decontamination need to know

Question 1

what are the 2 types of manual washing?

Answer 1

immersion
non-immersion

Question 2

what instruments are suitable for immersion manual washing?

Answer 2

probe
dental mirror
(most instruments)

Question 3

what instruments are suitable for non-immersion manual washing?

Answer 3

handpieces
other electrical/electronic devices

Question 4

Q
what PPE is required for manual washing and why?

Answer 4

gloves- protect hands from detergent (irritant) and contaminated substances
mask- prtect against aerosol from washing of contaminated instruments
full face visor- protect against splash back of contaminated/detergent filled water
plastic disposable apron- protect clothes and other parts of body from splashes during water

Question 5

why do we degas the ultrasonic?

Answer 5

oxygen/air inhibits cavitation and resulting bubbles have lower intensity when imploded
this would reduce efficiency of the machine in cleaning

Question 6

how often do you degas the ultrasonic?

Answer 6

necessary before every cleaning cycle, after filling the machine with clean water but before loading instruments

Question 7

why can handpieces not be placed in the ultrasonic?

Answer 7

handpeices should not be immersed in water
ultrasonic activity can damage the high-speed turbine

Question 8

why is demileralised water used in the steriliser?

Answer 8

minerals, endotoxins etc. present in normal water would coat the surface of the instruments, making them not sterile

Question 9

name 3 regulations for waste disposal

Answer 9

the controlled waste regulations 2012
the hazardous waste directive 2011
the environmental protection act 1990

Question 10

what procedures can be put in place to keep an amalgam container safe?

Answer 10

spill proof container
leak proof container
mercury vapour suppressant in lid
red lid and white body to distinguish from other containers

Question 11

what chemical would you use to clean blood?

Answer 11

sodium hypochlorite
sodium dichloro-iso-cyanurate

Question 12

what concentration of sodium hypochlorite would you use for a blood spillage?

Answer 12

10,000ppm

Question 13

what is the active agent used for blood spillage?

Answer 13

chlorine/chloride

Question 14

how do you decomtaminate an impression?

Answer 14

rinse under cold running water
place in perform for 10 minutes
remove and rinse under cold water
place damp gauze on impression
place into sealable labelled bag

Question 15

how long do you keep waste disposal records for?

Answer 15

3 years

Question 16

what are the different types of waste disposal stream?

Answer 16

• black stream
• orange stream bag
• orange stream bin
• blue stream bin
• red stream waste

Question 17

what is the main way to reduce healthcare associated infections?

Answer 17

use of the standard infection control precautions (SICPs)

Question 18

name the SICPs

Answer 18

• patient placement/assessment for infection risk
• hand hygiene
• respiratory and cough etiquette
• PPE
• safe management of care equipment
• safe management of care environment
• safe management of linen
• safe management of blood and bodily fluid spillages
• safe disposal of waste including sharps
• occupational safety- prevention and exposure management

Question 19

what is the chain of infection?

Answer 19

• infectious agent
• reservoir
• portal of exit
• mode of transmission
• portal of entry
• susceptible host

Question 20

give methods of breaking the chain of infection

Answer 20

• cleaning
• disinfecting
• sterilising
• SICPs

Question 21

how can clinical waste be made safe before landfill?

Answer 21

• heat disinfetion
• incineratin

Question 22

what is the licence regarding disposal of amalgam?

Answer 22

the consignment note

Question 23

what factors increase the risk of food poisoning in a care home?

Answer 23

• food touched by someone who is ill
• food touched by a carer who has looked after a sick resident
• food not stored correctly in fridge
• weakened immunity of the elderly

Question 24

what advice could be given to carers when performing oral hygiene on the elderly to stop cross infection?

Answer 24

• ensure hand hygiene is carried out before and after helping the pt
• PPE
• educate on cough etiquette and hand hygiene

Question 25

define sterile

Answer 25

an object free from all microorganisms

Question 26

define sterilised

Answer 26

when an object has went through a process of becoming free from bacteria and all other living microorgansism

Question 27

what is sterilisation?

Answer 27

the use of physical or chemical procedures to destroy all microorganisms including large numbers of resistant bacterial spores

Question 28

describe steam sterilsation

Answer 28

* process used to render reusable instruments free from viable microorganisms * does not destroy prions * the result of direct contact of medical devices with saturated steam in the absence of air

Question 29

what is validation?

