test 3 & 4 Flashcards
1
Q
Surfaces that are touched frequently
can act as __________ for microorganisms.
A
Reservoirs
2
Q
What is the primary source of contamination?
A
When a member of the dental team
touches surfaces with contaminated
gloves
3
Q
What is the definition of
environmental surfaces?
A
surface within a healthcare facility that is not directly
involved in patient care, but that may become
contaminated during the course of treatment
4
Q
What are some examples of
an environmental surface?
A
Countertops, floors, instrument
control panels, walls
5
Q
Is it possible to predict accurately the
life span of microorganisms on the
surface of dental equipment?
A
No
6
Q
What is the safest approach
for avoiding contamination?
A
Assuming the surface has
potentially infectious material on it
7
Q
According to the CDC Guidelines for infection
control in dental healthcare settings, what are
the two categories of environmental surfaces?
A
clinical contact surfaces and
housekeeping surfaces
8
Q
What does housekeeping
surfaces include?
A
Floors, walls, and sinks
9
Q
Which category of environmental
surfaces has the lower risk of disease
transmission?
A
Housekeeping
10
Q
What are the three categories
of clinical contact surfaces?
A
touch, transfer, and
splash/spatter/and droplet
11
Q
What are touch surfaces?
A
Surfaces that are directly touched and
contaminated during procedures
12
Q
What are some examples of
touch surfaces?
A
Light handles, dental unit controls, chair
switches, chaired computers, pens, telephones,
containers for dental material, and draw handles
13
Q
What are transfer surfaces?
A
Surface not directly touched and
contaminated during procedures
14
Q
What is an example of transfer
surfaces?
A
Instrument trays, hand piece
holders
15
Q
What are splash, splatter, and
droplet surfaces?
A
Surface that does not contact members
of the dental team or contaminated
instruments or supplies
16
Q
What is an example of splash,
splatter and droplet surfaces?
A
Countertops
17
Q
Which of the three types of clinical
contact surfaces should be barrier
protected?
A
Touch and Transfer surfaces
18
Q
At least how many times should splash,
splatter, droplet surfaces be cleaned?
A
At least once a day
19
Q
What are the two methods to
dealing with contamination?
A
Surface barriers or preclean
and disinfect between patients
20
Q
What type of surfaces should be
cleaned and not barrier protected?
A
Smooth, hard surfaces such as
countertops, trays, and supply
containers
21
Q
If a surface has crevices or knobs, how
should it be protected from
contamination?
A
Barriers
22
Q
Whose responsibility is it to make sure
the equipment and treatment room
surfaces are properly managed?
A
Dental Assistant
23
Q
What is an important
characteristic in surface barriers?
A
Fluid resistant
24
Q
When and how should you
remove barriers?
A
In-between patients and while
you are still gloved
25
Do surfaces with barriers ever need to
be disinfected, or are the barriers
enough?
Surfaces that are barriered still need to
be disinfected/ cleaned at the
beginning and end of each day
26
What are single use items?
aka disposable items, used only once
and then discarded (not intended to be
sterilized)
27
Why are single use items
| recommended?
They reduce the chance of
| patient to patient contamination
28
What should you do if a
| surface barrier tears?
Take it off and prequel and
| disinfect replace barrier
29
What regulation requires the
| use of a surface disinfectant?
OSHA Blood Borne Pathogens
30
Why must surfaces be
| precleaned?
Remove Bioburden, disinfectant's
effectiveness can be decreased if even the
smallest amount of saliva is still present
31
What is disinfection intended
| to do
Kill disease-causing microorganisms that
| remain on the surface after precleaning
32
What is the term disinfectant
| used for?
chemicals that are applied to inanimate
surfaces such as countertops and dental
equipment.
33
What are antiseptics used for?
antimicrobial agents applied
| to living tissue
34
Why should disinfectants and antiseptics
| never be used interchangeably?
Tissue toxicity and damage to
| equipment
35
What kills all microorganisms?
sterilant
36
Who regulates disinfectants and
chemical sterilants according to
chemical classification?
Environmental Protection
| Agency EPA
37
What does the word
| pathogenic mean?
Disease causing
38
What are the only types of products that
should be used to disinfect treatment
rooms in dental offices ?
products registered by the EPA such as
| hospital disinfectants and tuberculocidal
39
What type of bacteria is highly
| resistant to disinfectants?
Mycobacterium Tuberculosis
40
What label would be given to
| a product that can kill spores?
Sporicidal
41
What label would be given to a
| product that can kill some viruses?
Virucidal
42
What label would be given to
| a product that can kill fungi?
Fungicidal
43
What is the ideal surface disinfectant?
And is there any product on the market
that meets all of these expectations?
Rapidly kills broad spectrum of bacteria, minimal
toxicity, exhibit residual activity, not damage surface
being treated. No there is not one product that meets
all of these expectations
44
What are iodophors?
