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Patient Management And Health Promotion Flashcards

1
Q

What are the three roles of epidemiology?

A

Measure the amount of disease
Measure the distribution and natural history of disease
Assess peoples risk of disease, health care needs assessment and service planning

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2
Q

What is the definition of prevalence?

A

Number of disease cases in a population at a given time

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3
Q

What is incidence?

A

Number of new disease cases developing over a specific period of time in a defined population

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4
Q

What is a risk factor?

A

A factor that increases the probability of disease if present and reduces the probability of disease if absent

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5
Q

What is the definition of a causative agent?

A

An external factor that causes/results in disease in susceptible individuals

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6
Q

What is a determinant?

A

Attribute/circumstance which affects liability of an individual to be exposed to disease

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7
Q

What are the three types of risk index?

A

Absolute risk
Attributable risk
Relative risk

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8
Q

What is absolute risk?

A

Incidence of disease in those exposed to the agent

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9
Q

What is the definition of attributable risk?

A

Difference in incidence in exposed:non-exposed

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10
Q

What is the definition of relative risk?

A

Measure of proportion increase in disease rates in exposed groups

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11
Q

What is the SIMD?

A

Scottish Index of Multiple Deprivation
Ranks datazones in order of deprivation 1-5 or 1-10

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12
Q

What is SIMD based on?

A

Housing
Income
Geographical access to services
Health
Education
Skills and training
Crime

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13
Q

What are the 6 factors of consent?

A

Valid
Informed
With capacity
Voluntary
Not coerced
Not manipulated

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14
Q

What are the 5 factors of capacity?

A

Ability to Act
Make a reasoned decision
Understand a decision
Communicate a decision
Retain memory of a decision

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15
Q

What are the four features of a randomised control trial?

A

Specification of participants (inclusion/exclusion criteria)
Controlled
Randomisation
Blinded/masked

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16
Q

What is absolute risk difference?

A

The difference in risk between groups

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17
Q

What is the meaning of and calculation for number needed to treat (NNT)

A

Number of people needed to treat to prevent 1 outcome of disease
1/ARD

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18
Q

What are the stages in changing SoPs?

A

Identify the problem
Set criteria and standard
Observe practice and collect data
Compare performance with set out standards
Implement change

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19
Q

What are the principles of waste disposal?

A

Segregation
Storage
Disposal
Documentation

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20
Q

What are the laws and regulations associated with Waste Disposal?

A

Health and Safety at Work Act 1974
The Controlled Waste Regulations 2012
The Hazardous Waste Directive 2011
Control of Substances Hazardous to Health (COSHH) 2002

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21
Q

What are the features of an amalgam container?

A

Leak and spill proof
Mercury Vapour Suppressant Lid
White body and red lid drum

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22
Q

What are the signs and symptoms of nicotine withdrawal?

A

Irritability
Poor concentration
Depression
Restlessness
Increased appetite
Sleep disturbance

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23
Q

What are the oral side effects of smoking?

A

Staining
Halitosis
Nicotinic Stomatitis

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24
Q

What are the 3A’s

A

Ask
Advice
Act

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25
Q

What are the 5A’s?

A

Ask
Advice
Assess
Assist
Arrange follow up

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26
Q

What does AAR stand for?

A

Ask
Advice
Refer

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27
Q

What are the ABC’s of cessation?

A

Ask
Brief cessation
Cessation advice

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28
Q

How many ml of alcohol in 1 unit?

A

10ml

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29
Q

What are the recommended alcohol units?

A

14 units/week spread over 3 or more days with 2 alcohol free days

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30
Q

What is the calculation for alcohol units?

A

ABV x Volume /1000

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31
Q

What are the 10 SICPs?

A

Patient Placement and Assessment
Hand Hygiene
Respiratory and Cough Hygiene
PPE
Safe Management of Linen
Safe Management of Waste (in sharps)
Safe Management of Blood and Bodily Fluid Spillage
Safe Management of the Care Environment
Safe Management of Care Equipment
Occupational Safety, Prevention of Exposure

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32
Q

What is used for cleaning up blood spillages?

A

Sodium dichloroisocyanurate

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33
Q

What is the minimum contact time for cleaning up spillages?

A

3 minutes

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34
Q
A
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35
Q

How are sharps managed?

A

Stop
Encourage bleeding
Contact manager

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36
Q

How often is HBV contacted in sharps exposures?

