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Dental nurse exam revision > Unit 303 > Flashcards

Unit 303 Flashcards

1
Q

What does cross - infection mean?

A

a patient being contaminated by another patient/member of staff (infection), or from a dirty instrument.

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2
Q

The guidelines in regards to decontamination in general dental practice are covered by what regulations?

A

Department of health publication
Health technical memorandum
HTM 01-05

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3
Q

HTM01-05 is a working document, what does a working document mean?

A

it will be updated as evidence of better techniques and systems when they become available.

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4
Q

Essential quality requirements are:

A

the basic level of decontamination standards that all workplaces should have implemented within the first year of the publication of the document.

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5
Q

Best practice is:

A

gold standard to be aimed for in the future
-use of a washer disinfector
-separate facility for decontamination tasks- away from clinical area
-separate storage area for sterilised instruments - away from clinical area

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6
Q

Who oversees dental practice in regards to patient safety and decontamination?

A

CQC

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7
Q

The code of practice on the prevention and control of infections was introduced under what regulation?

A

health and social care act 2008
-CQC use this criteria to decide if a dental workplace is compliant with all infection control requirements.

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8
Q

What is direct cross infection?

A

the transfer of infection from person to person

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9
Q

What is indirect cross infection?

A

from person to equipment and onto a second person

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10
Q

What is the system of standard precautions designed to do?

A

protect staff from inoculation and contamination risks and also to protect patients from being exposed to the risk of cross infection.
Routine procedure for all patients

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11
Q

The basic principle of cross infection is to?

A

assume that any patient may be infected with any micro-organism and could pose a risk to patients and staff.

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12
Q

What type of people are called carriers?

A

patient who is infected with a micro-organism but not showing any signs of disease - unaware of the risk they pose to others.

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13
Q

Best practice dictates that good general infection control is achieved by what, list examples:

A
  • up to date written infection control policy in place
  • standard precautions are used for all patients
  • correct cleaning and disposal
    -validation, maintenance and testing of all decontamination equipment in accordance with the manufacturers instructions.
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14
Q

What are the current personal infection control protocol procedures to be followed by staff?

A
  • Hepatitis B vaccination
  • Immunised against current common illnesses
  • correct hand cleaning procedure`s
  • PPE
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15
Q

HTM 01-05 infection control policy update, what does the clinical governance require use to do?

A

written infection control policy

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16
Q

Examples of how we can minimise blood borne virus transmission to ourselves as nurses:

A

-Hepatitis B vaccination
-Safer sharps are used where reasonably practicable
-sharps injury policy

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17
Q

Examples of cleaning machines:

A

washer disinfector
ultrasonic bath
rinsing
manual cleaning

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18
Q

How are instruments inspected after cleaning?

A

illuminated magnifier

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19
Q

Examples of sterilisation machines:

A
  • vacuum autoclave B or S type
  • non vacuum autoclave n type
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20
Q

unwrapped instruments can be stored in a non clinical area for how long?

A

1 week

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21
Q

What does social cleanliness mean?

A

clean to a socially acceptable standard for personal hygiene purposes.
NOT disinfected or sterilised

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22
Q

What does disinfection mean?

A

process used to kill or inactive bacteria and fungi but not spores

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23
Q

What does sterilisation mean?

A

process of killing all micro-organisms and spores to produce asepsis

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24
Q

What does Asepsis mean?

A

The absence of all living pathogenic micro-organisms

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25
Q

What does decontamination mean?

A

the combination of processes used to remove contamination from reusable items
Also referred to as “reprocessing”

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26
Q

Dedicated hand washing sinks must be available in practice and have taps that are operated by either.. and why?

A

elbow or foot to avoid contamination from dirty hands.

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27
Q

What does “WHO`S” mean?

A

five moments of hand hygiene

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28
Q

What are the 5 moments of hand hygiene (whos)?

A
  • before touching a patient
    -before undertaking a clinical procedure
    -after exposure to a bodily fluid
    -after touching a patient
    -after touching a patients surroundings
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29
Q

Hand wash with soap and water (clinical) should take how long to complete?

