Unit 305: Principles of Infection Control in the Dental Environment Flashcards
LO1: Understand the process of infection control LO2: Understand the significance of microorganisms LO3: Understand the management of infectious conditions affecting dental patients LO4: Know the various methods of decontamination LO5: Understand the relevant health and safety legislation, policies and guidelines
Which level of hand hygiene aims to physically remove routinely acquired microorganisms?
Social
Which method of cross-infection is the least likely in a well-organised environment?
Inoculation injury
What is the correct term to describe a person who s infected with a pathogenic microorganism but who shows no outward signs of disease?
Carrier
What is the term used when only bacteria and fungi have been destroyed by the cleaning method involved?
Disinfection
What method is used to remove potential aerosol and droplet contamination between dental procedures?
Surface cleaning
What method prevents cross infection from staff to patients?
Handwashing
What method is used to prevent contamination of equipment which cannot be sterilised in the usual way?
Barriers
What assumption forms the basic principle of ‘standard (universal) precautions’?
Any patient may be infected with a pathogen at any time
Healthy carriers cannot be identified
What term describes items which have undergone a process to remove physical contamination so that they can be rendered safe for reuse?
Decontaminated
Which item of PPE is most important in preventing cross infection by aerosol spray?
Mask
What is the most likely route of transmission from a patient when a member of staff has an uncovered wound on their finger?
Direct entry
Which level of hand hygiene aims to significantly reduce the numbers of normally resident microorganisms on the hands?
Surgical
What term is used to describe items when all pathogenic microorganisms and spores have been destroyed by the cleaning method involved?
Sterilised
What method involves physically separating dirty instruments from clean ones during a dental procedure?
Zoning
Why are sealed pouches used to store instruments in the clinical area of the dental workplace?
To avoid aerosol contamination
Which chemical is used for routine cleaning of work surfaces in the clinical area between patients and for use as an impression disinfectant?
Sodium hypochlorite (bleach)
Which item is used to sterilise instruments and render them safe for reuse?
Autoclave
Which technique is best for preventing the occurrence of indirect cross-infection incidents from patient to patient?
Use of single-use disposables
Which chemical should be used to clean away a blood or body fluid spillage?
Sodium hypochlorite
Why do we no longer use metal brushes while manually cleaning instruments?
Creates micro-scratches on instrument surface which harbour microorganisms
What is the correct sequence of events to be followed during the decontamination of instruments before sterilisation is carried out?
Debride, inspect, rinse and scrub
Which infectious agent is present as protein capsules living within other body cells?
Virus
What are antibiotics?
Drugs taken to fight bacterial infections
Which bacteria are rod-shaped and associated with established carious cavities in teeth?
Lactobacilli
Which infectious agent is not classed as a microorganism?
Prions
Which route of transmission if most likely to be involved if a person infected with the common cold is sneezing regularly?
Airbourne droplets
Which tissues does Creutzfeldt-Jakob disease affect?
Nervous (nerves and brain)
What is a pathogen?
A disease causing microorganism
What is a non-pathogen?
A microorganism which does not cause disease
Which infectious agent is found as single-cell organisms that can exist in unfavourable environments as spores?
Bacteria
Which three disease are associated with a fungal infection of Candida albicans?
Denture stomatitis, oral thrush and angular cheilitis
Which route of infection is most likely to result in an infection?
Inoculation injury
What are the five signs and symptoms of an inflammatory response?
Redness, swelling, pain, heat and loss of function
Which virus affects the human immune system and may result in acquired immune deficiency syndrome (AIDS)?
HIV
What group of drugs is available for use against an infection caused by a bacterial microorganism?
Antibiotics
What type of bacteria is spiral shaped and is associated with an ulcerative periodontal infection?
Treponema vinceti (also Borellia vincenti)
Which route of transmission is especially likely in the dental workplace due to the use of the high speed handpiece?
Aerosol spray
How is hepatitis B mainly transmitted?
Through the blood
Which infectious agent is found as microscopic plant-like organisms that reproduce by budding or by producing spores?
Fungi
Which bacteria is round-shaped and associated with initial dental caries?
Streptococcus mutans
What causes a cold sore lesion?
It is a secondary infection after contracting the herpes simplex virus
Which disease must all dental professionals be vaccinated against?
Hepatitis B
Which infectious condition is most likely to infect a member of the dental team during normal chairside work?
Cold sore lesion
Which infection control measure is most likely to reduce cross infection from staff to patients?
Handwashing
What is produced during the immune response to neutralise the poisons from the microorganisms?
Antitoxins
Which disease presents as a swelling of the parotid salivary glands, usually in children and young adults?
Mumps
Which is more infective, HIV or hepatitis B?
Hepatitis B
Which type of immunity arises after immunisation?
Acquired immunity
Which infectious disease affecting the head and neck region is usually caused by the Epstein-Barr virus?
Glandular fever
What is released by the immune system to fight invaders following secondary exposure to an infectious disease?
Antibodies
What infection presents as generalised stomatitis with many shallow painful ulcers present and which takes up to 14 days to resolve?
Primary herpes simplex
How long should handwashing using antibacterial soap and a clinical handwashing technique take?
30 seconds
What type of immunity may be passed from mother to child?