EPA registered intermediate level
hospital disinfectants with tuberculocidal
action
45
During patient treatment, surfaces in
equipment and treatment rooms are likely to
become what with blood and saliva?
Contaminated
46
What have laboratory studies shown
about the time microorganisms may
survive on environmental surfaces?
Period of time varies
47
What 4 things do we consider when
cleaning and disinfecting patient
treatment areas?
1. )Amount of direct patient contact
2. ) Type and frequency of hand contact
3. ) Potential amount of contamination by aerosol and or spray
4. ) Other sources of microorganisms (dust, water, soil etc.)
48
What can be directly contaminated either by spray or spatter generated during dental procedures or by contact with the dental professional's gloved hands?
Contact Surfaces
49
Which organization recommended that
clinical surfaces be classified and
maintained under three categories?
OSAP
50
What are some common uses
| for plastic barrier tape?
touch pads on equipment, electrical
| switches on chairs, and X-ray equipment
51
What can be used instead of
| barriers? Why?
Aluminum foil because it is formed easily around any shape
52
According to CDC guidelines, what
should be done if barriers can not be
used?
Pre-cleaning and disinfecting
53
What PPE should be worn when cleaning
and and disinfecting environmental
surfaces?
puncture resistant gloves, protective
| eyewear, face shield, masks
54
why should you always wear PPE whiny are exposed to chemical disinfectants
Because of the risks associated with exposure to
chemicals and to prevent occupational exposure
to infectious materials.
55
What is bioburden?
Blood, saliva, and other body
| fluids
56
Can regular soap and water
| be used for precleaning?
yes
57
Can regular soap and water
| be used for disinfecting?
no
58
What is not killed during
| disinfection procedures?
Spores
59
What is the term disinfectant
| used for?
inanimate surfaces
60
What is the term antiseptic
| used for?
antimicrobial agents used on
| living tissue
61
What is the process in which
| all life forms are destroyed?
Sterliization
62
What are disinfectants?
chemicals that destroy or inactivate
most species of pathogenic
microorganisms
63
What are the only types of
| disinfectants used in dentistry?
Ones that are registered with the EPA as
hospital disinfectants with tuberculocidal
claims
64
What kills all microorganisms?
sterilants
65
What is residual activity?
Action that continues long after initial
| application, as with disinfectant
66
What recommendations from a
| manufacturer should you follow?
Mixing and diluting, application
technique, shelf life, activated use life,
and all safety warnings
67
What is the difference between
| disinfection and sterilization?
Disinfection only kills most
microorganisms while sterilization kills all
forms of life
68
How resistant is
| mycrobacterium tuberculosis?
Very resistant (that is why it is the benchmark
for disinfectants: if the disinfectant can kill it,
it can kill ALMOST everything else)
69
What does iodophors contain that
causes them to discolor certain metals,
clothing, and other surfaces?
Iodine
70
What are synthetic phenol
| compounds?
EPA - registered intermediate level
hospital disinfectant with broad-spectrum
disinfecting action
71
What can we use Phenols on?
metal, glass, rubber, or plastic
72
Can Phenols be used as a
| holding solution for instruments?
yes
73
What is a disadvantage of
| phenols?
They leave a residue film on treated
surfaces and they have to be prepared
daily to reduce battery growth
74
What is another name for
| Sodium Hypochlorite?
Household bleach
75
What is sodium hypochlorite
| classified as?
intermediate level disinfectant
76
What are some advantages of
| sodium hypochlorite?
fast acting, economical, and
| broad spectrum
77
What are some disadvantages
| to sodium hypochlorite?
unstable, must be prepared daily, has a strong odor, and is
corrosive to metals, destructive to fabrics, irritating to eyes and
skin, may eventually cause plastic chairs to crack, NO LONGER
RECOMMENDED BY THE CDC AND IS NOT EPA REGISTERED
78
Why is alcohol not effective as
| disinfectant?
Its rapid rate of evaporation limits
antimicrobial activity, can be damaging to
certain surfaces
79
Although alcohol is not a
| disinfectant? What is it used as?
An antiseptic
80
Who does not recommend
| alcohol as disinfectant?
ADA, CDC, OSAP
81
What is an immersion
| disinfectant?
can be used for high level
| disinfection or for sterilization
82
What is an advantage of immersion
disinfectants when it is used as a
sterilant?
It kills all microbial life including
| bacterial endospores
83
What is an advantage of immersion
disinfectants when it is used as a high
level disinfectant?
It inactivates all microorganisms
| except bacterial endospores
84
What is a disadvantage of
| immersion disinfectant?
toxic chemicals and can
| irritate eyes, skin and lungs.
85
What are immersion
| disinfectants used for?
Heat sensitive items
86
Can immersion disinfectants be
| used as a surface disinfectant?
no
87
How do you minimize the fumes
| of immersion disinfectants?