A

40-60 seconds

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30
Q

How should hands be dried after washing with hand wash and soap?

A

disposable paper towels

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31
Q

Hand rub with gel (social) should take how long to complete?

A

20-30 seconds

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32
Q

Should hands be dried after using hand rub with gel?

A

No - dry naturally

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33
Q

When should hand gels be used?

A

visibly clean hands between patients during surgery sessions

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34
Q

Can hand cream be used before putting on gloves and why?

A

No
encourage the growth of any micro-organisms present on the skin

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35
Q

Why is PPE worn?

A

to prevent staff from coming into contact with blood and other bodily fluids.

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36
Q

Examples of PPE:

A

gloves, uniform, plastic apron, safety glasses and facemasks

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37
Q

Why should alcohol gel not be used with clinical gloves?

A

damage the nitrile or vinyl material allowing leakage to occur.

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38
Q

What is the guidance that insists cleaning equipment should be colour coded?

A

NPSA
National patient safety agency

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39
Q

Red coloured cleaning items are used where in the dental practice?

A

toilet and washrooms

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40
Q

Yellow coloured cleaning items are used where in the dental practice?

A

clinical and decontamination areas

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41
Q

Green coloured cleaning items are used where in the dental practice?

A

Kitchen

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42
Q

Blue coloured cleaning items are used where in the dental practice?

A

office and reception

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43
Q

What standard should be achieved in the clinical dental environment?

A

disinfection

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44
Q

Bleach based cleaners:

A

contain sodium hypochlorite
used to disinfect all NON-METALLIC and NON-TEXTILE surfaces + labwork

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45
Q

Aldehyde based cleaners:

A

used on metallic surfaces and soak lab items

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46
Q

Isopropyl alcohol wipes:

A

disinfect items
such as exposed x-ray film packets
for safe handling during processing

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47
Q

Chlorhexidine gluconate:

A

irrigating disinfectant during rct treatment + skin cleanser

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48
Q

Alcohol/detergent combinations:

A

as wipes for use on HARD surfaces

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49
Q

Hypochlorous acid products:

A

surface sprays and for use in DUWLs

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50
Q

Other than surface sprays and DUWLS what can hypochlorus acid products be used for?

A

Impression disinfectant, instrument holding solution, ultrasonic bath, mouth rinse, root canal irrigant

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51
Q

Special precautions are required to ensure that the air conditioning unit does not become contaminated with the waterborne micro-organism - legionella

A
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52
Q

What is zoning?

A

areas should be designated as clean and dirty

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53
Q

What are protective barriers?

A

equipment’s likely to be contaminated should be covered with impervious plastic sheets and changed between patients.

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54
Q

What should aspirators be flushed daily with?

A

non-foaming disinfectant

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55
Q

Bleach has to be made up on a daily basis as a fresh solution

A
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56
Q

Bleach solution: 1% fresh solution should be made for?

A

disinfecting all non-metallic, non-fabric surfaces and for disinfecting lab impressions and removable prosthesis

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57
Q

Bleach solution: 10% fresh solution should be made for?

A

blood spillages

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58
Q

If disinfectants are ingested, what are their manufacture and usage strictly controlled by which legislation?

A

COSHH

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59
Q

What hand soap should be used for clinical hand washing?

A

antibacterial or antimicrobial hand wash

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60
Q

What hand soap should be used for surgical/aseptic hand washing?

A

chlorhexidine

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61
Q

How long should we wash our hands with chlorhexidine during a surgical/aseptic hand wash?

A

2 minutes
120 seconds

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62
Q

When cleaning the clinical area after use what should be used to do this?

A

Disposable cloths
water to wet the cloths
detergent

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63
Q

Spray bottles should be considered as…

A

single use items

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64
Q

Where should items be stored if they are not in use?

A

cupboards and drawers

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65
Q

When decontaminating a surgery after use, what should be done first?

A

the most contaminated items removed first

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66
Q

What should be available to work of when decontaminating a surgery after use?

A

written cleaning schedule

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67
Q

DUWL`S can become contaminated with micro-organisms such as what bacteria?

A

Legionella

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68
Q

Micro-organism contamination of micro-organism can come from what sources?

