Cleanliness champions / Cross infection

Question 1

What is wrong with this bay?

Identify dangers and how to rectify

Answer 1

1. Bracket table
   - LA needle unsheathed
   - Scalpel
   - Tooth in forceps
   - Endo files
2. Surgery
   - sharp box on floor
   - gloves in sink
   - Blood spillage

Question 2

What are the different waste streams?

Answer 2

• black - domestic
• orange - low risk clinical waste
• yellow - high risk clinical waste
• Red - hazardous - dispose AM in white ox with red lid
• Blue lid with yellow lids - medication
• Orange lid yellow box - sharps
• Brown - confidential

Question 3

What are some disposal rules of sharps

Answer 3

• in orange stream
• immediately after use
• keep out of reach of children
• do not retrieve anything from the sharps box
• Temp close between uses
• never fill more than 3/4

Question 4

How to deal with a blood spillage?

Answer 4

• Stop what you are doing
• Apply PPE - apron/mask/visor/gloves
• Cover spill with disposable paper towels and dispose
• Apply Sodium hypochlorite or sodium dichloroisocyanurate - liquid/ powder/ granules (10,000 ppm)
• Leave for 3-5 mins , use scoop to take gross contamination and out in orange waste
• Clean with water and general purpose neutral detergent disinfectant wipes
• Remove PPE and perform hand hygiene

Question 5

Sterilisers

What is the difference between type N and type B sterilisers?

What is the cycle of each ?

what is the type of water used?

Answer 5

~ Type N ( Sterilised at the point of use and needs to be taken to the procedure room)
- non vacuum
- passive air removal
- unwrapped solid products
- non-hollow
- non-lumened

~ Type S (Sterile)
- Vacuum
- Active air removal
- lumened
- hollow cannulated or porous

~ Cycle Stages
1. Air removal
2. Sterilising
3. Drying
4. Cooling
134-137 degrees , 2-2.3 bar for a minimum holding time for 3 mins

~ Type of water used
- reverse osmosis
- disilled
- Sterile
- De-ionised

Question 6

Sterilisers daily tests

Answer 6

• Ensure door seal is intact
• Ensure load carrier and chamber are free of debris
• Drain and fill water reservoir
• ACT

Question 7

Sterilisers weekly tests

Answer 7

• ACT
• Steam penetration test
• vacuum leak test
• automatic air detector function test

Question 8

Sterilisers quarterly tets

Answer 8

validation report to ensure steriliser effectiveness

Question 9

Sterilisers yearly tests

Answer 9

annual report to ensure safety

Question 10

How to know that instruments on top of steriliser are sterilised , and what to do?

Answer 10

• Check for steriliser print out
• Check for colour chang of packaged instruments ( brown to pink)
• If unsure take tray back to beginning - cleaning in AWD or manual cleaning

Question 11

Examples of instruments used in Type N steriliser

Answer 11

• mirrors
• probes
• Tweezers

Question 12

How should transport boxes be ?

Answer 12

• Leak proof
• Tight lid
• Colour coded
• Rigid sided
• Durable

Question 13

Stages of AWD

Answer 13

1- Flush - remove gross contamination
2. Wash - removing any residual soil ( water and detergent)
3- Rinse - removing any residual detergent
4- Disinfection - disinfection using hot water
5- Drying - to remove moisture using high temp

Question 14

Cleaning station of a dental chair

Answer 14

• PPE
• Remove all sharps and place in sharps box
• Remove all disposable items in the orange waste
• Replace gloves
• Wipe starting at the top of the unit
• Dispose wipes and gloves
• Perform hand hygiene