all stages of the decontamination process?
- staff training records
- cycle data for traceability
- daily
- validation and testing reports
- quarterly testing
- annual validation
- asset register with maintenance intervals
- faults, failures and diagnostics
How can compliance be assured at all stages of the decontamination process?
- equipment produced in line with MDD
- correct guidance followed
- monitoring of equipment performance
- CPD qualified and experience
- follow most up to date standard and guidance