Close the lid on the container in
| which the materials are soaking in
88
Depending on the type, what is the time
for sterilization of immersion
disinfectants?
6 hours to 30 hours
89
How can you make immersion
disinfectants into high level
disinfectants?
Weaker concentration and
| increased contact time
90
What always must be worn while
| handling immersion disinfectants?
PPE
91
What is chlorine dioxide
Effective, rapid-acting environmental
| surface disinfectant or chemical sterilant
92
What is the time for sterilization when
using chlorine dioxide as a chemical
sterilant?
6 hours
93
What is the time for disinfection when
using chlorine dioxide as a surface
disinfectant?
3 minutes
94
What is Glutaraldehyde?
high level disinfectant sterilant that can
also be used as a liquid sterilant
registered by the EPA
95
How can you make
| glutaraldehyde a liquid sterilant?
Greatly increasing immersion
| time
96
What is the time for disinfection
| using glutaraldehyde?
10-90 minutes
97
What happens if contact of certain types
of instruments and glutaraldehyde are
prolonged?
Discoloration or corrosion of
| instrument's surfaces and cutting edges
98
What is Orthojphthala Dehyde
| or OPA?
chemical used as a high level
| disinfectant (immersion disinfectant)
99
At room temperature, how long does it
take for high level disinfection to occur
using OPA?
12 minutes
100
What are some advantages of
| Ortho Phthala Dehyde?
good alternative for individuals with a
sensitivity to glutaraldehydes, very little
odor, does not require mixing or activation
101
What are some disadvantages
| of Ortho Phthala Dehyde?
More expensive, can only be used half as long as most
glutaraldehydes, it may stain fabrics, plastics turn bluegreen color when proteins have been removed, and it
would require more than 30 hours to secure sterilization
102
There is no scientific evidence showing
that housekeeping surfaces (e.g. floors,
walls, and sinks) pose a risk for what?
Disease transmission in dental
| healthcare settings
103
What are the majority of housekeeping
| surfaces cleaned with?
Only a detergent and water or EPA
registered hospital
disinfectant/detergent
104
Do you need to make fresh cleaning
solution each day or can you keep
leftovers for the next day?
You should discard of any remaining disinfectant
and allow the container to dry until the next day
when you make a fresh cleaning solution
105
What should you try to avoid doing
| while cleaning patient care areas?
Try to to produce mists, aerosols, or
| disperse dust in patient care areas
106
Can carpet be reliably
| disinfected?
no
107
What have studies found in
| carpeting
Fungi and bacteria
108
What does the CDC
| recommend on carpeting?
Avoid using carpeting and cloth upholstered
furniture in dental operators, laboratories, and
instrument processing areas
109
What causes the majority of
| blood contamination in dentistry?
Spatter from procedures using
| ultrasonic instruments
110
Has it been proved that housekeeping
surfaces can lead to HIV, HBV, and
HCV?
No, but it is still important to use
| good infection control practices
111
What does OSHA require when it
comes to blood spills and other bodily
fluids?
It needs to be removed from the surface
and the surface should be properly
disinfected
112
What should you aways wear when
cleaning up spills of blood or other
body fluid?
Gloves and other PPE
113
What is greener infection
| control?
Minimizing the environmental impact of
infection control products and
procedures
114
What does going greener
| require?
thoughtful planning, research,
| and experimentation
115
Are infection control procedures
| usually environmentally friendly?
no
116
How can we reduce paper use
| in the office?
Using electronic records instead of
paper records that require 12.8 pages per
person
117
How can we reduce radiology
| in the office?
Using digital radiology instead of film
based radiology that requires the use of
chemicals and lead foil
118
Which regulation requires the use
| of surface disinfectant?
OSHA Blood borne pathogens
| standard
119
Why do you need to read all
| labels carefully?
Statements may contradict each other,
| you do not want to misuse product
120
Autoclave
Instrument to sterilize by moist heat
| under pressure.
121
Biologic indicator
Vials or strips (spore test) that contains
harmless bacteria used to determine
whether sterilization has occured.
122
Biologic monitoring
Verifies sterilization
All spore-forming microorganisms have
been destroyed.
123
Chemical vapor sterilization
Hot formaldehyde vapors under
| pressure.
124
Clean area
Place where sterilized instruments, fresh
disposable supplies, & prepared trays are
stored.
125
Contaminated area
Place where items are brought for
| precleaning.
126
Critical instrument
Sterilization
Instruments used to penetrate soft tissue
& bone.
127
Dry heat sterilizer
heated air
128
Noncritical instrument
Intermediate to low-level disinfection.
| Contacts only intact skin.
129
Semicritical instrument
Sterilization or high-level disinfection.