A

Water supply - main system
proliferation within the water system if temp is not maintained
bacteria from the mouth of a patient “suck back”
Biofilm contamination of the bottle or water line

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69
Q

The risk assessment and written scheme for legionella risk assessment must be undertaken by whom in the practice?

A

competent person
a water engineering specialist e.g. legionella control association

70
Q

Reservoir bottles should contain what type of water?

A

freshly distilled
reverse osmosis generated water

71
Q

Specialist biocide chemicals (disinfectants) are available for use within the reservoir bottles while carrying out dental treatment. What do they help to reduce?

A

The build up of biofilm within the system

72
Q

In regards to reservoir bottles what other solution can be used in the water bottles?

A

hypochlorous acid solution

73
Q

At the start of a session DUWL`S should be flushed for how long?

A

2 minutes

74
Q

Between patients DUWL`s should be flushed for how long?

A

20-30 seconds

75
Q

During surgical procedures what source should be used (DUWLS)?

A

Single use sterile water or saline

76
Q

Micro-organims in water will grow at what temperature?

A

20-40`C

77
Q

How is water temperature checked (what do we use?) and how often?

A

Thermometer
stop watch system
- Recorded on a MONTHLY basis

78
Q

Infection with legionella in any person due to the workplace water supply system should be reported under?

A

RIDDOR

79
Q

What are the 3 main techniques available for cleaning reusable dental equipment, hand pieces, instruments:

A

Manual cleaning
Manual cleaning with ultrasonic decontamination
Decontamination and cleaning with washer disinfector

80
Q

What is the correct way to clean a curing light?

A

Wiped down with a suitable cleaning agent
Fibre optic tip - single use barrier cover

81
Q

What is the correct way to clean a aspirator tubing?

A

wiped down externally with a suitable cleaning agent
single use barrier cover

82
Q

What is the correct way to clean a x-ray unit tube?

A

wiped down with suitable cleaning agent after use

83
Q

With sterilising hand pieces what is the main aim?

A

reduce the risk of cross infection rather than completely eliminating it.

84
Q

What is the correct name for inner hallow surfaces of instruments?

A

Lumens

85
Q

How are the hallow surfaces of instruments correctly sterilised?

A

Vaccum autoclaves Type B and S
NOT N TYPE

86
Q

When should soft bristled brushes be replaced?

A

Follow manufacturers instructions
Before if bristles become splayed

87
Q

The procedure within the dental practice for cleaning instruments should be written down and included in what policy?

A

Infection control policy document

88
Q

In regards to best practice guidance manual cleaning should only be done when…

A

the manufacturer has instructed automatic cleaning is unsuitable

89
Q

What temperature should the water be during manual cleaning?

A

cold

90
Q

Why are wire bristle brushes not allowed during manual cleaning?

A

scratch the metal surfaces and allow corrosion and rustling to occur

91
Q

What should be used to check that all contamination has been removed during manual cleaning?

A

illuminated magnifier

92
Q

What do ultrasonic baths remove?

A

debris from items

93
Q

How do ultrasonic baths remove debris?

A

vibrating at an ultrasonic frequency and transmitting that vibration onto the instruments

94
Q

If an ultrasonic bath is overloaded with instruments what will not be effective?

A

Debridement

95
Q

Who is the ultra-sonic bath maintained by?

A

service engineer
delegated person competent in decontamination

96
Q

What are the 3 Daily duties of ultrasonic baths?

A

Strainer/filter cleaning
Tank draining
cleaning check

97
Q

What are the 2 weekly duties of ultrasonic baths?

A

Safety checks
Protein residue test

98
Q

What is the test called that should be done every 3 months with ultrasonic baths?

A

activity test - aluminium foil

99
Q

What is a washer disinfector similar too?

A

traditional dishwasher machine

100
Q

What are the 5 cycles called in a washer disinfector?

A

Flush, wash, rinse, thermal disinfection, drying

101
Q

What 3 in house tests should be carried out every 6 months for washer disinfectors?

