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REVISION BDS > decontamination 87 > Flashcards

decontamination 87 Flashcards

(56 cards)

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1
Q

life cycle of a re-usable surgical instrument

A

acquisition - purchase, loan

cleaning

disinfection

inspection –> disposal - scarp/return to lender

packaging

sterilisation

transport

storage

use

transport

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2
Q

at all stages of life cycle of re-usable surgical instrument consider

A

location

facilities

equipment

management

policies/procedure

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3
Q

facilities consideration in life cycle of surgical instrument

A

segregation of clean from dirty

linear flow

continuous production line in a single room

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4
Q

location consideration in life cycle of surgical instrument

A

is it in the correct location to service the surgeries

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5
Q

equipment consideration in life cycle of surgical instrument

A

does it have the correct equipment to make the instrument safe for the patent

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6
Q

management consideration in life cycle of surgical instrument

A

is the proper managament structure in place with quality managament system fit for purpose

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7
Q

policies and procedures consideration in life cycle of surgical instrument

A

are we aware of current recommendations and is the staff trained to appropriate levels

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8
Q

policy

A

is an overall statement of intent or is a set of rules or requirements to be followed

to achieve a given process/outcome

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9
Q

procedure

A

guidelines of major methods used to meet the policies as defined by teh company or practice

usually defined by WHO or at department level

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10
Q

objective

A

landmark event in pursuit of overall intent usually subject to regular review and amendment

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11
Q

work instruction

A

specific steps needed to carry out the procedure

or basically instructions on how to do it

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12
Q

cleaning

A

use recommended detergents

adhere to manufacturers instructions for dilution rate and temperature

nerve immerse handpieces etc - use non-linting towels and not wire brushes as this creates aerosol spray

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13
Q

disinfection

A

destruction of most pathological organism by PHYSICAL rather than CHEMICAL means

less lethal than sterilisation

still leaves bacterial spores

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14
Q

possible disinfection temps and timings

A

65-70o for 10mins

73-78o for 3mins

80-85o for 1min

90-95o for 12secs (most common in healthcare)

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15
Q

things to remember for manual washing

A
  • PPE - full face visor, gloves, marigold type gloves
  • follow work instructions
  • immersion method (most instruments)
  • non immersion method (lumened or cannulated such as handpieces)
  • detergent - should be neutral enzymatic (we use: endozyme AW plus) 30ml to 8l water
  • water temp 30-35oC
  • no metal brushes (plastic only)
  • rinse/immerse instruments in purified water (not handpieces) after cleaning and then dry
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16
Q

inspection methods

A

visual check

lit magnifier

protein residue

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17
Q

packing

A

vacuum pack the items for sterilisation

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18
Q

Type N sterilisation

A

normal

  • for non wrapped solid products
  • air passively displaced by gravity due to stem production
  • hollow or lumened items should not be used here
  • should be used immediately after sterilisation and not packaged for storage

‘sterilised’ but not sterile!

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19
Q

Type B sterilisation

A

better

  • cycle is intended for the sterilisation of wrapped solid, hollow and porous products
  • have _vacuum pump to actively remove air from the chamber and loa_d
    • a.k.a benchtop vacuum sterilisers
  • once packaged the instruments can be classed as ‘Sterile’
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20
Q

Heath and Saftey at Work Act 1974

A
  • up to date standard operating procedures for sharp injuries
  • all staff shuld know how to prevent and control sharp injuries
  • must ensure all members of staff are familiar with the safety policy
  • legal duty to protect the health of your employees and the general public
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21
Q

PPE at work at 1992

A

all equipment which is intended to be work or held by a person at work and which protects them against one or more risks to their health and safety

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22
Q

Consumer protection act

A

must put appropriate safety info or warnings on products

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23
Q

Medical Device Directive

Study These Flashcards
A

standardised european law to govern how medical devices are used to keep things consistent

24
Q

general practice single room local decontamination unit

Study These Flashcards
A

Separate Hand washing facility with PPE storage

  • Set down area for dirty instruments

Washing sink with detergent for cleaning instruments

  • Set down area for washed instruments

U/S cleaner
Rinsing sink

  • set down area for rinsed instruments

Automated washer/disinfector (that includes drying cycle)
Setting down area with task lighting and magnifier for inspection of all instruments
Dental Handpiece lubricator
Area for wrapping instruments (only if you use a vacuum steriliser)
Steam steriliser