Come in contact with the oral tissues but
do not penetrate soft tissue or bone
130
Ultrasonic cleaner
Instrument that loosens & removes
debris by sound waves traveling through
a liquid.
131
CDC
Centers for Disease Control &
| Prevention
132
Seven steps for Instrument Processing
```
Transport
Cleaning
Packaging
Sterilization
Storage
Delivery
Quality assurance program
```
133
What are the three basics ways to
reduce transfer of organisms between
patients???
Sterilization
Disinfecting
Cleaning/sanitizing
134
Transport
Transport contaminated instruments to the
processing area in a manner that minimizes the risk of
exposure to persons & the environment.
Use appropriate PPE & a rigid, leak proof container.
135
cleaning
Clean instruments with a hands-free, mechanical process such an
ultrasonic clean or instrument washer.
If instruments cannot be cleaned immediately, use a holding
solution.
All debris must be removed before disinfecting or sterilizing.
136
packaging
Packaging
In the clean area, wrap instruments in appropriate materials.
Place a chemical indicator inside the package next to the
instrument.
If an indicator is not visible on the outside of the package, place
an external process indicator on the package.
137
Sterilization
Load the sterilize according to the manufacturer's instructions.
Label packages.
Do not overload the sterilizer.
Place packages on their edges insingle layers. or on racks to increase circulation of the
sterilizing agent around the instruments.
Operate the sterilizer according to the manufacturer's instructions.
Allow packages to cool handling.
138
storage
Store instruments in a clean, dry environment in a manner that maintains the
integrity of the package.
Rotate packages so that those with the oldest sterilization dates will be used
first.
Do not store sterile instruments on an open tray or in a dental cabinet unless
they are covered.
139
delivery
Delivery packages to point of use in a manner that
maintains sterility of the instrument until they are used.
Inspect each package for damage.
Open package aseptically.
140
Quality assurance program
| Should incorporate:
Training
Record keeping
Maintenance
Use of biologic indicators
141
What are the three classification that are
used to determine the method of
sterilization???
Critical Instruments
Semicritical Instruments
Noncritical Instruments
142
Identify the major sterilization.
```
Liquid chemical sterilization
Glass (hot) bead sterilization
Dry heat sterilization
Rapid heat sterilization
Chemical vapor sterilization
Steam under pressure sterilization
Steam (flash) autoclave sterilization
```
143
Liquid chemical sterilization
Glutaraldehyde
144
What are the advantages &
| disadvantages Glutaraldehyde???
```
Advantages
-Disinfects
-Sterilize (6-10) hours
-Used for items that cannot endure heat sterilization
Disadvantages
-Difficult to monitor
-Toxic fumes
-Stains
```
145
Glass (hot) bead sterilization
Small sterilizer-glass beads or salt
| Temperature-450 degrees F (234 C
146
what are the advantages & disadvantages
| of Dry heat sterilization???
```
Advantage
-Dried instrumentsndo not corrode or rust.
-Easily monitored
Disadvantage
-20 minutes to preheat
-2 hours to sterilize
-Solder joints melt
-Instruments must be thoroughly dried before placing them in a wrap or bag.
```
147
Rapid heat sterilization
Temperature-375 f
148
What are the advantages &
disadvantages of Rapid heat
sterilization???
```
Advantages
-Sterilizes in 6-12 minutes
-No corrosion
Disadvantages
-Damage to some plastics
-Solder joints melt
-Pre-dry instruments
```
149
Chemical vapor sterilization
Temperature-270 F (132 C)
150
What are the advantages &
disadvantages of Chemical vapor
sterilization???
```
Advantages
-20 minutes to sterilize
-Very reliable & can be easily monitored
-No corrosion-carbide & non-stainless steel
Disadvantages
-Formaldehyde & alcohol
-Must be vented
-Instruments must be thoroughly dry before placing in this sterilizer
```
151
What instruments can go in the Chemical
| vapor sterilizer???
Carbon steel/stainless steel
Surgical burs
Surgical instruments
Dental rotary handpieces
152
Steam under pressure sterilizer
| Autoclave
Temperature- 250-273 F (121 C) 15psi
Best method
Sterilize in a short period of time.
153
What are the advantages & disadvantegs
| of Autoclave???
Advantages
-10-30 minutes
-Good penetration of steam
-Easily monitored
Disadvantages
-Distilled water
-Rusts nonstainless (carbibe) steel instruments & burs-main disadvantage.
-15 minute drying cycle door must be cracked open for the drying process to take place at the end of each cycle.
-Has a corrosive effect on anything that is made of carbide steel.
154
Steam (flash) autoclave sterilization
temperature - 270-273 F (132 C)
155
What are the advantages &
disadvantages of the Steam (flash)
Autoclave sterilizer???
```
advantages
-Easily monitored
-Sterilizes in 3 minutes unwrapped.
Disadvantages
-Instruments should be used promptly.
-Distilled water
```