Passive immunity
Why are all endodontic files single use?
The prevent the transfer of prions (such as those which cause CJD) from one patient to another
What type of immunity arises randomly from genetic inheritance or mutation?
Natural immunity
What precautions should be followed to ensure that dental staff and patients are not exposed to blood-borne viral diseases in the dental workplace?
Follow standard (universal) precautions
What process is used to kill microorganisms and spores to produce asepsis?
Sterilisation
How long can pouched items be stored before they need to be sterilised again?
1 year in any area
What date must be clearly visible on all pouched items?
Expiry date, one year from date pouched
What is the most likely cause for an ultrasonic bath to fail in debriding items?
Overloaded chamber
Which instrument cleaning method is the most difficult to validate?
Manual cleaning
How many stages are there in a washer-disinfector cycle?
5
List the five stages of the washer-disinfector cycle in order.
Flush, wash, rinse, thermal disinfection and drying.
What is the purpose of a Helix test?
To ensure steam penetration occurs
What is the term used to describe the separation of clean and contaminated areas in the clinical environment to avoid cross-infection?
Zoning
What does ‘TST’ stand for?
Time, steam and temperature
What chemical should not be used to disinfect metallic surfaces in the clinical environment?
Sodium hypochlorite (it is corrosive to metals)
Name 3 common techniques for industrial or large-scale sterilisation.
S-type autoclave
Ethylene gas exposure
Gamma irradiation
What direction should air flow within the decontamination room?
Clean to dirty (pouching area to instrument wash sink)
What is isopropyl alcohol commonly used for?
To wipe X-ray film packets
Alcohol hand rub
How does an N-type autoclave operate differently to a B-type autoclave?
Steam is displaced downwards in the chamber
How does a B-type autoclave operate differently to an N-type autoclave?
Use of a vacuum
Name 3 methods to remove debris before sterilisation
Manual cleaning
Ultrasonic bath
Washer-disinfector
What is the term for the killing or inhibiting the growth of bacteria and fungi?
Disinfection
Why are lidded boxes used to transport dirty instruments to the decontamination room?
Prevents contamination of the route, especially by dripping fluids.
What chemical decontaminant is found in skin cleansing products for use in the clinical area?
Chlorhexidine
What term describes cleaning agents which kill bacteria?
Bactericidal
What term describes cleaning agents which inhibit the growth of bacteria?
Bacteriostatic
What term describes cleaning agents which kill viruses>
Viricidal
What does the term ‘decontaminant’ mean when in reference to cleaning agents?
Decontaminants remove debris from contaminated items and sites
What type of items are not suitable for sterilisation in an N-type autoclave due to the downward displacement of steam?
Hollow items
What does COSHH stand for?
Control of Substances Hazardous to Health
Which legislation is concerned with the risk assessment of chemicals?
COSHH
Who is protected when PPE is worn correctly?
Staff are protected from being infected by patients
Who is protected by proper handwashing techniques?
Patients are protected from being infected by staff
Who is protected through the use of single-use disposables?
Patients are protected from being infected by other patients (indirect cross-infection)
Name the first stage of the risk assessment process
Identify the risk
List the 6 stages of the risk assessment process in order
- Identify the risk
- Identify who is at risk
- Evaluate the risk
- Control the risk
- Record findings and control measures
- Review after a suitable period
List the steps to follow immediately after a sharps/inoculation injury
Stop what you are doing. Remove gloves. Squeeze to encourage bleeding. Wash under clean running water. Dry and apply a waterproof dressing. Report and record in the accident book. If dirty sharps, immediately go to occupational health department for assessment and treatment.
What type of waste would out-of-date luting cements be classified as?
Non-hazardous waste (which is by definition also non-infectious)
List the four stages of decontamination in order
Cleaning
Inspection
Disinfection
Sterilisation
What type of waste are lead foils (found in x-ray film packets) classified as?
Non-hazardous waste (solid lead is no longer considered hazardous so does not need to classed as special waste)
Which item in the decontamination room should undergo a protein residue test on a weekly basis?
Ultrasonic bath
Which step in the risk assessment is concerned with the likelihood of harm?
Evaluate the risk
Why are powdered gloves considered the least suitable in the clinical environment?
Powder may produce hypersensitivity reactions.
Powder will absorb excess moisture remaining on the hands if not thoroughly dried.
What temperature do autoclaves sterilise at?
134 degrees Celsius
What pressure do N-type autoclaves reach?
2.2 bar or 32 psi
How long must the autoclave hold the time and pressure in order to achieve sterilisation?
3 minutes minimum
Which regulation or legislation is concerned with the consequences following an explosion of the autoclave?
RIDDOR
What type of waste is a sound extracted tooth?
Infectious waste (sharps)
Why are heavy-duty gloves worn when handling contaminated instruments in the decontamination room?
To avoid the possibility of a sharps injury
How long may un-pouched items be stored in a clinical area?
1 day
How long may un-pouched items be stored in a non-clinical area?
1 week
What maintenance action should be carried out each week for an autoclave?
Check door seal
What pathogen may be found in dental water lines?
Legionella (which causes Legionnaire’s disease)
Which regulation or legislation states that Legionnaire’s disease is a notifiable occurrence in the dental workplace?
RIDDOR
