Sterilization and Disinfection

Question 1

what are the routes for transmission during dental procedures

Answer 1

direct contact w saliva or blood or infectious lesions
fomites= indirect transmission via contaminated objects
spatter of body fluids
aerosolization of body fluids

Question 2

Ebola description

Answer 2

ebola= highly infectious, moderately contagious, 50% fatality rate transmitted by direct contact of infected body fluids, incubation of 2-21 days enveloped virus killed by alcohol hand sanitizers can survive via fomites for several hours

Question 3

HIV description

Answer 3

HIV= low risk of transmission from pt to worker vice versa, low occupational risk. no documented cases of infection in dental workers. standard infection control is effective immediate post exposure antiviral therapy highly effective

Question 4

Hepatitis B

Answer 4

300 k infected every year, 80% infections undiagnosed, 1 million carries, high occupational risk, vaccine available!

Question 5

TB

Answer 5

low risk of transmission, epidemic resurgence, coughing produces infective aerosols, not transmitted by fomites

Question 6

Herpes

Answer 6

1 and 2 frequent in oral cavity can be transmitted to healthcare workers. ocular herpes= blindness. viral whitlow on finger. may be transmitted from workers to pt

Question 7

what are other transmittable diseases we are concerned about

Answer 7

seasonal flue, dental pathogens, HPV

Question 8

prevention of disease transmission

Answer 8

sterilization of instruments, disposable supplies, unit dosing, disinfection of surfaces. barriers, hand antisepsis, immunizations

Question 9

Immunizations recommended for HCP by CDC

Answer 9

Hepatitis B, influenza, measles, mumps, rubella, varicella zoster

Question 10

what are critical items

Answer 10

critical items come into contact with tissue or the vascular system - burs, needles, blades

Question 11

what are semi critical items

Answer 11

semi critical items- items come into contact with mucous membranes or non intact skin (curing light)

Question 12

what are non critical items

Answer 12

items that touch intact skin (BP cuff)

Question 13

what is sterilization

Answer 13

sterilization is the destruction or removal of all forms on life including spores. can be heat or chemical only used on inanimate objects

Question 14

what is sterilization used on

Answer 14

you sterilize critical and semi critical objects

Question 15

what are disinfectants

Answer 15

disinfectants inhibit or destroy pathogens but NOT spores used only on inanimate objects

Question 16

what are disinfectants used on

Answer 16

non critical surfaces

Question 17

what are antiseptics

Answer 17

antiseptics are used to destroy pathos microorganisms on living tissues and are safe for human use

Question 18

what are antiseptic used on

Answer 18

living tissue

Question 19

can antiseptics and disinfectants be used interchangeably

Answer 19

NO!!

Question 20

what is high level disinfection

Answer 20

destroys all microbes but NOT spores

Question 21

what is intermediate level disinfection

Answer 21

inactivates TB, vegetative bacteria, viruses, fungi BUT NOT spores

Question 22

what is low level disinfection

Answer 22

kills most bacteria, some viruses, some fungi but not resistant microbes such as TB and spores

Question 23

describe critical items

Answer 23

enter sterile tissue or the vascular system and must be sterilized

Question 24

describe semi critical items

Answer 24

contact mucous membranes or non intact skin. sterilize if possible, HIGH OR INTERMEDIATE LEVEL disinfection

Question 25

describe non critical items

Answer 25

come in contact with INTACT skin but NO mucous membranes use LOW level disinfectant

Question 26

describe heat sterilization

Answer 26

saturated steam under pressure, dry heart. heat is most efficient and reliable bc it denature proteins killing microbes; however items must be cleaned before to limit bioburden

Question 27

Describe steam sterilization autoclave conditions

Answer 27

autoclave= oldest. 121 C (250 F). 15 psi . 15-20 mins with packaging material that allows for penetration of steam NO Metal or glass containers

Question 28

Advantages of autoclave | disadvantages of autoclave

Answer 28

advantages: short, good penetration disadvantages: corrosion of steel and dulls edges, deposits from hard water, may be wet at end, destroys heat sensitive materials

Question 29

describe flash steam sterilization

Answer 29

statim brand hotter than autoclave but faster

Question 30

how does dry heat sterilization differ from steam sterilization

Answer 30

requires higher temps for linger times

Question 31

advantages of dry heat sterilization | disadvantages

Answer 31

advantages: does not corrode or dull edges disadvantages: long, may discolor, destroys heat sensitive materials, rubber. and impression trays. unsuitable for handpicks CAN NOT BE DONE IN A COOKING OVEN!! has to be a FDA approved unit

Question 32

describe rapid heat sterilization

Answer 32

very very hot, fast!, does not corrode or dull but can't use for handpieces!

Question 33

unsaturated chemical vapor sterilization

Answer 33

``` depends on heat, water, and chemicals. items have to loosely packed and dry 131 C (270F) . 20-40 mins. ```

Question 34

advantages of chemical vapor | disadvantages of chemical vapor

Answer 34

``` + = short cycle time, does not corrode or dull - = chemical concerns, must be dry before use, chemical needed, heat sensitive material destroyed ```

Question 35

what is required by the CDC and ohio state law

Answer 35

monitoring of sterilization units

Question 36

what doe chemical treated tapes and heat sensitive tapes indicate

Answer 36

that package has been heated NOT that sterilization temps were reached - thus they DO NOT ensure adequacy of sterilization cycle

Question 37

what provides the best guarantee of sterilization

Answer 37

biological monitoring

Question 38

how is biological monitoring done

Answer 38

1. glass vial w suspended pores plus pH indicator- if spore germinate indicator changes color 2. spore impregnated strips in glassine envelopes that are sent to service for checking - most widely used!

Question 39

when does one use chemical sterilization instead of heat?

Answer 39

when heat is inappropriate

Question 40

Ethylene oxide

Answer 40

``` carcinogenic- alkylating agents. gas mixed w freon, EXPLOSIVE will burn tissue 25 C (75 F) 10-16 hours packaged in paper or plastic ```

Question 41

glutaraldehydes

Answer 41

used the most. effective against vegetative bacteria, TB

Question 42

glutaraldehyde conditions

Answer 42

10 hours at room temp immersed in solution

Question 43

+ of glutaraldehyde | - of glutaraldehyde

Answer 43

+ most potent chemical germicide, active in organic debris | - long, rinsing needed, allergenic, tissue irritation, biologically non verifiable cannot package items, corrosive