A

Automatic control test
chemical dosing
thermometric disinfection test

102
Q

N-type autoclave:

A

134`C 3 minutes 2.25 bar
cycle is 15-20 mins
Unwrapped items

103
Q

B-Type/S Type autoclave:
BEST PRACTICE

A

134`C 3 minutes 2.25 bar
Cycle can last 45 mins
Wrapped items and instruments with hollow lumen e.g surgical items
Date logging device

104
Q

What are N-type autoclave instruments dried with after sterilisation?

A

single use cloth or towel

105
Q

N-type autoclave post sterilisation: when they are stored unwrapped in a clinical area when should they be used?

A

Within the day

106
Q

N-type autoclave post sterilisation: when they are stored unwrapped in a lidded box in a non-clinical area when should they be used?

A

1 week

107
Q

N-type autoclave post sterilisation: when they are placed in a sealed window pouch how long do you have to reuse?

A

1 year

108
Q

Autoclaves are..

A

pressure vessels

109
Q

N -type autoclave test
Non-vacuum

A

TST strip

110
Q

B-type autoclave test
Vacuum

A

Helix test
bowie dick test

111
Q

How often should an authorised engineer carry out an inspection on autoclaves?

A

yearly/annually

112
Q

What instruments are industrially sterilised by exposure to gamma rays?

A

single use items

113
Q

The correct order of cleaning B-TYPE instruments:

A

clean
inspect
seal
autoclave

114
Q

The correct order of cleaning N-TYPE instruments:

A

clean
inspect
autoclave

115
Q

why is zoning done within a decontamination area?

A

to avoid cross contamination

116
Q

Airflow system (extractor fan) within the decontamination room to comply with dirty/clean zoning - best practice guidelines.

A
117
Q

What is the best method of avoiding indirect cross infection?

A

Single use items

118
Q

What instrument has changed on the HTM 01-05 guide that can now be reused ONLY on the same patient?

A

endodontic files and reamers

119
Q

What are the 3 categories of hazardous waste?

A
  • non-hazardous
    -hazardous infectious
    -hazardous chemical
120
Q

What colour is the container that non-cytotoxic medicines are put in?

A

blue-lidded yellow containers

121
Q

What colour is the bin that soft infectious waste is put in?

A

orange sacks

122
Q

Offensive waste is

A

non infectious but may cause offence to those who come in contact with it.
e.g. PPE, cleaning towels, x-ray films
Not been contaminated with bodily fluids etc

123
Q

Trade waste is

A

dental equipment e.g. chairs, curing lights
Commercial electronic waste e.g. computer screens, TV

124
Q

What are the 3 main occupational hazards in dentistry?

A

mercury poisoning
radiation
cross infection

125
Q

Pathogenic micro-organisms that are transmitted by contact (indirect/direct) with bodily fluids and secretions raise concern to the dental team.

A
126
Q

Pathogenic micro-organisms: HIV

A

Viral
destroys the bodies leucocytes, weakening immune system
Eventually develop AIDS
No current vaccination

127
Q

Pathogenic micro-organisms: Hepatitis B

A

Viral
liver inflammation - fatal
vaccination needed in dentistry

128
Q

Pathogenic micro-organisms: Hepatitis C

A

Viral/virus
Highly likely to prove fatal
No current vaccination

129
Q

Pathogenic micro-organisms: Herpes simplex type 1

A

Viral
lips and oral cavity
“cold sores”

130
Q

Pathogenic micro-organisms: CJD

A

Rare but fatal
affects the brain and nerve tissues
caused by Prions

131
Q

Pathogenic micro-organisms: Influenza

A

Viral
respiratory
similar to a cold but worse
can be fatal with patients who have a low immune system and elderly

132
Q

Pathogenic micro-organisms: Tuberculosis

A

Bacterial infection
respiratory and organ damage
spread by droplet contamination and direct contact
vaccination is a must in dentistry

133
Q

Pathogenic micro-organisms: Ebola virus

A

Viral haemorrhagic fever
spread direct contact with bodily fluids and secretions

134
Q

Pathogenic micro-organisms: MRSA

A

“superbugs”, affect hospitalised patients
MRSA bacteria - spread due to poor infection control procedures

135
Q

What vaccinations are we given as an infant?

