Overview of Decontamination Process Flashcards
What are the reasons for cleaning and disinfecting instruments before sterilisation?
Legal requirement
Preserve function- biological matter can clog instruments
To remove biological contamination-
-> minimises the spread of infection/cross-contamination (could lead to mis-diagnosis)
So that it is safe to inspect
-> this allows steam to clean devices properly
What are the requirements of the container for transporting used instruments?
Durable
Leak proof
Rigid sided
Colour coded/clearly marked
Tight-fitting lid
What daily tests should be carried out for AWD?
Check spray arms rotate and are not blocked
Check filter/strainer for debris and contamination from instruments
Check door seal for damage and cleanliness
Check chemical and water level- replenish
Verify condition of load carrier
Record disinfection temp of first cycle
How should AWD be loaded (this should be established at validation)?
No overlapping of instruments
Do no overload machine
Assemblies should be disassembled
Restorative materials should be removed beforehand
Forceps should be open at hinge and positioned so they will remain open
What are the stages of AWD cycle?
Flush
Wash
Rinse
Disinfection
Drying
What is the function of using an illuminated magnifier when inspecting instruments?
Can verify if AWD was successful
Can identify if contamination still present
Can verify functionality of instruments
-> if damaged can be sent for repair
What happens if contamination is still present on instruments that have been through AWD?
They are manually cleaned and processed through ultrasonic
-> removes dried-in or gross contaminants
What are the recommendations for manual cleaning?
Water should be <35
pH neutral or enzymatic detergent is used
-> amount depends on volume of water
-> Follow manufacturers instructions
Use long handled soft bristled brush
Use separate sinks for washing and rinsing
What are the 2 methods of manual cleaning?
Immersion
Non-immerion
-> required for handpieces as they should not be immersed
What is used following manual cleaning?
Ultrasonic bath
What are the recommendations when using ultrasonic bath?
Fill to required level
Degas before use
Load as for AWD
*do not process handpieces using this
What are the recommendations when using ultrasonic bath?
Fill to required level
Degas before use
Load as for AWD
*do not process handpieces using this
Why are instruments reprocessed through AWD following manual/ultrasonic cleaning?
Disinfection stage makes it safe for staff to handle and inspect
What temperature and pressure banding are achieved by sterilisers? (type N, S, B)
134-137 degrees for minimum hold time of 3 mins
Pressure equivalent gauge (from atmospheric) 2.05 – 2.35 bar
-> required to reach temperature
Pressure equivalent absolute (from absolute zero) 3.05 – 3.35 bar
What additional tests are needed for Type B sterilisers?
Bowie dick- steam penetration
-> daily
Air leakage test- weekly
Air Detector function test- weekly
How does a steriliser work?
Purified water is introduced into chamber and heated
-> when it boils and turns to steam pressure in chamber increases
What is a type N steriliser known as?
Gravity displacement
What can be processed by type N steriliser?
Rigid steel instruments
Cannot process wrapped, channelled or lumened instruments
What is a type B steriliser known as and why?
Vacuum capable or porous load
-> active air removal in initial stage creates vacuum in chamber
-> this means no air in chamber allowing steam to flow in from generator
What happens in type B steriliser when sterilisation is finished?
Machine draws another vacuum for drying
-> Allows water to vaporise at Lower temp
What can be processed by type B steriliser?
Wrapped (ensure no damage to these), channelled and lumened instruments
Porous loads- cotton swabs
What is different about instruments processed by type N and type B?
Type B- wrapped instruments, sterile at point of use
Type N- sterilised only, should be wrapped as soon as possible
How should wrapped instruments be stored?
Environmentally controlled atmosphere free of moisture and contaminants
What are the safety considerations when decontaminating instruments?
Are instruments being transported correctly
Are we wearing PPE
Are items being disposed of in correct waste stream
Are single use items managed correctly
Are we storing sterilised items correctly
What are the considerations regarding staff in an LDU?
Do staff understand key stages of process
Are staff trained to use equipment
Have staff been supplied with PPE
Do staff know how to work safely
-> are they aware of dangers
What are the considerations regarding records of decontamination process?
Do we have training records for all staff on
all equipment and processes
Do we have machine printouts and cycle data
Are our validation and testing records up to date
Are we maintaining a maintenance register for our equipment
Are we recording faults and failures
What are the considerations regarding compliance with standards when carrying out decontamination?
Are we following the correct and most
up to date guidance (SHTM 01 – 01):
Can the equipment consistently achieve the set-points (temperature, chemical, pressure, time)
Has it been produced in line with the relevant standards (MDR)
Does my test partner comply with the guidance (SHTM 01 -01)
Do they test my equipment in-line with the required standards (BS EN)
Sinners Circle:
Time
Chemical
Energy
Temperature
Water