A

1 in 3

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37
Q

How often is HCV contacted in sharps exposures?

A

1 in 30

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38
Q

How often is HIV contacted in sharps exposures?

A

1 in 300

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39
Q

How often is HIV contacted in sharps exposures?

A

1 in 300

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40
Q

What is the workflow for decontamination?

A

Wash
Disinfect
Inspect
Pack
Sterilise
Transport

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41
Q

What is the sinners circle?

A

Time
Temperature
Energy
Chemical

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42
Q

What is the definition of domestic abuse?

A

Any form of physical, verbal, sexual or psychological abuse that takes place within the context of a relationship between partners/ex-partners

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43
Q

What type of behaviours are considered domestic abuse?

A

Situational couple violence
Co-ersive and controlling behaviours

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44
Q

What act deals with domestic abuse?

A

Domestic Abuse Act (Scotland)

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45
Q

What types of abuse are covered in the Domestic Abuse Act (Scotland)?

A

Physical
Psychological
Emotional

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46
Q

What proportion of women are affected by domestic abuse?

A

1 in 5

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47
Q

What is gender-based violence?

A

Violence directed against a person on the basis of gender

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48
Q

What is coercive control?

A

A pattern of behaviours that aims to isolate someone from their family and friends
The person is degraded to a point of low self esteem with micro regulation overall aspects of life: money, dress, surveillance

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49
Q

Who is most at risk of domestic abuse?

A

Women aged 16-24
Men aged 16-19
Those with long term illness or disability (x2), mental health problems
Women who are separated or pregnant

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50
Q

What are the non-fatal outcomes of domestic abuse?

A

Physical issues
Chronic conditions
Reproductive problems

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51
Q

What are the fatal outcomes of domestic abuse?

A

Femicide
Suicide
Maternal mortality

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52
Q

What are the behavioural signs of domestic abuse?

A

Low self esteem
Victims may appear fearful, anxious or sad
Constant phoning or texting partner
Alcoholism
Partner may do all the talking

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53
Q

What are the physical signs of domestic abuse?

A

Repeated injuries
Bruises at different stages of healing
Dental/maxillofacial injuries
Delay in seeking help
Unlikely explanations for injuries

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54
Q

What are the barriers for screening domestic abuse?

A

Patient accompanied to appointments
Lack of training
Concern about offending the patient
Cultural norms
Embarrassment
Lack of time

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55
Q

What does AVDR stand for?

A

Ask
Validate
Document
Refer

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56
Q

What does Ask mean in AVDR?

A

Ask about abuse in a non-judgemental way

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57
Q

What does Validate mean in AVDR?

A

A way to show someone that they are not to blame and they deserve better

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58
Q

What does Document mean in AVDR?

A

Taking clinical notes: specific and detailed descriptions of the injuries

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59
Q

What does Refer mean in AVDR?

A

Referring the patient to appropriate services
May provide a small card with details

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60
Q

What is the calculation for incidence rate?

A

Number of new cases/ number of individuals at risk

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61
Q

What is the calculation for prevalence rate?

A

Number of affected individuals/ total number in population

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62
Q
A
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63
Q

What is black stream waste for?

A

Non-infected household waste

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64
Q

What is orange stream bag for?

A

Low risk waste
Picked up for heat disinfection

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65
Q

How is the orange stream bin managed?

A

Containers filled to line
Label completed and identified on bin
Picked up by heat disinfection

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66
Q

What is yellow stream waste?

A

High risk
Body parts, medicine, anaesthetics, sharps, drug vials

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67
Q

How is yellow stream waste managed?

A

Incinerated

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68
Q

What is red stream waste for?

A

Amalgam

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69
Q

How is red stream waste managed?

A

Specialist treatment to recover chemicals

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70
Q

What are the key aspects of a waste transfer note?

A

Description of waste
Origin
Quantity
Transport and destination

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71
Q

How long is a consignment note kept?

A

Minimum of three years

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72
Q

What are examples of regulations for waste disposal?

A

Special Waste (Amendment) Regulations 2004
Health and Safety at Work Act 1974
COSHH 2002
Environmental Protection Act 1990
Health and Safety Executive (HSE)
Scottish Environmental Protection Agency (SEPA)

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73
Q

What does AWD stand for?

A

Automatic Washer Disinfector

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74
Q

What does an AWD do?

A

Removes prions and proteins

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75
Q

What are the differences between an Ultrasonic cleaner and an automatic washer disinfector?

