1 Instrument Processing DA 116 Infection Control.
-
Upload
chester-long -
Category
Documents
-
view
220 -
download
2
Transcript of 1 Instrument Processing DA 116 Infection Control.
1
Instrument ProcessingDA 116 Infection Control
3
Critical Instruments
– Instruments that touch bone or penetrate soft tissue.– Ex. Forceps, scalpels, scalers, dental burs
After each use:
Heat sterilize all these instruments
4
Semi-Critical Instruments
Instruments that will touch mucous membrane or nonintact skin but do not penetrate soft tissue or bone• mirrors, amalgam condensers, x-ray film and digital sensor holders and high and low speed handpieces• Use high-level disinfection with all lab materials used in the mouth
After each use:
Sterilize all that are heat resistantUse disposable items or high-level
disinfection/cold sterilant on others ***Do not reprocess or reuse any disposable items!
5
Non-Critical Instruments
• Non-critical instruments are those that come into contact only with intact skin – Ex. X-ray Heads, Light handles, BP cuff
Use intermediate or low level disinfection agent
Floors and walls: okay to clean if no blood contamination If an item is visibly contaminated
with blood, choose intermediate level disinfection
6Transporting Items to Sterilization Center
Holding Solutions for used instruments:
– In operatory or (more commonly) sterilization center
– Enzymatic properties– Prevents debris from
drying and becoming difficult to clean
Transport contaminated Instruments
– from the point of use – in a sturdy, solid
container – to the initial receiving
area of the sterilization area
7
• Instrument Processing Area • DHCP should process all instruments in a
designated central processing area to more easily control quality and ensure safety (248). The central processing area should be divided into sections for 1) receiving, cleaning, and decontamination; 2) preparation and packaging; 3) sterilization; and 4) storage. Ideally, walls or partitions should separate the sections to control traffic flow and contain contaminants generated during processing. When physical separation of these sections cannot be achieved, adequate spatial separation might be satisfactory if the DHCP who process instruments are trained in work practices to prevent contamination of clean areas (248). Space should be adequate for the volume of work anticipated and the items to be stored (248).
Which do you think is the correct choice?
#2 is CORRECT!
2
1
8
Sterilization Center
• Instrument processing area – well-designed and conducive to accomplishing the
multiple steps to achieve sterilization or high-level disinfection.
DIRTY:receiving and decontaminatingrinsingdryingpackaging
CLEAN:sterilizationsterile storage
9
Pre-Cleaning
• Basic first step of decontamination– remove bioburden from instruments– Place dental burs in a bur basket before placing
them in the ultrasonic cleaner
• Mechanical methods– Ultrasonic cleaner
• Cavitation (ultrasonic sounds waves create bubbles that implode cause an unseen scrubbing action)
• 10 minutes• Change solutions daily• Aluminum Foil test
– Instrument Washer
11
Instrument Washer
• http://www.youtube.com/watch?v=2a6_OIsZQ7w
12
Dental Handpieces • Require special handling due to
internal mechanical parts• Flush for 20-30 seconds at
chairside• Remove bur• Clean outer surface with
handpiece wipe• Lubricate according to
manufacturer’s instructions• Wipe off excess lubricant • Package and heat sterilize• Some handpieces must be
lubricated after sterilization; check manufacturer’s directions
Manual and automatic methods are available
13
Packaging
Paper Pouches• Permeable so steam
can reach instruments• Appropriate for
specific sterilizer
Cassettes• Plastic or metal
– Perforated so steam can penetrate
• Less instrument handling reduces risk of percutaneous injury
• Can go into ultrasonic and autoclave
• Must be wrapped for autoclave and storage
15
Methods of Sterilization:
• Process by which all forms of organic life are destroyed by physical or chemical means
• Steam under pressure Autoclave• Dry Heat Sterilization• Chemical under pressure (Chemical
Autoclave or Chemiclave)• EPA registered disinfectant/sterilant;
also called “cold sterilization” least preferred method
• Always best to use heat sterilization
16
Monitoring the Sterilizer
• Chemical– Treated indicator (inside package) or tape (outside
package)– Indicates that items have gone through the
sterilization process• DOES NOT GUARANTEE STERILITY
• Biological (weekly per CDC)– Live bacterial spores– Autoclaves/chemical vapor:
• Bacillus Stearothermophilus or Geobacillus Stearothermophillus
– Dry heat/ethylene oxide:• Bacillus Subtilis or bacillus atrophaeus
• Mechanical– Monitor gauges for times, temperatures, cycles– Check and keep print-outs if available
17
Storage
• Keep sterile items and disposable items – Covered, enclosed area (not under a sink)– Keep packages/cassettes wrapped and unopened
until use
• Do you need to re-sterilize?– Per CDC, wrapped items are
sterile indefinitely– Re-sterilize if it becomes
contaminated (i.e. wet, torn)– Some offices date each package
and rotate use according to dates