Decontamination in primary care dental practices - Gov.uk

More documents

Recommendations

Info

Decontamination: Health Technical Memorandum 01-05 – Decontamination in primary care dental practices (2013 edition)62– the required amount of any chemicaladditive specified by the manufacturer hasbeen added; and– the water in the tank is at the specifiedoperating temperature.• Carry out the manufacturer’s recommendedstart-up procedure. This will normally include aperiod of operation to eliminate dissolved gasesfrom the solution in the bath (the degassingprocedure).• Using strips of adhesive tape across the top ofthe bath, suspend nine strips of the preparedfoil in the bath in a 3 × 3 grid. Ensure that therolled bottom end of each foil strip is no morethan 10 mm above, but not touching, thebottom of the bath.• Operate the bath for the predeterminedexposure time. This varies typically between30 seconds and 10 minutes depending on thepower rating of the ultrasonic transducers.• Remove the strips from the bath, blot-dry andexamine. The strips can be filed conveniently bysticking them to a sheet of plain paper using atransparent adhesive tape.• Drain the bath and clean to remove debris oferoded aluminium foil.Reproduced by kind permission of the Scottish DentalClinical Effectiveness ProgrammeResults and interpretation15.10 When the foil strips are inspected, the areas thatshow maximum erosion should be at similarpositions on all nine foils and each should beeroded to a similar extent.15.11 On re-testing the extent of erosion, the erosionpattern should remain consistent. If the zones oferosion are markedly different on the nine foils,it indicates poor uniformity of cleaning. Pooruniformity of cleaning might be due to failure ofone or more of the transducers that produce theultrasonic vibration in the base of the bath.15.12 A significant change between tests indicates adeterioration or failure in the transducers. If thereis no erosion, this indicates complete failure. Inthe event of any of these findings, withdraw theultrasonic cleaner from use and send it for repairor replace it.Wand meters15.13 Ultrasonic energy meters are now available tomonitor efficiency and operating frequency ofultrasonic baths. They are much quicker and moreconvenient than the classic foil ablation test butshould be used with care. Precise positioning of thewand will need to be noted in order to make thetest repeatable.Safety checksWeekly checks15.14 The User should check the following beforeproceeding:• Examine the door seals.• Check the security and performance of thedoor safety devices.15.15 Where the equipment possesses a pressure vessel,the following checks should be performed:• Ensure safety valves and other pressure-limitingdevices are free to operate.• Carry out any other checks required by theCompetent Person (Pressure Systems) or thewritten scheme of examination.Yearly checks15.16 The Competent Person (Decontamination) orservice engineer should conduct a series of safetychecks before proceeding. Advice on the yearlyprogramme of safety checks may be sought fromthe Authorising Engineer (Decontamination).15.17 The validation checks and tests may be used as abasis for yearly safety checks, paying particularattention to those factors affecting safety andparticularly those which may have changed sincethe previous annual safety check or validation test.15.18 The Competent Person (Decontamination)/serviceengineer should ensure verification of the adequacyand safe connection of engineering services.
16 Approach and protocol for manual cleaning16 Approach and protocol for manual cleaningNoteThe use of manual cleaning presents particularproblems. Because the process is not automatic, itis not possible to fully validate the process. Manualcleaning is thus not the preferred method of cleaning.Where possible, manual cleaning should be replacedwith automated cleaning. However, where manualcleaning is necessary (for example, as advised by themanufacturer) and where the practice is operatingunder the essential quality requirements, the criticalparameters should be controlled as much as possible toreduce the variability in cleaning performance. Thefollowing advice aims to enable this control as muchas possible.16.1 A dirty-to-clean workflow should be maintainedthroughout the cleaning procedure. Two sinksor bowls should be provided – one for manualcleaning and one for rinsing. In addition, separatesetting-down areas should be used for dirtyinstruments and for clean instruments.16.2 If lack of space means that a setting-down area hasto be used for both dirty and clean instruments atdifferent times during the decontamination process,the surface should be thoroughly cleaned betweenstages using a water–detergent solution to minimisethe risks of cross-contamination.16.3 Always use detergents specifically formulated formanual cleaning of instruments.ImportantDo not use chlorhexidine handscrub (for exampleHibiscrub), washing-up liquid, cleaning creams orsoap. Chlorhexidine in particular makes proteins stickto steel.Cleaning procedure for dentalinstrumentsa. Measure the volume of water and detergent toachieve the concentration specified by thedetergent manufacturer. A line painted on thesink is useful to indicate the required volume ofwater. The detergent should be designed for themanual cleaning of dental instruments.b. Using a mercury-free thermometer, monitorthe temperature of the water throughout thecleaning procedure to ensure the temperatureof the water is 45oC or lower (a highertemperature will coagulate protein and inhibitits removal). The temperature of the fluidshould be as recommended by the detergentmanufacturer.c. Where manufacturers’ instructions permit, fullysubmerge items to be cleaned in the detergentsolution.d. Scrub instruments using long-handled brusheswith soft plastic bristles. To minimise aerosolrisk, fully immerse the instruments in thesolution and keep under water during thecleaning process.e. Following cleaning, drain the water, avoidingsplashing. If the water is heavily soiled, repeatthe cleaning procedure.f. Brushes should be single use. Where they arereusable, after each use, the brushes should bewashed in hot water using the manufacturer’srecommended detergent, in order to removevisible soil, and be stored dry and head up.Or dispose of brushes if they are single-use.Reusable brushes should be replaced at themanufacturer’s recommended interval or morefrequently if the brush is seen to havesignificantly deteriorated.g. Carry out a final rinse in the clean sink usingsatisfactory potable water (see paragraphs 3.14,and 17.8–17.10), or RO water or distilled wateronly.h. After rinsing, drain and dry if instruments are tobe wrapped.63
Page 4:
Decontamination: Health Technical M
Page 7 and 8:
Executive summaryPreambleThis docum
Page 9 and 10:
ContentsContentsPrefaceExecutive su
Page 11 and 12:
ContentsValidation and testingPerio
Page 13:
1 Policy and foreword (Barry Cockcr
Page 16 and 17:
Page 18:
Page 21 and 22:
2 Essential quality requirements an
Page 23 and 24: 2 Essential quality requirements an
Page 29 and 30: 3 Cleaning instrumentsAutomated cle
Page 31 and 32: 3 Cleaning instrumentsNote1. Some w
Page 33 and 34: 3 Cleaning instrumentsprofessionals
Page 35 and 36: 4 SterilizationSterilizer with auto
Page 37 and 38: 4 Sterilization• temperature/pres
Page 39: 4 SterilizationImmediately after re
Page 42 and 43: Decontamination: Health Technical M
Page 90: Decontamination: Health Technical M
Page 93 and 94: Table A4 Autoclave history record s
Page 95 and 96: ReferencesReferencesIt should be no
Page 97 and 98: ReferencesChoice Framework for loca
show all

Decontamination in primary care dental practices - Gov.uk

Create successful ePaper yourself

Delete template?

Save as template?