A
  • Pertussis- whooping cough
    -MMR - measles, mumps, rubella
136
Q

What vaccinations are we given in childhood?

A

-diphtheria
-Poliomyelitis
-tetanus
-chicken pox - if not naturally immune

137
Q

What vaccinations are we given as a teenager?

A
  • meningitis
    –tuberculosis
138
Q

What vaccination are we given as an adult?

A
  • influenza and swine influenza
139
Q

What virus is present in saliva before any signs of illness?

A

MMR
measles, mumps, rubella

140
Q

If rubella occurs in the first 3 months of pregnancy the unborn child could be affected causing serious physical defects.

A
141
Q

Is there a cure for AIDS?

A

NO

142
Q

What drugs can be used to pro-long life for a patient who has aids?

A

antiviral and other drugs that boost the immune system

143
Q

what is aids caused by?

A

infection with HIV virus

144
Q

How is aids transmitted?

A

contact with blood containing the virus

145
Q

What are the usual modes of transmission in regards to HIV?

A

sex, sharing of needles by drug addicts, childbirth, repeated transfusions with contaminated blood

146
Q

Prevention of AIDS in a dental practice:

A

same as HEP B
correct sterilisation and surgery hygiene

147
Q

In regards to washing uniform after being in contact with a known carrier how long and what temp should the wash be?

A

10 mins
90`C

148
Q

What can occur as a result of Hepatitis B?

A

Liver cancer 80%

149
Q

What disinfectants are used when killing the virus HBV?

A

hypochlorite

150
Q

What is the main source of infection in regards to hepatitis B in a dental setting?

A

direct contact with blood containing HBV
sharps injury, nose, eyes, skin abrasions

151
Q

What is always present in the blood of patients carrying the virus HEP B?

A

HBV

152
Q

All dental nurses should be vaccinated against HBV (hep b virus)

A
153
Q

IS hepatitis C more dangerous than hepatitis B?

A

yes

154
Q

What is the reason behind hep c being more dangerous than hep B?

A

no vaccination

155
Q

What is the main source of transmission for hepatitis C?

A

Blood to blood contact
sexual transmission is uncommon

156
Q

What is the pathogenic micro-organism called that is involved with Hepatitis C?

A

Hepatitis C virus
HCV

157
Q

How can the virus when dormant be reactivated? (herpes simplex type 1)

A

general illness, stress, hormonal changes, exposure to sunlight

158
Q

What is herpes simplex type 1?

A

virus - cold sores
children - lips, mouth, face
adults - lips

159
Q

How is herpes simplex type 1 transmitted?

A

contact with the lesion and infected saliva

160
Q

What areas during transmission can herpes simplex type 1 virus spread to, that will affect the dental team?

A

areas of the skin or eyes

161
Q

What is CJD and new variant CJD similar to…

A

mad cow disease

162
Q

What is CJD caused by?

A

unique non-microbial source of disease
PRION PROTEIN

163
Q

Where does the CJD infection occur and what does it affect?

A

nerve tissue, affects both the brain and the nerve tissues
tooth pulp

164
Q

Prions CANNOT be destroyed by normal sterilisation methods.

A
165
Q

How is influenza transmitted?

A

close contact with an infected person, environmental contamination (sneezing, coughing)

166
Q

What micro-organism is influenza?

A

RNA virus

167
Q

What is an inoculation injury?

A

SHARPS
contaminated object or substance breaks the skin or mucous membrane or comes into contact with the eyes.

168
Q

What is the regulation in regards to sharps injuries?

A

Health and safety (sharps instruments in healthcare regulations) 2013

169
Q

What is the inoculation injury policy?

A

Bleed it
Wash it
Cover it
Report it

170
Q

Within 1 hour of inoculation injury what treatment should the member of staff be given (A&E occupational health)?

A

prophylaxis treatment
antiretroviral drugs

171
Q

Where should a sharps injury be reported?

A

accident book

172
Q

What regulatory body determines whether each workplace complies with cleanliness and infection control requirements of the health and social care regulations?

A

CQC

Dental nurse exam revision (13 decks)

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