Competency

Question 1

You have dirty instruments, in the red box, where would you place these instruments first in the LDU?

Answer 1

In the dirty instrument set down area (red box for dirty instruments)

Question 2

What is the first step of the cleaning process?

Answer 2

The use of the washer disinfector21§q

Question 3

Before starting operating the WD , what should be carried out?

Answer 3

Daily checks

Question 4

What are the 6 daily checks for the washer disinfector?

Answer 4

• Check load carrier is free from damage, instruments or debris
• Check spray arms are rotating freely, and jets are not blocked
• Check door seal is intact and free of damage or debris
• Ensure strainer is not blocked / free of debris or instruments
• Verify enough chemical and replenish if necessary
• Record disinfection temperature of the first cycle

Question 5

3 rules of placing instruments in the WD?

Answer 5

• No overlapping or shadowing of instruments
• Unhinge hinged instruments and place in position where they will not close
• Disassemble instruments

Question 6

Which programme will you select in the WD?

Answer 6

P1 then press start

Question 7

Name the 5 stages of the WD?

Answer 7

• Prewash
• Wash
• Rinse
• Thermal disinfection
• Drying

Question 8

Describe prewash and give temperature?

Answer 8

Remove gross contamination using water - below 35C

Question 9

Describe (wash)

Answer 9

• physical force of water and chemical action of detergent
• Thermal heat activates and facilitate the action of detergent
• This removes any remaining soil

Question 10

Describe (rinse)

Answer 10

Removal of any cleansing agents

Question 11

Describe thermal disinfection and give temperature + holding time ?

Answer 11

• Using reverse osmosis water and heat (90-95C) for 1 minute holding time

Question 12

Describe drying stage and give temperature?

Answer 12

Circulating air heated to 90 degrees for 20 minutes to remove any remaining moisture

Question 13

After the instruments are out of the washer disinfect-or, what is the next step?

Answer 13

Inspection

Question 14

How would you inspect the instruments?

Answer 14

• Under illuminated magnifier to look for contamination or damage
• Send for repair if damaged
• If contamination present then process manually then in USB

Question 15

What PPE should be worn during manual washing?

Answer 15

• Heavy duty gloves
• Apron
• Visor

Question 16

What are the two types of manual washing?

Answer 16

Immersion and non immersion

Question 17

When would you not immerse instruments during manual washing?

Answer 17

• Instruments with channels
• such as hand pieces

Question 18

Which instruments are not suitable to be processed in the USB?

Answer 18

Handpiece

Question 19

Once USB cycle is complete, what is the next step?

Answer 19

• Rinse the instruments in a separate sink than the one for manual washing using cold water

Question 20

After this, you need to change your PPE , then what?

Answer 20

Reprocess the instruments in the washer disinfector, then inspect again

Question 21

What is the temperature, time and pressure for sterilisation?

Answer 21

• 134-137 degrees C
• 2.05 - 2-35 Bar
• For the 3 minutes

Question 22

What are the two main types of sterilisers?

Answer 22

• Type B - vacuum
• Type N - non vacuum

Question 23

What type of water must be used in sterilisation?

Answer 23

Purified water such as RO , distilled , deionosed or sterilised

Question 24

What test is unique to type B steriliser?

Answer 24

• Bowie dick test
• This tests for steam penetration

Question 25

What instruments can be processed in type B steriliser?

Answer 25

* Wrapped * Porous * Lumened or channelled

Question 26

What instruments can be processed in type N steriliser?

Answer 26

* Rigid instruments * non-wrapped and non lumened * Such as mirrors or proves

Question 27

Once the instruments are sterilised, how are you going to remove them from the chamber?

Answer 27

Using a handle as they will be hot; may lead to a burn

Question 28

Once instruments are removed from the steriliser , where are they placed?

Answer 28

* in the clean instruments cool down area * once cooled, they are placed in the clean transport box (blue) * The blue box is then transported to a storage facility or procedure room

Question 29

How should the boxes be? (5)

Answer 29

* Leak proof * tight lid * colour coded/clearly marked * Rigid sided * Durable

Question 30

Pt has just left, the procedure room is messed up (needles , matrix band .... etc) , what should have been done?

Answer 30

* Dispose sharps before the patient leaves into sharp box * Tick the sheet for checklist * Put instruments into dirty red box * then talk through the whole process

Question 31

When recording the temperature, where do you put it ?

Answer 31

Into the log book or USB

Question 32

Describe type N steriliser cycle?

Answer 32

* Air is removed by gravity displacement as the water boils * Simple * non-vacuum

Question 33

Describe type B steriliser cycle?

Answer 33

* Active air removal using a vacuum pump allowing steam to flush in due to negative pressure

Question 34

One advantage of Type N steriliser over type B?

Answer 34

Simpler

Question 35

Disadvantages of type B steriliser over type N steriliser?

Answer 35

* Additional periodic testing is needed * more time cycle due to drying stage for wrapped instruments

Question 36

How should the storage area be ?

Answer 36

* Dry * Clean * good temperature * no direct sunlight

Question 37

What should you do to the hand-piece before placing them in the WD?

Answer 37

Lubricate (oil)

Question 38

Give the 6 daily tests for AWD?

Answer 38

* ACT - compare to log book * levels of detergent * Check spray arms spin freely and jets are not blocked * Check strainer and filters * verify load carrier * Check door seal

Question 39

Give 3 weekly tests for AWD?

Answer 39

* Safety checks ( door seal) * Daily tests ( ACT) * Cleaning efficacy test by residual soil detection

Question 40

Give the 5 daily checks for sterilisers?

Answer 40

* Check load carrier and chamber * Check door seal * Fill feed water reservoir * Crain used water reservoir * Record cycle information

Question 41

What daily check is carried out out for vacuum sterilisers?

Answer 41

* Steam penetration test * Using bowie-dick or helix device

Question 42

What are the weekly tests for sterilisers?

Answer 42

* Safety checks - door seal and safety devices * ACT and steam penetration test * Air leakage test ( Type B) * Automatic air detection function test (Type B)

Question 43

What should you do before inspecting the instruments?

Answer 43

* Dry

Question 44

What are the daily tests for ultrasonic bath?

Answer 44

* Ensure filter and strainers are clean * Drain machine after each session * Check detergent levels

Question 45

What are the weekly tests for USB?

Answer 45

* Safety checks * Protein residue test * ACT * Daily checks