Answer 29

* reviewing that the practice is safe * related to regulations 12 and 15 * essential to ensure equipment performs to an optimum standard * should be done in accordance to manufacturers instructions

Question 30

what is the sinner circle?

Answer 30

shows components essential for adequate cleaning * chemicals * temperature * time * energy (mechanical force)

Question 31

what is disinfection?

Answer 31

* destruction of pathogenic and other kinds of microorganism by physical or chemical means * achieved by thermal disinfection * destroys most recognised pathogenic microorganisms but not bacterial spores

Question 32

what is removed by degassing?

Answer 32

air/oxygen

Question 33

what are the principles of waste disposal?

Answer 33

* segregation * storage * disposal * documentation

Question 34

give legislation for the decontamination of instruments

Answer 34

health and safety at work act 1974 the medical device regulations 2017

Question 35

what si the standard that everyone must achieve for decontamination?

Answer 35

BS EN standards

Question 36

what standard from BS EN relates to sterilisation?

Answer 36

285 13060

Question 37

what guidance is there for decontamination?

Answer 37

SHTM01 part c- sterilsation part d- automated cleaning and disinfection

Question 38

explain the spoulding classification and how they are cleaned

Answer 38

* critical- penetrates sterile tissue must be sterile * semi-critical- contacts non intact skin/mucous membranes sterile preffered, high disinfaction accepted * non-critical- contacts intact skin/mucous membrane disinfection/clean

Question 39

why is it important for instruments to be sterile?

Answer 39

* reduce infection transmission * high quality care * meet legislative and professional standards

Question 40

what type fo detergent is used in manual cleaning?

Answer 40

enzymatic detergent or pH neutal

Question 41

what is immergen better than non immersion?

Answer 41

minimises splashing minimises aerosol production

Question 42

what detergent is used in the ultrasonic cleaner?

Answer 42

ezymatic or neutral pH

Question 43

what type of water is used in the ultra sonic?

Answer 43

tap water acceptable

Question 44

what must be included in records for ultasonic use?

Answer 44

* date * time * cycle number * detergent added * operator name

Question 45

describe the load requirements for the ultrasonic

Answer 45

* hinge instruments open * no overlapping/shadowing * all assemblies unassembled * load carrier must be used

Question 46

what type of detergent is used in the AWD?

Answer 46

high or low alkaline detergent

Question 47

what are the 5 stages of the washer disinfector?

Answer 47

flush/pre-wash main wash rinse thermal dinsinfection drying

Question 48

what must occur between all stages of the washer disinfector

Answer 48

water change to remove contamination

Question 49

when must prions be removed and why?

Answer 49

before high temperature is added they adhere to the surface of the instruments

Question 50

what happens during the flush stage

Answer 50

saturates and removes decontamination <35degrees

Question 51

what happens during the main wash?

Answer 51

deterghent added to remove biological matter temp is chemical dependent

Question 52

what happens during the rinse stage?

Answer 52

removes remaining residue <65degrees

Question 53

what happens during thermal disinfection stage?

Answer 53

kills microorganisms occurs between 90-95 degrees for at least a minute

Question 54

what occurs during the drying stage

Answer 54

hot air removes moisture at least 100degrees

Question 55

give daily checks for AWD

Answer 55

* **record disinfection of first daily cycle** * check condition of the door seal * check chemical levels in reservoir * check spray arms spin freely * check that spray jets are not blocked

Question 56

what type of water is used in steriliser?

Answer 56

purified

Question 57

name 3 types of sterilser

Answer 57

N B S

Question 58

describe the type N sterilser

Answer 58

cannot process wrapped instruments

Question 59

explain the type B sterilser

Answer 59

**vacuum created ****** can process wrapped instruments - makes things sterile

Question 60

explain the type S sterilser

Answer 60

specialised can only be used for certain equipment cannot process a wrapped instrument has a vaccuum

Question 61

what temp does sterilsation occur at?

Answer 61

134-137 for at least 3 minutes

Question 62

what are daily tests for the steriliser?

Answer 62

* **stem penetration test** * bowie dick or helix * check the door seal * fill feed water reservoir * drain the used water