BESC Module 7 – Sterilization and Disinfection of Patient Care Items and Devices

Transcript

1 Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care MODULE 7 — Sterilization and Disinfection of Patient -Care Items and Devices

2 MODULE -Care Items and Devices 7 — Sterilization and Disinfection of Patient Modules in the Slide Series 1. Introduction 2. Hand Hygiene 3. Personal Protective Equipment 4. Respiratory Hygiene/Cough Etiquette Sharps Safety 5. 6. Safe Injection Practices Sterilization and Disinfection of Patient 7. -Care Items and Devices (this module) 8. Environmental Infection Prevention and Control 9. Dental Unit Water Quality 10. Program Evaluation Slide 2

3 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Categories of Patient -Care Items  Three categories: Critical. 1. 2. Semicritical. 3. Noncritical.  Based on intended use and the potential risk of disease transmission 3 Slide

4 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Critical Items  Penetrate soft tissue or contact bone, enter into or contact the vascular system or other normally sterile tissue.  Greatest risk of transmitting infection.  Must be heat sterilized between use, or sterile single -use, disposable devices must be used. Examples: surgical instruments  and periodontal scalers. Slide 4

5 MODULE -Care Items and Devices 7 — Sterilization and Disinfection of Patient Semicritical Items  Contact mucous membranes or non- intact skin (e.g., exposed skin that is chapped, abraded, or has dermatitis).  Lower risk of transmission. Should be heat sterilized or high- level  disinfected.  Examples: mouth mirrors, amalgam condensers, and reusable impression trays. -sensitive, DHCP should replace NOTE : If a semicritical item is heat it with a heat- tolerant or disposable alternative. . disinfection If none are available, the item should, at a minimum, be processed using high -level Slide 5

6 MODULE -Care Items and Devices 7 — Sterilization and Disinfection of Patient Semicritical Items Special Considerations — Dental Handpieces  Follow manufacturer’s instructions to and safely reprocess dental handpieces accessories (e.g., low -speed motor, reusable prophylaxis angles).  Clean and heat sterilize between patient uses.  Do not subject the handpiece to high -level disinfection and do not simply wipe the surface level disinfectant. with a low- Slide 6

7 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Semicritical Items Special Considerations — Digital Sensors  Follow manufacturer’s instructions to safely reprocess digital radiography equipment.  Ideally, barrier protection should be used, followed by cleaning and heat sterilization or high -level disinfection between patients. – If the item cannot tolerate these procedures, then at minimum, barrier protection should be used, followed by cleaning and disinfection with an -level disinfectant between patients. intermediate Slide 7

8 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Noncritical Items  Contact intact skin. Barrier protect or clean and disinfect  (if visibly soiled) using a low to intermediate -level ) disinfectant. (i.e., tuberculocidal  Examples: x -ray head or cone, facebows , blood pressure cuff. Slide 8

9 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Single -Use (Disposable) Devices  Intended for use on one patient during a single procedure.  tolerant. Usually not heat-  Cannot be reliably cleaned. Do  NOT reprocess. Examples: syringe needles, prophylaxis  cups, and plastic orthodontic brackets. Slide 9

10 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Instrument Processing  Follow manufacturer’s instructions for reprocessing (i.e., cleaning, packaging, disinfecting, sterilizing) reusable dental instruments and equipment. – Maintain manufacturer’s instructions (ideally) in or near the reprocessing area. Use FDA  -cleared devices and supplies for cleaning, packaging, and heat sterilization. Should be assigned to DHCP with training in the required  reprocessing steps. Slide 10

11 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Instrument Processing Area  Use a designated processing area to control quality and ensure safety. Divide processing area into work areas:  – Receiving, decontamination, and cleaning. – Preparation and packaging. – Sterilization. – Storage. Devices and instruments should flow from high  contamination areas to clean and sterile areas. Slide 11

12 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Cleaning  Cleaning should always occur before disinfection or sterilization. Presence of soil can compromise the disinfection or – sterilization process.  Automated or manual. Minimize exposure potential.   Use carrying containers to transport contaminated instruments. Wear personal protective equipment (e.g., heavy duty utility  gloves, mask, protective eyewear and clothing). Slide 12

13 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Automated Cleaning  Ultrasonic cleaner.  Instrument washer.  Washer -disinfector. 13 Slide

14 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Manual Cleaning  If not performed immediately, soak instruments until ready to clean to prevent debris from drying on instruments.  Wear heavy -duty utility gloves, mask, eyewear, and protective clothing. 14 Slide

15 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Preparation and Packaging  Wrap, package, or place instruments in containers before heat sterilization. Instruments should be thoroughly dry before they – are packaged, wrapped, or otherwise contained.  Follow manufacturer’s instructions. – For example: open hinged instruments, disassemble instruments if required, and ensure that packaging materials are compatible with the method of heat sterilization being used. 15 Slide

