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Sterilization & Blood Pressure (Dental)

Group 4
by

andres hernandez

on 3 April 2013

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Transcript of Sterilization & Blood Pressure (Dental)

Sterilization/Disinfection & Blood Pressure Instrument Sterilization Single use items should be disposed of after each use
All critical and semi-critical surfaces must be sterilized
Soiled instruments should be cleaned in the ultrasonic, NEVER handscrubbed! All high-speed handpieces and their attachments must be heat sterilized between patients, following manufacture's instructions for cleaning and lubrication. After patient treatment, flush the water lines for 20-30 seconds with the high speed handpiece still attached. Effectiveness of heat sterilizers should be MONITORED WEEKLY, or more often if practice demands it with live spore test.
False positive spore test occur if the sterilizer is overloaded or if the instruments are improperly package.
In the event of a positive spore test, re-sterilize and retest immediately. Dental units waterlines should be checked to contain fewer than 500 CFU of bacteria.
DUWLs should be flushed at the beginning of each day, and for 20-30 seconds between each patient. PPE and puncture-resistant utility gloves should be worn during instrument processing. Handpiece Sterilization Sterilization monitoring/
live spore test Environmental and Equipment Asepsis Laboratory Asepsis Materials, impressions, and intra-oral appliances must be cleaned and disinfected before being handled or sent to the laboratory.
Utilize the appropriate disinfecting agent for the recommended time.
Same procedures should be followed when articles are received from the laboratory. Water Disposal Infectious Disease Hazard (Biohazard) containers should be label and easy identified according to regulations.
Contaminated sharps containers and other contaminated holders are included. All waste must be disposed correctly following federal, state, and local regulations. Tuberculosis (TB) Has emerged as risk factor for DHCWs, and standard precautions do not prevent the spread of this airborne disease.
Person's with this disease should be treated in a facility with appropriate infection control measures. DHCW: Dental Health Care Worker Training All DHCW involved in direct provision of patient care are required by OSHA to have annual training on infection control, the Hazardous Material Standard, and the Bloodborne Pathogen Standard. Other Safety & Maintenance Measures Use of dental dam and high volume evacuation during dental procedures producing splash, splatter, and aerosols.
Use of sharps containers
Recap needles using either a one-handed scoop method, a recapping device, or a resheathing mechanism.
Never removed needles from reusable syringe without a hemostat or hub-clamping device.
Information about materials used may be found in the Material Safety Data Sheet as mandated by OSHA.
... *some Surface Covers Prevent Contamination
Protects surfaces that are difficult to adequately clean
Reduces turnaround time Surface Covers
ADVANTAGES Pre-Cleaning and Disinfection
ADVANTAGES Fewer items to purchase for surface asepsis
May be less expensive than covering
Doesn't change appearance of operatory Surface Covers
DISADVANTAGES Surface Covers
ADVANTAGES Variety of sizes needed
Plastic is non-biodegradable Pre-Cleaning and Disinfection Chemicals added to environment on disposal
Vary time- consuming if done correctly
PPE needed to protect from chemicals MODIFIED CDC CLASSIFICATION OF CONTAMINATED ENVIRONMENTAL SURFACE Classification
-Critical surfaces
-semi- critical surfaces
-Non- critical surfaces (intra oral contact)
-Environmental surfaces (patient care)
-Environmental surfaces Housekeeping Contaminated surfaces with blood or saliva 1. Touch surfaces- touched and contaminated during treatment (lights)

2. Transfer surfaces- not directly touched but contaminated by contact with instruments

3. Splash, spatter, and aerosol surfaces- not contacted by DHCW or contaminated dental instruments

4. High- level disinfectant

5.Intermediate- level disinfectant

6. Hospital grade disinfectant

* Sterilization- destroys all microorganisms, including bacterial endospores
*Disinfection- reduces pathogens to safe level Chemicals Used for infection Control Advantages Disadvantages Chemical Chlorines kills viruses irritants to skin Bleach Chemicals Used For Infection Control Chemicals Advantages Disadvantages Chlorines Kills viruses Irritant to skin Bleach destroys HIV, HBV does not kill viruses idophors Residual action stains vinyls Phenolics Kills TB microbe Unpleasant odor Alcohol Aerosols fast, effective distinct odor Surface contaminated with Blood Touch Surface- touched and contaminated during treatment.
Transfer surface- not directly touched, but contaminated by contact with instruments
Splash, spatter, and aerosol surfaces- not contacted by the DHCW or contaminated dental instruments Disinfectants High-level disinfectant- destroys or inactivates all microbial life, including endospores with extended contact
Intermediate-level disinfectant- destroys vegetative bacteria, but not endospores
Low-level disinfectant- destroys the majority of vegetative bacteria, certain viruses and fungi, but not M. tuberculosis
Hospital grade disinfectant-demonstrated efficacy against staphylococcus aureus, salmonella cholerasuis, and psuedomanas aeruginosa Instrument processing and Sterilization Holding step- dried blood and saliva left on instruments prevent thorough cleaning
Cleaning step- cassettes are preferred, but transfer forceps may be used to remove instruments from ultrasonic cleaner
Packaging step- prevents contamination of sterilized instruments and allows storage in sets for appointment use
sterilize- method used must provide complete destruction of all microorganisms, viruses, and spores, yet not damage the instruments Biological monitoring or sterilization Testing chemical or heat indicator are process indicators that show that the correct temperature was reached
biologic testing utilizes spores of non-pathogenic bacteria to ensure that all life forms are destroyed in the sterilization process. Dental Unit Water Lines self-contained water systems- The dental unit is isolated from municipal water supplies, providing water or treatment solutions from reservoirs filled and maintained by staff.
microfilters- uses iodine to trap free-floating microorganisms water purifiers- treat the source water with ultraviolet germicidal irradiation, filtration, or both, to remove or inactivate plaktonic microorganisms Quality Assurance Program for infection control in Dental office Training all new staff on appropriate infection control measures
Annual OSHA training and updates of infection control measures
Biological monitoring and documentation of sterilization on a weekly basis
scheduled and documented routine maintenance of all equipment involve in infection control
scheduled and documented cleaning and changing of solutions and materials related to infection control
Periodic update of staff immunizations and TB skin testing Types of Sterilization Autoclaves
Unsaturated chemical vapor
Dry heat Static Air
Dry heat forced Air
Ethylene Oxide Gas
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