Clinical Disinfection and Sterilization
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Questions and Answers

What is the primary function of an ultrasonic cleaner in the context of instrument sterilization?

To use a detergent solution along with sonic action to break up and loosen debris on instruments.

Why is hand scrubbing the least preferable method for cleaning instruments?

It poses an increased risk of exposure to biological hazards.

What steps must be taken after cleaning instruments before they can be sterilized?

Instruments must be free of biological debris, disinfecting solutions, and detergents, and they must be dry.

What should be included on the labeling of instrument packages before sterilization?

<p>The name of the sterilizer, the date, and the time.</p> Signup and view all the answers

Why is heat sterilization considered the most effective method in dentistry?

<p>It effectively eliminates microorganisms when combined with steam under pressure.</p> Signup and view all the answers

What is the purpose of using biological indicators (BIs) in sterilization processes?

<p>Biological indicators are used to verify that sterilization processes eliminate resistant bacterial spores, ensuring other microbes are also killed.</p> Signup and view all the answers

How often must practices in Saskatchewan complete biological indicator tests for each sterilizer?

<p>Practices in Saskatchewan are required to complete biological indicator tests weekly for each sterilizer.</p> Signup and view all the answers

List two scenarios in which biological monitors must be used.

<p>Biological monitors must be used after introducing a new sterilizer and following any sterilizer repair.</p> Signup and view all the answers

What steps should be taken if a positive spore test is identified?

<p>All sterilization packages since the last negative test must be re-processed, and the results should be reported to the regulator.</p> Signup and view all the answers

Why is it important to review sterilizer procedures after a positive spore test?

<p>Reviewing sterilizer procedures helps identify potential issues such as operator error and ensures effective sterilization practices.</p> Signup and view all the answers

List three human errors that can lead to a positive spore test result.

<p>Improper packaging, improper timing, and improper loading.</p> Signup and view all the answers

What actions should be taken if a mechanical failure of a sterilizer is confirmed?

<p>The sterilizer must be removed from service, inspected, repaired, and re-challenged with a biological indicator three times on an empty chamber.</p> Signup and view all the answers

Why is it important to check wrappers/packages before opening sterilized items?

<p>To ensure they are intact and have not been compromised, which maintains sterility.</p> Signup and view all the answers

What are the factors that determine the shelf life of in-house sterilized items?

<p>The quality of packaging material, storage conditions, methods and conditions of transport, conditions of handling, and internal policy.</p> Signup and view all the answers

What percentage of dental practice autoclave failures were due to human errors according to the SWMS database?

<p>92% of failures were due to human errors.</p> Signup and view all the answers

What is the significance of a Central Sterilization Room (CSR) in instrument processing?

<p>The CSR is crucial for the organized and safe processing of instruments according to local, provincial, and federal regulations.</p> Signup and view all the answers

List the first three stages of instrument processing.

<p>The first three stages are wiping gross debris, discarding sharps, and transportation to CSR.</p> Signup and view all the answers

What distinguishes critical items from semi-critical items in terms of sterilization?

<p>Critical items must be sterilized by heat as they contact sterile areas, while semi-critical items have a lower risk and must be sterilized if heat-tolerant.</p> Signup and view all the answers

What classification system is used to determine the level of disinfection required for dental instruments?

<p>The Spaulding Classification System is used to measure infection transmission risk and determine necessary sterilization levels.</p> Signup and view all the answers

Why must non-critical items be cleaned and disinfected between uses?

<p>Non-critical items, which contact intact skin, can still harbor pathogens, thus requiring cleaning to prevent cross-contamination.</p> Signup and view all the answers

What is the recommended procedure for transporting contaminated instruments?

<p>Contaminated instruments should be placed in a closed cassette for transport to the CSR, using utility gloves.</p> Signup and view all the answers

Explain the role of dividers in the instrument processing area.

<p>Dividers are used to separate sections, control traffic flow, and contain contaminants during the processing phase.</p> Signup and view all the answers

How should visible blood and contamination on instruments be addressed after use?

