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Patient Safety Decon > Process Revision Lecture > Flashcards

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
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2
Q

Requirements of Contaminated Instrument transport box

A
  • durable
  • leak proof
  • rigid sided
  • colour coded/ clearly marked
  • tight-fitting lid
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3
Q

Washer- Disinfector

A
  • single level
  • single chamber
  • underbench model
  • first step of process
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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
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5
Q

Loading patterns at validation

A
  1. no overlapping/ shadowing
  2. do not overload the machine
  3. utilise the available load carrier
  4. all assembles should be disassembled
  5. restorative materials should be removed beforehand
  6. forceps should be open at the hinge and positioned in a way they will remain open
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6
Q

5 Core stages (FWRDD)

A
  • flush
  • wash
  • rinse
  • disinfect
  • dry
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7
Q

Washer-disinfector core stages, time and temperature

A
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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
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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
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10
Q

2 methods of manual cleaning

A
  • immersion
  • non- immersion

**some handpieces cannot be immersed in aqueous solution
- consult manufacturers recommendations

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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
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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
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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
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14
Q

2 Most commonly used sterilisers?

A
  1. Type- B
  2. Type- N

Type S

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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
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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

Patient Safety Decon (3 decks)

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