Patient safety revision notes Flashcards
10 SICPS
Hand hygiene
Resp and cough hyg
PPE
Safe disposal of waste
Safe management of equipment
Safe management of care enviornment
Prevention of occupational exposure
Assessment for infeciton risk
Management of blood and bodily fluids
Safe managment of linen
Chain of infection
infectious agent
reservoir
portal of exit
mode of transmission
portal of entry
susceptible host
Mode of transmission types
inhaltion
ingestion
indirect
mother to infant
inncoulation
intercourse
Sharps risk
Hep B = 1in 3
Hep C = 1 in 30
HIV = 1 in 300
Priciples of waste disposal
Segragation
Storage
Disposal
Document
Spaulding classification
non critical - things that come into contact with intact skin
semi critical - things that come into contact with intact mucous memebrane
critical - things that come into contact with noramlly sterile body sites
Blood spillage
Contain the large spillage with paper towels
Apply either sodium hypoclorite or sodium dichlorisocysnurate, 10,000ppm for 5mins
remve and clean area
wsah hands
Social handwashing
plain or antimicrobial soap or ABHR if not soild for 15secs
Hygienic handwashing
removes transient microgransims and reduces resident micro
antiseptic or antimicrobial
Surgical handwashing
longer and more thorough
includes the forearms
designed to remove resident flora before surgery
Retraction of soft tissues
3 in1
aspirator
tongue depressor
mirror
cheek retractor
Sharps box requirmenrs
have a tmeporary closure mechanism
dispoise of when reached full line or open for 3 months
labelled with date of opening, closure and orgin
have a handle for moveability
Sotre waste
seperate, designant locked secure palce
no more than 3/4s full and tie with swan neck
Wast streams
black = domestic waste for landfill
yellow waste = waste been in contact with saliva or body - heat disinfeciton then landifll
orange waste = waste that is highly infectious or contimination risk - incerated
red waste = chemical waste
Sinner circle
time
temp
energy
chemical
How adrenaline works
bronchodilator
internal vasodilater
external voascontrictor
Drugs in emergecny kit
salbutamol
GTN
Glucagon
adrenaline
aspirin
Emergency equipment
AED
Oxygen and BVM
BLood glucose monitor
Pulse oximeter
Seizures/ fit
give pt 10mg of midazolam in the buccal mucosa if longer than 3mins
supply 100& oxygen
Angina/MI
400mg GTN spray supplied sublingually x2 puffs every 3mins
300mg crushed or chewed asprin - do not give with water ans does not metabolise as quickly (works as slowing down platelet aggregation)
adminster 100% oxygen
Hypogylcaemia
unconscious = 1Mg of glucagon suppplied IM using ztrack tech once gain consciousness supply 10-20 of oral glucose
adminster 100 oxygen
Asthma
salbutamol inhaler 100mg x10 puffs and breathe in 20 secs - used spacer to help control the med going into the lungs
100% oxygen supplied
Anaphylaxis
supply adrenaline 1:1000 0.5ml IM using the z track technique
supply 100% oxygen
What is anaphylaxis
a severe life therening reaction to a trigger such as an allergy
What is asthma
a lung coniditon which casues narrowing and inlammation of the airway passage to the lungs causing wheezing and difficulty breathing correctly.
Complains - CLEAR
C - connect
L - listen
E - empathy
A - ask
R - review and monitor
Acts for complaints
Patients rights act
Scottish apology act
Scotland complaint management
local lvel - 5 working days
investigation - awknowedlge - 3days and completed in 20days
England complaints managmeent
awknoledge in 3 days and responnse in 40 days andif target missed then informed every 10days
Response includes
apology if neccessary
the response of the complaint
if the complaint was full or upheald
response of lessons learnt
the nature and type of complaint
info for pt regarding services avilable and the ombusdman
was a conclusion reached
4 handed dentistry - operator
about 11-18 inchs between pt and operator
thighs parallel to floor and feet fully seated on floor
straight back
elbows bent at 90 degrees
90 degrees between hips and knees
Aspiration
direct - where the aspirator is held adjacent to the tooth, bevel adjacent to tooth
indirect - used when difficult to gain aceess for nurse like the lower ants, the 3 in 1 can be used for retration and to remove water and debris from the mirror
Operator clock for right handed
dentist - 12-7
dental nurse -2-4
transfer - 4-7
static -7-12
Operator clock for left handed
dentist - 12-5
dental nurse -8-10
transfer -5-8
static - 10-12
Cleaning
removes any bodily fluids, biological matter and infectious substances from instruments
Disinfection
targets microbial presence
Steriliesed
free from all viable micro-organsisms
Engineer
person who is in charge of maintinance of equipment on an annual and quaterly basis
Manager
person in charge of running of the LDU’s
Operator
person how perates the equipment and notes readings
User
person who is in charge of the day to day running of equipment, daily tests, and maintance records
Manual washing
non metallic, long brsitled brush with soft brsitles
12 litres of water
60 litres of chemial
detergent - netural enzymatic
temp = 30-35 degrees
Ultrasonic
soundwaves at high frequence produce bubbles that implode on intruments cuasing an scourring effect to cleaning them.
Neutral /enzymatic detergent
why degas from empty
ultrasonics must be degassed after filling from empty to remove oxygen as does not allow correct cleaning of instruments
tests for sterilisation
bowie dick test - carried out on type B sterilliers on a daily basis - steam penetration
Air leakgage and vacuum leakage test - carried out on weekly basis
Type n steriliers
non vacuum sterilisers- passive air removal
for non wrapped instruments only
stored for 60 days
Type b steriliers
vacuum steriliers which is active air removal
for wrapper instruments
stored for 21 days
Why use deminerialised water
prevents the deposit of minerals on surface of instruments
Virulence
ability of microbe to cause disease
RIDDOR
reporting of injuries, diseases and dangerous occurences regulation
Decon legisilation
Medical Device directive
Health and saftety at work act
Consumer protection act
PPE at work act
Weekly test for wd
cleaning efficacy test (protein strip test)
WD cycle
rinse <35 degrees - saturates the insturments
Main wash - suppledment with detergent to remove contamination
Flush - <65 degrees - removes any remaining residue contamnation before thermal disinfeciton
Thermal disifeciton - 90-95 degrees for 1 min - activley kills microgroanisms with heated water
Drying 90-110 degrees - drying off the insturments and remove moisutre before sterilisation
Why sterilies instruments
to remove viable microganissm
high quality of care for pts
professional standdards
prevent the transmission of inefectious diseases
Why cleaning important before sterilisation
removes any gross debris
removes any harden dental material off insturments
restores function
aids disinfeciton
medico - legal requirement
Daily things to notes for sterilises etc
date and time
operator
chemical used
was cycle complete
cycle no
sterilisation temp
A.C.T WD weekly
stages
temp reached
completed
daily checks
operator
date and time
detergent used
chemical volume
temp of eacch stage
pressure at start, 1min, 2mins, 3mins
Shtm 2030
Scottish Health Technical Memorandum
Comptenent person
a person designated to carry out maintance, validation and periodic tests of WD and sterilisers
Decon legislation
Health and safety at work act
Medical Device Derective
Consumer Protection Act
PPE at work act
Decon cycle
cleaning
disinfection
inspection
packing
sterilisation
transport
storage
usage
Handpiece faults
air pressure
incorrect use
incorrect burs
poor cleaning
poor lubrication
WD daily checks
automated control test - notes temp of 1st cycle each day
spinnning arm
freely rotates
no debris present
chemical detergent enough
door seal