  • An area for setting down and wrapping instruments sterilised in a non-vacuum sterliser
25
4 elements of sinner circle
time temperature mechanical chemical
26
RED ZONE in LDU includes
transport acquiring medical device cleaning disinfection
27
AMBER ZONE in LDU includes
inspection packaging
28
GREEN ZONE in LDU includes
sterilisation transport storage
29
acquiring medical device in LDU
instruments arrive in box from clinic and are placed in recieving area of the LDU 6 steps of hand hygiene performed and PPE donned
30
cleaning stage in LDU
1. U/S bath turned on and cleaning agent and water added (see manufacturers instructions) may need enzymatic cleaner and deionised water or by reverseosmosis 2. Open any hinged instruments 3. Dispose any residual single use items 4. U/S trays then removed and finished items are placed in a new separate tray to betransported to the washer disinfector area **\*NEVER PUT HANDPIECES IN U/S BECAUSE IT WILL DAMAGE TURBINE**
31
disinfection stage in LDU
Handpieces are loaded onto the washer disinfector recepticles Load instrument casettes into the washer disinfector too but not on top of each other Single instruments i.e couplands should be placed in a mesh basket Stages of disinfection (w/ reverse osmosis water) * Flushing - removes gross contamination - 45\*C * Washing - removes any remaining soil * Rinsing - removes any additives from cleaning process * Disinfection - temp must reach 90\*C for 1 minute * Drying - purges load and chamber with heated air to remove excess moisture PPE removed, and disposed new PPE donned Hand hygiene carried out and worktop cleaned with wipes PPE then disposed again U/S receipt printed and recorded along with one from the Washer Disinfector too and record * Date * Time * Cycle number * Temperature * Holding time Don new PPE and carry out hand hygiene Protein test (1x per week) * Vigorously swab an instrument and test in protein reagent for 10 secs, if turns brown to blue then its a failed test Handpieces lubricated
32
inspection stage in LDU
PPE re-donned check under light and magnifier that the lumened instruments are clear check for rusting, debris or hinge fracture
33
Packaging stage in LDU
placing handle of instrument into packaging pouch first tip protectors for sharp instruments seal bag with envelope style sticky backing cassettes are wrapped in sterilisation wrap sheet paper and are taped with autoclave tape (this paper changes colour when sterilisation occurs)
34
sterilisation in LDU
Type B vacuum steam steriliser used (Autoclave) Tests for autoclave (daily and weekly) * RO water pumped in * warm up cycle done in the morning before tests carried out * vacuum test done on first working day of the week * Bowie and Dick test done daily - 134oC for 3.5 mins (for uncondensed gases) - light colour to even dark colour Validation tests - record and report all failures Sterilising - 134oC for 3-4 mins Remove kits while wearing heat resistant gloves Inspect pouches for wetness, colour indicators have changed and that theres no tears in the pouches
35
transport stage in LDU
sterilised instruments moved to storage area
36
storage stage in LDU
sterile items should be separate from unsterilse wrapped items
37
use of sterilised instruments
open when pt arrives using peelback technique
38
5 reasons for cleaning
1. remove oragnic matter 2. remove restorative material 3. restore functionality 4. aid disinfection and sterilisation 5. medico-legal requirement
39
manager role
responsible for LDU
40
user role
day-to-day running of LDU, maintains records, ensures tests and maintenance carried out
41
operator role
uses equipment, simple housekeeping and maintenance
42
authorising engineer (decon)
free NHS Scotland service, advises on validation, maintenance and testing
43
test person
conduct and report on validation and periodic tests, must be qualified with \>2yrs experience
44
maintenance person role
routine and requested maintenance, qualified
45
competent person role
responsible for perssure vessels
46
daily checks for ultrasonic cleaner
check paper levels change water clean and maintain as necessary degass solution as if there is residual oxygen then it inhibits cavitation and causes less intense bubbles change water every 4hrs or if visible soiled
47
weekly checks for ultrasonic cleaner
daily tests as above protein tests (brown to blue if it fails?)
48
quaterly checks for ultrasonic cleaner
foil ablation test
49
annual checks for ultrasonic cleaner
according to SHTM30 visual display of cycle complete
50
daily checks for automatic washer disinfector
wipe door seal check spray arms clean filter automatic control test (ACT) with print out
51
weekly checks for automatic washer disinfector
act cleaning efficacy test (protein test strip) staple result into log book protein test
52
quarterly checks for automatic washer disinfector
according to SHTM30 visual display of cycle complete values within normal limits door cannot be opened till cycle complete no mechanical or other anomaly recorded into log book
53
daily checks for sterilisers
wipe clean change water automatic control test (ACT) steam penetration test - bowie dick or helix
54
weekly checks for sterilisers
ACT steam penetration test vacuum leak test air detector function test
55
vacuum leak test
is programmed into steriliser to be able to do this pulls a deep vacuum and holds it any loss in pressure indicates a leak so fails
56
air detector function test
programmed into steriliser vacuume is pulled and at the same time air is let into the chamber thermocouple should detect this due to change in temperature

REVISION BDS (43 decks)

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