A

Ultrasonic does not disinfect or dry

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76
Q

What are the stages of an automatic washer disinfector?

A

Flush/Pre-wash
Main wash
Rinse
Thermal disinfection
Drying

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77
Q

Discuss the flush/pre-wash?

A

<35 degrees
Removes gross contamination

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78
Q

Discuss the main wash?

A

Supplemented by detergent

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79
Q

Discuss rinse?

A

<65 degrees
Removes residue

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80
Q

Discuss thermal disinfection?

A

90-95 minutes
Kills micro-organisms with hot water

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81
Q

Discuss drying:

A

> 100 degrees
Hot air to remove moisture

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82
Q

What are the daily checks for an Automatic Washer Disinfector?

A

Verify condition of load carrier
Check that the spray arms spin freely
Check that the spray jets are not blocked
Ensure there is no debris on the strainer/filter
Check the condition of the door seal
Verify there is suitable chemical levels
Record the disinfection temperature of the first cycle

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83
Q

What happens during the inspection stage?

A

Use an illuminated magnifier to check for damage or contamination

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84
Q

What is the journey that dental instruments go on during processing?

A

Acquisition

Cleaning
Disinfection
Inspection
Packaging
Sterilisation
Transport
Storage
Use
Transport

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85
Q

What happens during the cleaning stage?

A

Proteins and prions are removed

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86
Q

What PPE is required during cleaning?

A

Apron
Face shield
Rubber gloves and heavy duty rubber gloves

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87
Q

What are the requirements for manual cleaning?

A

Dedicated sinks: 1 for manual cleaning, 1 for rinsing
Standard tap water: between 30-35 degrees
Enzymatic or pH neutral detergent

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88
Q

Why should standard tap water be less than 35 degrees?

A

> 35 degrees: protein coagulation

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89
Q

What is manual cleaning?

A

Instruments scrubbed below the surface of the water with a long handed soft-bristled brush

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90
Q

Why does manual cleaning take place underwater?

A

To minimise splashing and aerosols

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91
Q

When should you manual wash?

A

Specifically recommended in the manufacturers instructions
No alternative available

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92
Q

How does the ultrasonic bath work?

A

Uses high frequency sound waves to produce bubbles that implode causing a scouring effect

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93
Q

How does cavitation work?

A

As sound waves pass through the water, they cause the formation of micro bubbles
The fluctuation in pressures produced by the sound waves leads to bubbles rapidly expanding and collapsing

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94
Q

How is the ultrasonic machine set up?

A

Set to 20-30 degrees
Filled with tap water to marked volume
Chemical added based on manufacturers instructions
Cycle ran for period of time specified at validation

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95
Q

What is a Degas cycle?

A

Before ultrasonic used- it is ran on a cycle filled with detergent

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96
Q

Why is a Degas cycle used?

A

To remove air/gas bubbles in the water as the ultrasonic bubbles will collapse into them and this reduces the efficacy of the ultrasonic

97
Q

What values should be recorded when cleaning instruments?

A

Date
Detergent Added
Time
Cycle Number
Temperature
Operator Name

98
Q

What takes place after manual cleaning or ultrasonic cleaning?

A

Rinsing in a separate sink

99
Q

What should be checked during inspection?

A

Check functionality
Remove excess moisture (lint free drying cloth)

100
Q

What are the benefits of manual cleaning?

A

More force than washer disinfector
Some items can only be manually washed

101
Q

What are the benefits of an ultrasonic cleaner?

A

Ferocious
Good at removing contamination

102
Q

What are the downsides of manual and ultrasonic cleaning?

A

Staff member must be present
Risk of aerosol production
Risk of contaminating environment
Potential inconsistency: human error
High risk of sharps injury
Ultrasonic can damage some instruments
No automatic water changes in ultrasonic bath
No thermal disinfection targeting microorganisms

104
Q

What tests can be carried out on a type B steriliser?

A

Steam penetration tests: Bowie dick or helix

105
Q

What is the active ingredient in alkaline peroxides?

A

Sodium perborate

106
Q

When are prions and proteins removed during cleaning?

A

Pre-wash
Main wash

107
Q

What are the settings for sterilisation?

A

134-137C for minimum 3 minutes

108
Q

When can tap water be used in decontamination?

A

Mechanical cleaning
Washer disinfected

109
Q

What were the findings from the Hunter V Hanley (1995) case?