<p>Instruments should be wiped clean of visible blood as soon as possible, and enzymatic products should be used if cleaning cannot be immediate.</p> Signup and view all the answers

What is an automated washer's advantage over hand scrubbing in instrument cleaning?

<p>An automated washer is the best option for cleaning instruments as it minimizes the risk to staff and ensures thorough cleaning.</p> Signup and view all the answers

What key practices must be followed when handling contaminated instruments?

<p>Contaminated instruments should be handled with care to avoid sharp injuries, and disposable sharps must be disposed of immediately in appropriate containers.</p> Signup and view all the answers

What is the most common type of autoclave used in dental practices?

<p>Class B autoclave (pre-vacuum steam sterilizer)</p> Signup and view all the answers

What temperature and pressure are typically used for flash sterilization of unwrapped items?

<p>132 C (270 F) at 30 psi for 3 minutes</p> Signup and view all the answers

Why is chemical vapor not an acceptable method for instrument sterilization?

<p>It requires specific medical sterilization equipment, which may not ensure effective sterilization.</p> Signup and view all the answers

What must be done to instrument packs before removing them from the sterilization chamber?

<p>They must be dry inside the chamber.</p> Signup and view all the answers

What is the minimum exposure time for dry heat sterilization at 170 C (340 F)?

<p>60 minutes</p> Signup and view all the answers

What are the key factors to inspect in sterilized packages before use?

<p>Package integrity, dryness, and correct indicator color change.</p> Signup and view all the answers

What is the recommended sterilization temperature and duration for heavily wrapped items in an autoclave?

<p>132 C (270 F) for 10 minutes at 30 psi.</p> Signup and view all the answers

Identify one disadvantage of using dry heat sterilization compared to steam sterilization.

<p>Dry heat requires longer exposure times.</p> Signup and view all the answers

What are high-level disinfectants not suitable for in dental practices?

<p>Sterilizing critical instruments.</p> Signup and view all the answers

What is the significance of sterile packaging materials in the sterilization process?

<p>They must be designed specifically for the sterilization process used to ensure effectiveness.</p> Signup and view all the answers

What is the role of mechanical monitors in sterilization processes?

<p>Mechanical monitors assess cycle time, temperature, and pressure during the sterilization process.</p> Signup and view all the answers

Why can’t a single sterilization indicator assure complete sterilization?

<p>No single indicator can assure sterilization; they only indicate that a package was exposed to the sterilization conditions.</p> Signup and view all the answers

What is the significance of recording sterilization cycle readings for 10 years?

<p>Recording cycle readings for 10 years can help identify patterns or problems in sterilization processes over time.</p> Signup and view all the answers

How do chemical indicators provide information about sterilization conditions?

<p>Chemical indicators change color based on the physical variables of time, temperature, and pressure during sterilization.</p> Signup and view all the answers

What is the purpose of a Bowie-Dick test in sterilization?

<p>The Bowie-Dick test detects air leaks and assesses air removal adequacy in pre-vacuum sterilizers.</p> Signup and view all the answers

What distinguishes Class V chemical integrating indicators from other indicators?

<p>Class V indicators react to all critical variables during the sterilization process and are the most accurate.</p> Signup and view all the answers

What are biological indicators, and why are they important in sterilization?

<p>Biological indicators, such as spore tests, are crucial for confirming that the sterilization process effectively kills all microbes.</p> Signup and view all the answers

Why is it necessary to use chemical indicators in every sterilization load?

<p>Chemical indicators in every load provide real-time verification of the sterilization conditions achieved.</p> Signup and view all the answers

What is the main function of Class I and Class IV chemical indicators?

<p>Class I and Class IV indicators measure important physical variables during the sterilization process.</p> Signup and view all the answers

What indicates a 'fail' result during the Bowie-Dick test?

<p>A 'fail' result is indicated by the color change not occurring during the test, suggesting inadequate air removal.</p> Signup and view all the answers

Study Notes

Clinical Disinfection and Sterilization

  • Clinical disinfection and sterilization are crucial for preventing the transmission of diseases in healthcare settings.

