Revision Questions

Question 1

Legislation for amalgam waste

Answer 1

COSHH
Environment protection 1999
Hazardous waste

Question 2

What is the spaulding classification

Answer 2

Critical - devices that enter the tissue that is usaully sterile or enters vascular system
Semi Critical - instruments that have contact with intact mucous membrane but does not penetrate sterile tissue
Non critical - Instruments that contact with intact skin only

Question 3

What is the elements of sinner circle?

Answer 3

Time
Temp
Chemical
Energy

Question 4

What is the lift cycle of instruments

Answer 4

Cleaining
Disinfection
Inspection
Packaging 
Sterilisation
Transport
Stroage 
use

Question 5

What does cleaning mean?

Answer 5

Remove any biological matter, bodily lfuids, proteins or infectious substances

Question 6

What does disinfection mean?

Answer 6

Targeting microbial presence and reducing amount on surface of instruments. removes some microns

Question 7

What does sterile mean?

Answer 7

Free from all viable micro organsisms

Instrument sterile if probability that there are viable microbes on instrument = to 1 in a million

Question 8

What is the criteira for transportation containers?

Answer 8

Rigid and durable
Tight fitting lid
Must be easily cleaned and disinfected
Leak proff

Question 9

Why do we need to sterilise instruments

Answer 9

Reduces probability of infection transmission
Legislative and profressional standards
International strandards for surgical instruments
High quality of care for patients

Question 10

Reasons for manaual washing

Answer 10

Manual scrubbing with brush exerts a greater force than the washer disinfector
Some pieces of instruments can only be manually washed
Ultrasonic baths good at removing contamination

Question 11

Reasons against manual washing

Answer 11

Member of staff has to be present
Aerosol production
Risk of sharp injuries
Potential for inconsistency - human error
Risk for contaminating surrounding area
Ultrasonic can damage some instruments

Question 12

What is the detergent used for manaul washing?

Answer 12

Neutral enzymatic

Question 13

What is the water temp for manual washing

Answer 13

30-35 degrees - rinse/immerse in purified water after cleaning and then dry

Question 14

How is manual washing completed

Answer 14

Below the surface of the water

Long handled, soft bristle, non metallic brush taht can be processed throught a thermal washing cycle

Question 15

What is non immersion

Answer 15

Appropraite for certain equipment where items will become compromised by soaking in aqueous solution

Question 16

What is immersion

Answer 16

Wash temp important when using enzymatic detergents

Question 17

What is an ultrasoninc cleaner?

Answer 17

Soundwaves at high frequency to produce bubbles that implode and have scourring effect against the surface of instruments
The soundwaves cause bubbles to rapdily expand and then collapse

Question 18

What are the key points for an ultrasoinc cleaner

Answer 18

Take care when loading, no overlapping or shadowing, hinged instruments open
First run with instruments will be a daily test and rinse instruments after cleaning then dry
Always drain and fill x2 a day and always drain at end of day
Carry out weekly tests - daily test and cleaning efficacy/ protein test strip

Question 19

What detergent is used for an ultrasoninc?

Answer 19

Neutral or enzymatic chemical

Question 20

When do you degas an ultrasonic

Answer 20

After filling from emepty to remove air/oxygen from water otheriwse instruments are not cleaned correctly.

Question 21

What does a washer disinfector do?

Answer 21

Produce clean instruments free from contamination, thermally disinfected and dry
Do not kill spores
Prions removed during washing process

Question 22

What are the stages of the washer disinfector?

Answer 22

Pre wash/ flush - saturates the contaminated instruments <35
Main wash - supplemented with detergent to remove contamination
Rinse - removes any remaining residue, bioogically or chemically before thermal disinfection <65
Thermal disinfection - Actively killing micro-organsims with heated water - 90-95 for q min
Drying - removes any remaining moisture from instruments before sterilisation - 90-110`

Question 23

What detergent is used for the WD?

Answer 23

Neutral (pH 7)

Question 24

What are the weekly tests for the WD?

Answer 24

Daily test and cleaning efficacy test (protein test strip)

Question 25

What are the daily and weekly checks for the WD?

Answer 25

Check spray arms rotate freely and without obstruction and no jets blocked
Check load carrier is not damaged and no debris
Check filters on bottom of chamber are clear
Check door seal is intact and no contamination
Check sufficient amount of chemical within reservoir of machine
Record cycle number. times, temp, volume, chemicals

Question 26

What is clean steam?

Answer 26

Steam made from purifed water

Question 27

Type N steriliser

Answer 27

Non vacuum, passive air removal
Gravity displacement sterilisers
Machine heats water in the chamber and as it turns to steam it passively forces air from chamber
Cannot process wrapped instruements, channelled and lumened instruments

Can be stored for 21 days after strilisation
134-137 for 3mins

Question 28

Type B steriliser

Answer 28

Vacuum, active air removal
Removal all air from the chamber using a vacuum pump creating a negative pressure
Fills chamber with steam
Can pentrate wrapped instruments

Can be stored for 60 days after strilisation

Question 29

Type S steriliser

Answer 29

Specialsed for certain instruments
Washes and lubricates handpeices
Vacuum cycle but does not process wrapped instruments

Question 30

What are the daily checks for the steriliser?

Answer 30

Check seal of door
Check no instruments in loard carrier or debris
Check inside of chamber
Check sufficent amount of water in reservoir

Question 31

Why do you use deminerlised water?

Answer 31

Prevents deposit of minerals on machine and instruments

Question 32

What are the tests carried out on sterilisers

Answer 32

Helix Bowie/ Bowie Dick Test - for type B sterilisers, checks for steam penetration and informs temp has been reached (yellow to blue) - daily basis
Vacuum leak test/air leakafe test - check vacuum capability of machine on weekly basis
Air dector function test - check safety device within machine for detecting air - weeekly basis