A

No negligence where doctors disagree

110
Q

What were the findings from the Bolam v Friem Hospital Management Committee (1957) case?

A

No negligence where doctors disagree

111
Q

What were the findings from the Sidaway v Bethlem Royal Hospital (1985) case?

A

Patient should be informed if risk over 10%
No negligence if one group of clinicians would communicate risk and one would not

112
Q

What were the findings from the Chester v Afshart case?

A

Even a small risk of a severe outcome should be communicated

113
Q

What are the findings from the Montgomery case?

A

Patient should be told of the risk even if they do not ask

114
Q

What are material risks?

A

A reasonable person, if warned of the risk would be likely to attach significance
The dentist is aware, or should be reasonably aware that this particular patient, if warned of these risks would attach significance

115
Q

What percentage of adverse events in hospitals are associated with non technical skills?

116
Q

What are examples of non-technical skills?

A

Task management
Team working
Situation awareness
Decision making

117
Q

What does SBAR stand for?

A

Situation
Background
Assessment
Recommendation

118
Q

What are examples of human factors?

A

Perception
Cognition
Memory
Motor activity
Involuntary Automaticity
Stress
Overload
Affect

119
Q

What are the barriers to care?

A

Physical
Attitudinal
People centered
Professional centered

120
Q

What is critical by Spaulding classification?

A

Penetrates soft tissue

121
Q

What are examples of critical instruments based on Spauldings?

A

Scalpels
Forceps

122
Q

How are critical instruments processed?

A

Sterilise and clean

123
Q

What is semi critical in Spauldings classification?

A

Contacts non intact skin

124
Q

What are examples of semi critical instruments?

A

Dental mirrors
Anaesthetic syringes

125
Q

How are semi critical instruments processed?

A

Clean and disinfect

126
Q

What are non critical instruments by Spauldings?

A

Contacts intact skin

127
Q

What are non critical instruments?

A

Chair
Light handle

128
Q

How do you process a non critical instruments?

A

Clean and disinfect

129
Q

What types of water can be used in a steriliser?

A

Purified; reverse osmosis, deionised, distilled, sterile

130
Q

What is a type N steriliser?

A

Non vacuum

131
Q

What is a type B steriliser?

132
Q

What is a type s steriliser?

A

Specialised

133
Q

What are the stages of an audit?

A

Set guidelines
Observe practice
Compare with guidance
Implement change

134
Q

What is the definition of decontamination?

A

Process of making re-usable medical devices safe for handling and usage

135
Q

What is the definition of policy?

A

Overal statement of intent

136
Q

What is the definition of procedure?

A

Guidelines of major methods used to meet policy

137
Q

What is the definition of objective?

A

Landmark event in pursuit of overall intent

138
Q

What is the user in regard to decontamination science?

A

The person designated by management to be responsible for the steriliser/ washer disinfector
Usually the dental practitioner or nurse

139
Q

What legislation discusses the general duty of employers for their employees to carry out in regard to health and safety in a dental practice?

A

Health and Safety at Work 1974

140
Q

What are the features of a container that carries dangerous goods?

A

Rigid sided
Leak proof
Tight fitting lid
Colour coded

141
Q

What are the features of a container that carries dangerous goods?

A

Rigid sided
Leak proof
Tight fitting lid
Colour coded

142
Q

What is the statement on hand hygiene from NIPCM?

A

Hand hygiene is considered an important practice in reducing the transmission of infectious agents which cause infections

143
Q

What is the statement on hand hygiene from SHTM 01-05?

A

Effective hand hygiene is essential for preventing spread of infection

144
Q

What is the statement on Personal Protective Equipment from NIPCM?

A

Before undertaking any care task or procedure, staff should assess any likely exposure to blood and/or body fluids and ensure PPE is worn that provides adequate protection against the risks associated with the procedure or task undertaken

145
Q

What is the role of gloves?

A

Protect against substances adhering to hands

146
Q

What is the role of aprons?

A

Prevent contamination contacting the person or adhering to clothing

147
Q

What is the role of a face shield/visor?

A

Protect the face and eyes from splashes

148
Q

What temperature is achieved by the washer disinfect or?

A

90-95 C for minimum 1 minute

149
Q

What is the definition of sterile?

A

Free from viable microorganisms

150
Q

What can be processed through a B type steriliser?

A

Wrapped instruments- sterile at point of use

151
Q

What can be processed through a N type steriliser?

A

Unwrapped instruments- not sterile, just sterilised

152
Q

What are the requirements for a clean transport container?

