Process Revision Lecture Flashcards
1
Q
Why clean and disinfect before sterilisation?
A
- legal requirement to clean all of our instrumentation
- functionality
- biological matter can clog instruments preventing them working the way we need them
- remove biological contamination
- minimizes spread of infection and cross- contamination of devices (can lead to misdiagnose in biopsy)
- ensure steam can contact all the surfaces of instruments
2
Q
Requirements of Contaminated Instrument transport box
A
- durable
- leak proof
- rigid sided
- colour coded/ clearly marked
- tight-fitting lid
3
Q
Washer- Disinfector
A
- single level
- single chamber
- underbench model
- first step of process
4
Q
Daily testing of washer- disinfector
A
- check spray arms rotate and jets are free from blockages
- check filler/ strainer for debris, contamination/ instruments
- check door seal for damage and cleanliness
- check chemical level; replenish if required
- verify condition of load carrier
- record disinfection temperature of first cycle
5
Q
Loading patterns at validation
A
- no overlapping/ shadowing
- do not overload the machine
- utilise the available load carrier
- all assembles should be disassembled
- restorative materials should be removed beforehand
- forceps should be open at the hinge and positioned in a way they will remain open
6
Q
5 Core stages (FWRDD)
A
- flush
- wash
- rinse
- disinfect
- dry
7
Q
Washer-disinfector core stages, time and temperature
A
8
Q
Why use illuminated magnifier?
A
- verify that washer- disinfector process has been successful
- identify any contamination that may still be present
- verify functionality of instruments
- if instruments are damaged, they can be sent for repair
- if contamination still present, instruments can be manually cleaned and processed through ultrasonic
9
Q
Requirements of manual cleaning
A
- water should be <35 degrees
- chemical used should be pH neutral/ enzymatic
- chemical depends on volume of water
- long, handled soft bristled brush should be used
10
Q
2 methods of manual cleaning
A
- immersion
- non- immersion
**some handpieces cannot be immersed in aqueous solution
- consult manufacturers recommendations
11
Q
Why manually wash?
A
- remove hard- to -remove contamination (dried in/ gross contamination)
- separate is needed for manually washing and then rinsing instruments
- correct PPE should be worn
- instruments manually washed under surface of water
- processed through ultrasonic bath
- rinse in separate sink from wash sink
12
Q
Before using Ultrasonic bath
A
- should be filled to required level
- chemicals should be added referencing manufacturers instruction for volume
- de-gas cycle must be ran before any cycle
- same loading recommendations should be followed
- handpieces should not be processed within ultrasonic
- always check manufacturers instructions before processing instruments
13
Q
What to do after manual washing?
A
- process through ultrasonic bath
- then process back in WD because of disinfection stage
- making it safe for staff to handle and inspect
14
Q
2 Most commonly used sterilisers?
A
- Type- B
- Type- N
Type S
15
Q
Requirements of Sterilisation
A
- all achieve same sterilisation temp and pressure banding
- 134-137 degree celsius for a min hold time of 3 mins
- pressure equivalent gauge from atm: 2.05- 2.35 bar
- pressure equivalent absolute (from absolute zero): 3.05- 3.35 bar
- cycles differ
16
Q
Daily and Weekly test for Sterilisers
A
- check door seal for damage/ decontamination
- check load carrier for damage
- check chamber for debris
- fill and drain water daily
17
Q
Type- B required test
A
- Bowie-Dick (steam penetration) daily
- Air leakage test- weekly
- Air detector function test (ADFT) weekly
18
Q
Type N steriliser
A
- “gravity displacement” steriliser
- purified water is introduced to chamber and heated
- as it boils and turns to steam, chamber pressure increases
- pressure we require to reach our temp is 2.05- 2.35 bar above atm
- once it reaches 134-137 degrees, it hold that temp for 3 mins
- can only process rigid steel instruments in machine
- cannot processed wrapped instruments
- cannot processed channelled/ lumened instruments either
19
Q
Cycle graph of Type N
A
20
Q
Type-B steriliser
A
- “Porous Load” or “Vacuum Capable” steriliser
- has active air removal in the chamber in initial stage
- as there is no air in the chamber, vacuum rapidly draws steam in from the generator
- temp and pressure same as type N
- 134- 137 degree celsius for a minimum hold time of 3 mins (2.05-2.35 bar above atm)
- after sterilisation, machine draws another vacuum for drying, allowing water to vapourize at lower temp
21
Q
Vacuum sterilise Type B
A
22
Q
Differences after processing
A
- for type B, because we can process wrapped instruments; as long as wrapping stays intact, instruments are sterile
- can also store wrapped instruments in environmentally controlled atm that is free from contaminants and moisture
- Instruments processed in Type-N are not wrapped, hence will need to be wrapped as soon as removed from sterilizer and transported to procedure room
23
Q
Before putting in transport container?
A
- leave instruments to cool down after process
- as it will cause condensation to build up and damage wrappings
24
Q
At all stages
A
- safety
- staff
- record
- compliance
25
Q
Safety
A
- are we transporting our equipment safely
- are we using required PPE
- are we disposing of items in appropriate waste stream
- are single use items being managed correctly
- is sterile instrumentation stored correctly
26
Q
Staff
A
- do the staff understand the key stages of process
- have they been trained
- have they been supplied required PPE
- do they know how to work in a safe manner
- are they aware of dangers with decontamination
27
Q
Records
A
- do we have training records for all staff on all equipment and processes
- do we have machine print out and cycle data
- are our validation and testing up to date?
- are we maintaining register for out equipment
- are we recording faults and failure
28
Q
Compliance
A
- are we following the most up to date guidance (SHTM01-01) - Scottish Health Technical Memorandum 01-01
- can equipment consistently achieve set points (temp, chemical, pressure, time)
- has it been produced in line with relevant standards (MDR) - medical device regulation
- does test partner comply with guidance (SHTM01-01)
- do they test equipment in line with required standards (BS EN) - british standard european norm
