Decontamination in primary care dental practices - Gov.uk

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Decontamination: Health Technical Memorandum 01-05 – Decontamination in primary care dental practices (2013 edition)2 Essential quality requirements and bestpracticeDecontamination of instruments –an overview2.1 Decontamination is the process by which reusableitems are rendered safe for further use and for staffto handle. Decontamination is required tominimise the risk of cross-infection betweenpatients and between patients and staff.2.2 Decontamination of instruments (also known asreprocessing) is a complex process that involvesseveral stages, including cleaning, disinfection,inspection and a sterilization step. The diagrambelow summarises how the individual stages ideallylink together to complete the process of instrumentdecontamination.ComplianceEssential quality requirements2.3 Instruments should be reprocessed using a validateddecontamination process including a validatedsteam sterilizer, and at the end of the reprocessingcycle they should be sterilized.2.4 In maintaining and developing dentaldecontamination practices, all the following shouldbe included:a. A local infection control policy subject toupdate as required by the Code of Practice, or attwo-yearly intervals, whichever is the shorter.AcquireClean:• with a washer-disinfector (WD);• with or without an ultrasonic cleaner;• manuallyTransportNon-clinical area(max. 1 week)UseClinical area(max. 1 day)Store(max. 1 year)• Location• Facilities• Equipment• Management• Policies and proceduresInspectRepeat cleaningif necessaryUnwrappedand dryWrappedand dryStore(max. 1 year)Steam-sterilize(Type N)WrapSteam-sterilizein vacuum sterilizer(Type B or S)10
2 Essential quality requirements and best practiceCompliance definitionsCompliance – Essential quality requirementsThis terminology is used within this Health TechnicalMemorandum to define a level of compliance expectedas a result of its implementation. Guidance containedwithin this document will assist dental practices inmaintaining these requirements and developingtowards higher levels of achievement in this area overtime. The use of an audit tool will assist dentalpractices in reaching the necessary standards (seeparagraph 2.21).In order to demonstrate compliance with essentialquality requirements, practices will beexpected to provide a statement on plans for futureimprovement. Details on registration requirements aregiven in Chapter 8.Compliance – Best practiceBest practice refers to the full level of compliance thatmay be achieved immediately or via a documentedimprovement from essential quality requirements.b. The above policy should have detailedrequirements/procedures for thedecontamination of instruments.c. The practice should have a nominated leadmember of staff responsible for infection controland decontamination.d. The storage, preparation and use of materialsshould take full account of the requirements ofthe Control of Substances Hazardous to Health(COSHH) Regulations 2002. Particular careshould be taken in the storage and preparationfor use of decontamination chemical products.Manufacturers’ instruction sheets shouldbe consulted for further information.Guidance on COSHH is available from theHealth & Safety Executive (http://www.hse.gov.uk/coshh).e. Practices should have a clear procedure forensuring appropriate management of single-useand reusable instruments, which safeguardstheir status. (Section 3 contains detailedguidance on instrument purchase and disposal.)f. Reprocessing of dental instruments should beundertaken using dedicated equipment (seeSection 3).g. Dedicated hand-washing facilities should beprovided.h. Cleaning and inspection are key parts ofsatisfactory dental instrument reprocessing.Instruments may be cleaned using an ultrasonicbath, but this should be covered during use torestrict the release of aerosols. Manual cleaningmay also be used. Practices should plan for theintroduction of washer-disinfectors. Inspectionprocesses should ensure that the standards ofcleaning achieved are visually satisfactory – thatis, that instruments are free from particulatecontamination, salt deposits or markeddiscoloration. The use of a simple magnifyingdevice with task lighting is required.j. The separation of instrument reprocessingprocedures from other activities, includingclinical work, should be maintained by physicalor temporal means. Decontaminationequipment including sterilizers shouldaccordingly be located in a designated area.The layout within this area should reflect theprogression from the receipt of dirty, usedinstruments towards clean instruments sterilizedin a specific controlled clean area. In the firstinstance, where practices are meeting theessential quality requirements defined bythis guidance, the designated area fordecontamination may be in, or adjacent to, aclinical room. At a later stage of development,more complete separation involving the useof a designated room or rooms will becomeappropriate (see Figures 1–3 in Chapter 5).k. Instrument storage and wrappingrecommendations:(i) Wrapped instruments may be stored up to1 year (see paragraphs 4.25–4.29):• pre-sterilization wrapped if type B or S;• post-sterilization wrapped if type N.(ii) Unwrapped instruments in the clinicalarea: maximum storage 1 day. Instrumentsshould be:• dry; and• protected from contamination, forexample in mini-racks placed in cupboardsor in covered drawer inserts. Instrumentsshould not be stored on open worksurfaces, particularly in clinical areas. It isimportant that practices have well11
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Table A4 Autoclave history record s
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ReferencesReferencesIt should be no
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ReferencesChoice Framework for loca
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Decontamination in primary care dental practices - Gov.uk

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