A

Rigid sided
Leak proof
Tight fitting lid
Colour coded (blue)

153
Q

Who is the user?

A

The person designated by the executive manager to be responsible for the management of the process
Is also responsible for the operators
General practitioner, dentist, senior dental nurse

154
Q

What are the responsibilities of the user?

A

To certify that the decontamination equipment is fit for use
To hold all documentation relating to the decontamination equipment, including the names of other key personnel
To ensure that decontamination equipment is subject to periodic testing and maintenance
To appoint operators where required and ensure they are adequately trained
To maintain production records
To establish procedures for product release in line with the quality management system where applicable
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

155
Q

What guidance should be referred to for decontamination?

A

SHTM 01-05 Part A, B and C

156
Q

Who governs the decontamination standards?

A

BSI or ISO

157
Q

What does Part A of SHTM focus on?

A

Management
Management of the decontamination process within the LDU and applies to dental instruments that are processed by the user or a third party

158
Q

What is the main topics discussed in SHTM part A?

A

Rationale
Definitions, descriptions and abbreviations
Roles and responsibilities
Documentation and traceability
Relevant legislation

159
Q

What is the main focus of SHTM 01-05 part B?

A

Decontamination
Covers the decontamination equipment used to carry out processing of dental instruments
Details the maintainance, periodic testing and test equipment requirements for decontamination equipment in line with the CDO letter and current guidance

160
Q

What is the main focus of SHTM 01-05 part B?

A

Decontamination

161
Q

What does the SHTM 01-05 part B discuss?

A

Maintainance and servicing (MIFU)
Periodic testing and process verification (schedules and tables)
Test equipment and consumables
Performance requirements (stage descriptions)

162
Q

What is the main topic of SHTM 01-05 part C?

A

Process
Provides practical guidance on the whole instrument decontamination process, presenting in a form designed to be readily understandable by members of the dental team and has been written in collaboration with SDCEP

163
Q

What are the main focuses of SHTM 01-05 part C?

A

Steps for processing and handling of instrumentation
Carriage and loading of instrumentation
Practices for working safely (PPE etc)
Record keeping

164
Q

What are the 5 stages of the washer disinfect or?

A

Pre-wash
Wash
Rinse
Disinfection
Drying

165
Q

What are the daily tests for the washer disinfector?

A

Remove and clean strainers and filters
Check spray arms/ nozzles
Detergent levels

166
Q

What are the weekly tests for the washer disinfector?

A

Safety checks
Protein residue test
Automatic control test (ACT)

167
Q

What does ‘remove and clean strainers and filters’ consist of?

A

Ensure filters and strainers are clean

168
Q

What does ‘check spray arms/nozzles’ consist of?

A

Ensure these are clear from obstruction and free to rotate

169
Q

How long must 70-75C disinfection last to get a A0 value of 600?

A

100 minutes

170
Q

How long must 80-85C disinfection last to get A0 value of 600?

A

10 minutes

171
Q

How long must 90-95C disinfection last to get an A0 value of 600?

172
Q

What does checking ‘detergent levels’ consist of?

A

Ensure adequate detergent is available

173
Q

What does the weekly ‘safety check’ consist of?

A

Check condition of the door seal

174
Q

What does the weekly ‘protein residue test’ consist of?

A

Confirms that the cleaning process retains the capacity of removing protein

175
Q

What does the weekly automatic control test (ACT) consist of?

A

Designed to show the operating cycle functions properly and that the disinfection temperature/time are within the original specification

176
Q

What are the min-max temp for a 121C sterilisation cycle and what is the minimum holding time?

A

121-124C
15 minutes

177
Q

What are the min-max temp for a 134C sterilisation cycle and what is the minimum holding time?

A

134-137C
3 minutes

178
Q

What daily test is carried out on a steriliser?

A

Bowie and Dick or Helix Test (Type B/S only)

179
Q

What does Bowie and Dick or Helix tests check for?

A

Steam penetration

180
Q

What are the weekly checks for sterilisers?

A

Safety checks
Automatic controls tests (ACT)
Air leakage test (Type B/S only)
A/D function test (Type B/S only)

181
Q

What does the weekly ‘safety check’ of a steriliser consist of?

A

Check condition of the door and seal and safe operation of doors and door interlocks

182
Q

What does the weekly ‘Automatic control test’ for the steriliser consist of?

