HEALTH AND SAFETY - decontamination

Question 1

what is decontamination?

Answer 1

the process of:
- cleaning
- rinsing
- disinfection
- drying
- inspection
- sterilisation

Question 2

what guidance documents are available for decontamination?

Answer 2

SDCEP - managing decontamination in the dental practice

Scottish health technical note (SHTN)

Scottish health technical memoranda (SHTM)

Question 3

define disinfection?

Answer 3

a process which eliminates any pathogenic microorganisms EXCEPT bacterial spores

Question 4

what does disinfection not eliminate?

Answer 4

bacterial spores

Question 5

define sterilisation?

Answer 5

a process that removes or kills all forms of microbial life

Question 6

when would an instrument be defined as sterile?

Answer 6

when the probability of a viable microorganism being present in or on the device following sterilisation is 1 in 1 million

Question 7

what microorganisms are most resistent to disinfection and sterilisation?

Answer 7

prions and bacterial spores

Question 8

what microorganisms are most susceptible to disinfection and sterilisation?

Answer 8

lipid envelope viruses and gram positive bacteria

Question 9

what are examples of substances hazardous to health?

Answer 9

biological agents - bacteria, fungi, viruses
chemicals
fumes
dust
vapours

Question 10

what is the LDU divided into?

Answer 10

dirty activity and clean activity

Question 11

what type of detergent is used for manual cleaning of instruments?

Answer 11

enzymatic detergent

Question 12

what temperature should the water be for manual cleaning?

Answer 12

30-35 degrees

*should not exceed 45 degrees

Question 13

advantages of manual cleaning?

Answer 13

inexpensive
less risk of wear and tear
quicker process
less instruments to purchase

Question 14

disadvantages of manual cleaning?

Answer 14

not an automated process
cannot be validated
not reproducible
less effective processes
increased risk of sharps injury
no disinfection stage

Question 15

how long is a cycle in the ultrasonic cleaner?

Answer 15

6-10 mins

Question 16

what dental instruments can not be cleaned in the ultrasonic cleaner?

Answer 16

dental handpieces

Question 17

what temperature does the ultrasonic clean at?

Answer 17

25-35 degrees

Question 18

how often should the solution in the ultrasonic cleaner be changes?

Answer 18

if visibly contaminated or every 4 hours

Question 19

what are the types of ultrasonic tests?

Answer 19

daily tests
weekly tests: foil ablation and cleaning efficacy
electronic tests

Question 20

what are the types of cleaning processes?

Answer 20

manual
ultrasonic
washer disinfector

Question 21

how should instruments be dried?

Answer 21

with a lint free towel

Question 22

what are the 5 stages of the washer disinfector?

Answer 22

1. pre wash
2. wash
3. rinse
4. thermal disinfection
5. dry

Question 23

what temperature is the pre wash in the washer disinfector?

Answer 23

> 45 degrees

Question 24

what temperature is thermal disinfection in the washer disinfector?

Answer 24

80 degrees for 10 mins or 90 degrees for 1 min

Question 25

what are the tests for the washer disinfector?

Answer 25

efficacy testing (daily/ weekly) automatic control test (daily/ weekly)

Question 26

how are instruments visualised after inspection?

Answer 26

illuminated magnifier

Question 27

what are the methods of sterilisation?

Answer 27

heat chemical radiation

Question 28

why must you ensure instruments are fully dried?

Answer 28

moisture can inhibit sterilisation as the steam cannot penetrate all surfaces

Question 29

what are the temperature and pressure hold for steam sterilisation in NHS tayside?

Answer 29

134-137 degrees for 3 mins 2.1-2.25 bar gauge

Question 30

what is sterilisation cycle B?

Answer 30

VACUUMED - PREFERRED METHOD active air removal using a vacuum pump

Question 31

advantages of steam sterilisation?

Answer 31

most efficient, practical, cost effective and safe method rapid heating rapid penetration of the load rapid destruction of microorganisms including bacterial spores no toxic residues produced readily controlled and monitored

Question 32

properties of the steriliser water?

Answer 32

low mineral, pathogen and endotoxin free

Question 33

whats the daily test for steriliser?

Answer 33

steam penetration test

Question 34

what are the weekly steriliser tests?

Answer 34

automatic control test air leakage test air detection system function test

Question 35

what are the legal requirements for sterilisers?

Answer 35

a written scheme of examination a periodic examination of the pressure system third party liability insurance a record of repairs and maintenance of the pressure system

Question 36

what are the 2 types of traceability?

Answer 36

through the decontamination process directly to the patient

Question 37

when may you require traceability records?

Answer 37

defending against an allegation of HAI arising from the use of inadequately decontaminated medical devices

Question 38

what risk is dentistry classed as for vCJD and BBV transmission?

Answer 38

vCJD = low risk BBV = high risk

Question 39

what is the FIFO system?

Answer 39

first in/ first out to allow stock rotation