  • Key terms are defined for understanding the process.

Definitions

  • Sanitation: Public health conditions focusing on clean water and proper waste disposal to prevent disease transmission. Includes hand-washing and adequate food preparation. Sterilization is not achieved.
  • Cleaning: Removal of foreign material like soil or bodily fluids. Does not disinfect or sterilize. Often accomplished with soap and water; must remove debris for effective disinfection/sterilization.
  • Disinfection: Reduces the number of pathogens on inanimate objects, but may not eliminate all microbes, including bacterial spores. Usually a chemical process.
  • Antisepsis: A specific type of disinfection applied to living tissue (e.g., skin or mucous membranes).
  • Sterilization: Destroys all forms of microbial life, including parasites, fungi, bacteria, bacterial spores, and viruses. It's an absolute term; an object is either sterile or not.
  • Spores are difficult to destroy; if spores are destroyed, sterilization is assured.

Instrument Processing

  • Standard Operating Procedures (SOPs) are used for instrument processing and central sterile room (CSR) is recommended.

  • Standard protocols must be followed.

  • Stages of instrument processing

    • Wiping off debris and discarding sharps
    • Transport to CSR
    • Sorting instruments
    • Cleaning Instruments
    • Preparation and Packaging
    • Sterilization
    • Storage
  • Instruments must be cleaned and disinfected within 24 hours of use.

Instrument Processing Pathway

  • Instrument are first cleaned and inspected at point-of-use

  • Transportation to processing area in a closed, labeled container.

  • Cleaning and sorting proceed after appropriate personal protective equipment (PPE) is put on.

  • Choice of treatment (either autoclave or ultrasonic cleaner) may depend on type of instrument.

  • Reprocessing (e.g. washing, cleaning, drying or other protocols) occurs before packaging/labeling.

  • Items are packaged and labeled (as applicable).

  • Items must be dry before further process. -Sterilization processes used, and their variables (time and temperature) are recorded and followed.

  • Packaging requires consideration of sterilization equipment. External and internal chemical indicators are utilized for every instrument package.

Classification for Dental Instruments

  • Critical: These items come into contact with sterile areas of the body, creating a higher risk of transmitting infections. They must be sterilized. Examples include surgical instruments, periodontal scalers, and scalpel blades.
  • Semi-critical: These instruments contact mucous membranes or non-intact skin, which pose a moderate risk of transmitting infections. Heat-tolerant semi-critical items are typically sterilized, but if a semi-critical item is heat-sensitive, it should be single-use. Examples include dental mouth mirrors, air/water syringe tips, and handpieces.
  • Non-critical: These objects have the lowest risk of infection transmission, typically contact only intact skin. Cleaning and, when necessary, disinfection is generally adequate. Examples include blood pressure cuffs, radiograph head/cone, lead aprons, etc.

Monitoring Sterilization

  • All sterilized items require pre-use inspection.
  • Packaging, cassettes, and instruments must be free of damage.
  • Indicators must be inspected to verify proper sterilization procedures have taken place
  • Mechanical monitors (e.g., digital displays and printouts), chemical monitors, and biological monitors verify sterilization.
  • Report all positive results to the regulatory body.

Sterilization Techniques

  • Heat is the most effective sterilization method in dentistry, especially with steam under pressure (autoclave).

  • Steam Sterilization techniques (pulse vacuum autoclaves, class B autoclaves), used for heat-tolerant instruments.

  • Dry heat (hot air oven), for a longer duration and high-temperature sterilization.

  • Chemical Vapor is not suitable for sterilizing instruments.

Storage

  • Sterilized items must be stored in covered/closed cabinets.
  • Check wrappers for integrity before opening.
  • Damaged items must be reprocessed.
  • Instruments are open and visible for inspection.

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Description

Explore the essential concepts of clinical disinfection and sterilization to prevent disease transmission in healthcare settings. This quiz covers key definitions and practices including sanitation, cleaning, disinfection, antisepsis, and sterilization processes.

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