A

Designed to show the operating cycle functions properly and that the sterilising temperature/time are within the original specification

183
Q

What does the air leakage test for sterilisers consist of?

A

Check for excessive air leakage into the chamber

184
Q

What does the A/D function test consist of?

A

Check steriliser fails with air leaks

185
Q

What are the requirements for facilities in a dental LDU?

A

Compliance with the design layout of SHPN 12 p2- one room model

186
Q

What are the requirements for equipment in a dental LDU?

A

Use of automatic washer disinfector and steriliser in compliance with the relevant standards
Installation and validation tests in accordance with the current guidance
Operation, maintainance, annual revalidation and periododic testing in accordance with the manufacturers instructions

187
Q

What are the requirements for management in a dental LDU?

A

The role of the user and operator within the LDU must be defined
The user and operator must have training records appropriate to their needs
Completion of NES training
Appropriate documentation of policy, procedures and records

188
Q

What are the requirements for process in a dental LDU?

A

Decontamination process in accordance with the device manufacturers instructions
Production of sterilised product
Sterilised devices mist be packed in suitable containers to provide protection and to minimise contamination during transport and storage
When transported off site, contaminiated devices must be packed and transported in suitable containers in accordance with the guidance on carriage of dangerous goods

189
Q

What guidance and standards should be referred to in regard to decontamination?

A

Scottish Health Technical Memorandum
Scottish Health Planning Note
Compliant Dental Local Decontamination Units in
Scotland
BS EN- British Standard European Norm
BSI- British Standards Institute
NP 143- National Procurement Framework

190
Q

What legislation should be considered in regard to decontamination?

A

Medicines and Medical Devices Act (MMD) 2021
Medical Device Regulations (MDR) 2002
Health and Safety at Work Act 1974
Management of Health and Safety at Work Act 1999
Consumer Protection Act 1987
Pressure System Safety Regulations (PSSR) 2000
Control of Substances Hazardous to Health (COSHH) 2002
The Carriage of Dangerous Goods and Use of Transporable Pressure Equipment Regulations (CDG) 2009

191
Q

Who caries out conformity marking?

A

CE- Conformite Europeene (European Conformity)
UKCA- United Kingdom Conformity Assessed

192
Q

Who caries out conformity marking?

A

CE- Conformite Europeene (European Conformity)
UKCA- United Kingdom Conformity Assessed

193
Q

What is a consignment note?

A

Legal requirement for hazardous/clinical waste

194
Q

Where do the three copies of a consignment note go?

A

Practice
Carrier
Consignee

195
Q

What are examples of types of questions?

A

Open
Closed
Scale (likert)
Agree/disagree

196
Q

What are examples of demographic factors?

A

Gender
Age
Marital status
Employment

197
Q

When and how are sharps containers disposed?

A

3/4 full
Information slip carried out and sent to disposal

198
Q

How are sharps injuries managed?

A

Stop
Run under water
Encourage bleeding
Wash: dont scrub

199
Q

What are the features of dental neglect?

A

Dentist has a duty of care
Duty of care was breached
This breach caused or materially contributed to harm
This harm was reasonably foreseeable

200
Q

How is it decided that harm was reasonably foreseeable?

A

Judged in a balance of probability

201
Q

What are the danger zones when considering hand hygiene?

A

Fingertips
Between fingers
Under nails
Around thumb

202
Q

What is ABHR ineffective against?

A

C. difficile
Norovirus

203
Q

How are blood and body spillages managed?

A

Cordon spillage off
Assess type of spillage
Collect correct equipment
Protect yourself
Disinfect and clean

204
Q

How are blood/body fluid spillages cleaned?

A

Apply chlorine releasing granules or place disposable towels and 10,000ppm chlorine for 3 minutes
Discard waste into healthcare waste
Wash area with disposable paper towels, general purpose detergent and warm water
Dry area or allow to dry
Discard paper towels and PPE into healthcare waste
Hand hygiene

205
Q

How are urine/faeces/vomit/sputum spillages managed?

A

No chlorine
Soak up using disposable paper towels
Gelling agent used for chlorine
Decontaminate area with 1,000ppm chlorine
Wash area with disposable paper towels, general purpose detergent and warm water
Dry area or allow to dry
Discard paper towels and PPE into healthcare waste
Hand hygiene

206
Q

What is epidemiology?

A

The study of the distribution and determinants of diseases in a population

207
Q

What are the three components of epidemiology?

