Post on 23-Dec-2015
Instrument ProcessingDA 116 Infection Control
Instrument Contamination Levels:
• 1. _______________
• 2. _____________________
• 3. _____________________
Critical Instruments
– _______________________________________________
– Ex. Forceps, scalpels, scalers, dental burs
After each use:
_________________all these instruments
Semi-Critical Instruments ________________________________________________________________
__________________________________________________• 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 resistant Use disposable items or high-level disinfection/cold sterilant
on others ***Do not reprocess or reuse any disposable items!
Non-Critical Instruments
• _______________________________________________________________________– 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
Transporting Items to Sterilization Center
____________________for used instruments:
– In operatory or (more commonly) sterilization center
– Enzymatic properties– ________________________
________________________________________
Transport contaminated Instruments
– from the point of use – in a ____________________– to the initial receiving area of
the sterilization area
• 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
_________________________• Instrument processing area
– well-designed and conducive to accomplishing the multiple steps to achieve sterilization or high-level disinfection.
____________:receiving and decontaminatingrinsingdryingpackaging
_______________:sterilizationsterile storage
• ________________________________– remove bioburden from instruments– Place dental burs in a bur basket before placing them in
the ultrasonic cleaner• Mechanical methods– _______________________
• ___________________ (ultrasonic sounds waves create bubbles that implode cause an unseen scrubbing action)
• 10 minutes• Change solutions daily• Aluminum Foil test
– __________________
_________________
________________________
• Require special handling due to internal mechanical parts
• Flush for ________________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
Packaging
_______________________• Permeable so steam can
reach instruments• Appropriate for specific
sterilizer
_________________________• 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
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
Monitoring the Sterilizer
• __________________– Treated indicator (inside package) or tape (outside package)– Indicates that items have gone through the sterilization process
• DOES NOT GUARANTEE STERILITY
• _________________________(weekly per CDC)– Live bacterial spores– Autoclaves/chemical vapor:
• Bacillus Stearothermophilus or Geobacillus Stearothermophillus
– Dry heat/ethylene oxide:• Bacillus Subtilis or bacillus atrophaeus
• ____________________________– Monitor gauges for times, temperatures, cycles– Check and keep print-outs if available
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