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)Recordsof this part of the process.) The satisfactorycompletion of this step means that theseinstruments may be clearly designated as readyfor sterilization.3.19 Washer-disinfector logbooks and records shouldbe kept by the designated “user” – an identifiedmember of the practice staff. Cycle parametersshould be recorded together with details of routinetesting and maintenance of the equipment used.The use of automated data-loggers or interfacedsmall computer-based recording systems isacceptable, provided the records are kept securelyand replicated. It is recommended that records bemaintained for not less than two years.Considerations for cleaning handpieces3.20 Check with the handpiece manufacturer that awasher-disinfector can be used to clean thehandpieces.3.21 Certain types of washer-disinfector can be adaptedto clean handpieces, and these can be validatedindependently as being effective.3.22 Where a handpiece manufacturer does notrecommend a washer-disinfector for cleaning thehandpiece, use of a dedicated handpiece-cleaningmachine may be considered. This uses a pressurisedsystem to clean and lubricate handpieces. However,unlike a washer-disinfector, it does not disinfect.3.23 Always consult the washer-disinfector manufacturerfor operating details (for example whether filters arerequired) and running costs before purchase.3.24 Washer-disinfectors might remove all lubricantsduring the cleaning cycle; therefore, handpiecesmight require further lubrication after cleaning.Follow the handpiece manufacturer’srecommendations for lubrication (see alsoparagraphs 3.55–3.57 and Chapter 18 inSection 3).Using a washer-disinfector is the preferred method for cleaning dental instruments because it offers the best option for the control andreproducibility of cleaning18
3 Cleaning instrumentsNote1. Some washer-disinfectors that have a handpieceirrigation system require that a special filter be fittedto protect the internal mechanism of the handpiecefrom extraneous debris during the operating cycle.These filters need to be replaced at regular intervalsin accordance with the manufacturer’s instructions.2. There are machines that both clean and sterilizedental handpieces. At present it is not possible tovalidate the cleaning cycle of these devices usingaccepted criteria. However, due to the use of avacuum sterilization cycle (Type S) there is anadvantage of this process over using a Type Nsterilizer.Automated cleaning: ultrasoniccleaning3.25 Evidence on the effectiveness of ultrasonic cleaninggives support to its use in dentistry. However,it is important to ensure that the water/fluid ismaintained, cleaned and changed at suitableintervals (see paragraph 3.30k). The bath shouldalso be kept free of dirt released in the cleaningprocess. Good maintenance is also essential. Theappearance of instruments following ultrasoniccleaning should be checked to ensure that theprocess is operating effectively (see also Section 3).3.26 Ultrasonic cleaning in a well-maintained machineenhances removal of debris. Thus, although awasher-disinfector is preferred and should beincorporated into new plans or upgrades, anultrasonic cleaner can be used as a cleaning method– including being used as an extra cleaning stageprior to an automated washer-disinfector process.This may be particularly helpful for instrumentswith hinges and/or intricate parts.3.27 To enable consistent cleaning of instruments,follow the manufacturer’s operating instructionsand ensure that all staff use a specified anddocumented operating procedure. Details onvalidating ultrasonic cleaners are supplied inSection 3.3.28 The use of ultrasonic cleaners to clean dentalhandpieces should not be undertaken withoutconfirmation from the manufacturer that thedevices are compatible.3.29 The ultrasonic cleaner should be tested accordingto the manufacturer’s instructions or, in the absenceof these, quarterly (see Section 3, Chapter 14).Ultrasonic cleaning procedure3.30 The following procedures should be followed:a. Instruments should be briefly immersed in coldwater (with detergent) to remove some of theblood and other visible soil before ultrasoniccleaning. Care should be taken to minimiseaerosol production in this process and tosafeguard against inoculation injury. The use ofa purpose-designed container with sealing lid isrecommended.b. Follow the manufacturer’s recommendations forthe safe operating procedure of the ultrasoniccleaner and follow the points outlined belowregarding loading and unloading the cleaner.c. Ensure that joints or hinges are opened fullyand instruments that need taking apart arefully disassembled before they are immersedin the solution.d. Place instruments in a suspended basket andfully immerse in the cleaning solution, ensuringthat all surfaces are in contact with the solution.The solution should be made up in accordancewith the manufacturer’s instructions.e. Do not overload the basket or overlapinstruments, because this results in poorcleaning and can cause wear to the instruments.f. Do not place instruments on the floor of theultrasonic cleaner, because this results in poorcleaning and excessive instrument movement,which can damage the instruments.g. To avoid damage to delicate instruments,a modified basket or tray system might alsobe necessary depending on operationalrequirements.h. Set the timer to the correct setting as per theultrasonic cleaner manufacturer’s instructions.Close the lid and do not open until the cycle iscomplete.j. After the cycle is complete, drain the basket ofinstruments before rinsing.k. Change the solution when it becomes heavilycontaminated or otherwise at the end of everyclinical session, because the build-up of debriswill reduce the effectiveness of cleaning. Ensure19
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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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