A

Time
Place
Person

208
Q

What does standardised data mean?

A

Takes into account the population age-structure

209
Q

What are the methods of measuring/recording dental caries?

A

DMF/dmf: (decayed, missing or filled)
ICDAS: International caries detection and assessment score
Significant caries index

210
Q

What does ICDAS include?

A

Restorative status
Caries index

211
Q

What are examples of caries prevention strategies?

A

High risk individual approach
Targeted population approach (deprivation)
Whole population (universal)

212
Q

What is upstream in regard to oral health inequalities?

A

Socioeconomic and political

213
Q

What are examples of upstream factors?

214
Q

What is midstream in regard to oral health inequalities?

215
Q

What are examples of midstream factors?

A

Community assets and workforce
Schools and nurseries
Voluntary
Social and physical environment

216
Q

What is downstream in regard to oral health inequalities?

A

Behaviour and Biological
Psychosocial
Health services

217
Q

What are examples of downstream factors?

A

Age, biofilm, behaviours
Stress, social support
Quality of care

218
Q

What is a medical device?

A

Any instrument, apparatus, appliance, software, implant, reagent, material or other article intended by the manufacturer to be used alone or in combination for human beings for one or more specific medical purposes

219
Q

What are examples of specific medical purposes?

A

Diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of disease

Diagnosis, monitoring, treatment, alleviation of or compensation for an injury or disability

Investigation, replacement or modification of the anatomy of or a physiological or pathological process or state

220
Q

What must machines be compliant with?

A

Current MDR

221
Q

What are the annual decontamination costs?

222
Q

What are the components of record keeping and traceability?

A

Installation, validation and maintainance
Staff training and procedures (SOPs)
Cycle data, proof of process
Fault registers and incident reporting

223
Q

How long must decontamination records be stored for?

224
Q

What machine components need testing?

A

Temperature probes
Pressure transducers
Dosing volumes
Stage timers
Level sensors
Pumps and fans
Steam generator
Valve operation
Interlocks
Safety devices

225
Q

Who must test and validate equipment?

A

A competent person (D)

226
Q

What is the definition of a competent person (Decontamination)?

A

A person designated by AP(D) to carry out maintainance, validation and periodic testing (quarterly/annual) of decontamination equipment such as washer disinfectors and sterilisers

227
Q

Why is handpiece cleaning and maintainance important?

A

The practice is responsible for procurement
Handpieces cost £200-1000
Infection prevention and limiting cross contamination
Standardised maintainance to achieve correct operation

228
Q

When should the handpiece be cleaned and how?

A

After every patient use
Manual cleaning first
Cleaning cycle should be carried out in a WD
Handpiece should be lubricated after wash and before sterilisation
Steriliser with a vacuum capability is required for adequate air removal

229
Q

How often should maintainance be carried out on a WD?

230
Q

What piece of equipment should not be used to clean a handpiece?

A

Ultrasonic bath

231
Q

What are the top 5 causes of handpiece failures?

A

Incorrect compressor settings and lack of knowledge
Damaged or oversized bur fitted
Incorrect instrument usage
Poor or inadequate cleaning, including incorrect processing
Incorrect or inadequate lubrication

232
Q

How can you prevent the handpiece fault- incorrect compressor settings and lack of maintainance

A

Medical/dental grade compressor is essential
Incorrect air pressure causes faulty operation
Compressor maintainance is essential

233
Q

How often should pressure vessels be inspected?

234
Q

What is the effect of the handpiece fault- damaged or oversized bur?

A

Mainly oral surgery
Damaged chuck- cannot remove bur or bur sticks
Damages the chuck of the handpiece- may not hold bur

235
Q

What is there to remember in regard to hand piece hygiene?

A

Need to be processed in a washer disinfect or
Must be lubricated after every use
Must be sterilised after every use
Service handpiece each year

236
Q

Why should you clean and flush through the spray air channels in a handpieve?

A

Prevents buildup of scale
Keeps the fine spray nozzles free

237
Q

What are the benefits of an automatic oil dispensing system?

A

Guarantee optimum lubrication
No excess oil

238
Q

How does the assistina lubrication system work?

A

Rotational lubrication of the spray tubes, flushing through with compressed air in 35 seconds

239
Q

What are the features of dental air compressors?

A

Oil free with a dryer and do not need any day to day maintainance
Need annual maintenance
Breathing air filter to be changed annually to maintain air quality standards

Finals (20 decks)

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