16 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Preparation and Packaging (Continued)  Place a chemical indicator inside each package. If the internal chemical indicator cannot be seen – from the outside, place another indicator on the outside of the package.  Label the package with the following: Sterilizer number. – – Cycle or load number. – Date of sterilization. Expiration date, if applicable. – Slide 16

17 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Heat -Based Sterilization -cleared devices and follow manufacturer’s  Use FDA instructions.  Steam under pressure (autoclaving): – Gravity displacement. – Pre -vacuum.  Dry heat. Unsaturated chemical vapor.  Slide 17

18 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Liquid Chemical Sterilant or Disinfectants Only for heat -sensitive critical and  semicritical devices.  Highly toxic.  Follow manufacturer’s instructions (e.g., regarding dilution, immersion time, and temperature) and safety precautions precisely. Heat -tolerant or disposable alternatives are available.  Slide 18

19 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Sterilization Monitoring: Types of Indicators  Mechanical: – Measures time, temperature, and pressure.  Chemical: – Change in color when physical parameter is reached.  Biological (spore tests): – Uses biological spores to asses the sterilization process directly.  Indicators are specific to the type of sterilization used. Slide 19

20 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Mechanical Monitoring  Monitor each load with mechanical (physical) indicators: – Time. – Temperature. – Pressure. 20 Slide

21 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Chemical Monitoring  Use an internal chemical indicator in every package. If the internal indicator is not visible from the outside, then also use an external indicator. – Chemical indicators may be integrated into the package design.  Inspect indicator(s) after sterilization and at time of use. If the appropriate color change did not  occur, do not use the instruments. Slide 21

22 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Biological Monitoring  Assess sterilization process directly by killing known highly resistant microorganisms.  Use biological indicators (spore tests) at least weekly. 22 Slide

23 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Record Keeping Sterilization monitoring (e.g., biological, mechanical,  chemical) and equipment maintenance records are important components of a dental infection prevention program.  Ensures cycle parameters have been met and establishes accountability.  If there is a problem with a sterilizer, documentation helps to determine if an instrument recall is necessary. 23 Slide

24 MODULE Sterilization and Disinfection of Patient -Care Items and Devices 7 — Storage of Sterile and Clean Items and Supplies  Store clean items in dry, closed, or covered cabinet. -related shelf  -life practices. Use date - or event  Examine wrapped items carefully before use.  When packaging of sterile items is damaged, clean, repackage, and heat sterilize again. 24 Slide

25 MODULE -Care Items and Devices 7 — Sterilization and Disinfection of Patient Resources  CDC. Guidelines for Infection Control in Dental Health -Care Settings — 2003  CDC. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008  CDC. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care Resources to use in the event of a reprocessing error or failure:  CDC. Health Care -Associated Infections website: Outbreaks and Patient – Notifications Patel PR, et al. Developing a broader approach to management of infection – . 2008;36:685– control breaches in health care settings. Am J Infect Control 690. – Rutala WA, et al. How to assess risk of disease transmission to patients when there is a failure to follow recommended disinfection and sterilization guidelines. . 2007;28:146– 155. Infect Control Hosp Epidemiol Slide 25

26 End of Module 7 For more information, contact Centers for Disease Control and Prevention (CDC). 1-800- CDC- INFO (232 -4636) T T Y: 1 -888- 232- 6348  www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position o f the CDC.

Related documents

Section 508: What is It and Why is It Important to You?

Section 508: What is It and Why is It Important to You?

Section 508: What is It and Why is It Important to You? Introduction: Welcome! Welcome to Section 508: What Is It and Why Is It Important to You? When it comes to making sure persons with disabilities...

More info »
pisa 2012 results volume I

pisa 2012 results volume I

PISA 2012 Results: What Students Know and Can Do tICS, themA StuDent PeRfoRmAnCe In mA ReADIng AnD SCIenCe Volume I rogramme for ssessment A tudent S nternational I P

More info »
ADS Chapter 508   Privacy Program

ADS Chapter 508 Privacy Program

ADS Chapter 508 Privacy Program Partial Revision Date: 04/10/2019 Responsible Office: M/CIO/IA File Name: 508_041019

More info »
Conjunction Data Message

Conjunction Data Message

CCSDS His torical Document is docu ment’s Histo ri cal Th tu s indi cate s that it is no lo nger curre nt. It sta has eit her been replaced by a newer issu e or with drawn becau se it wa s deem rr ent...

More info »
UL White Book

UL White Book

GUIDE INFORMATION FOR ELECTRICAL EQUIPMENT THE WHITE BOOK 2015-16 UL PRODUCT CATEGORIES CORRELATED TO THE 2011 AND 2014 NATIONAL ELECTRICAL CODE® UL’s General Guide Information is updated daily. To co...

More info »
CDIR 2018 07 27

CDIR 2018 07 27

S. Pub. 115-7 2017-2018 Official Congressional Directory 115th Congress Convened January 3, 2017 JOINT COMMITTEE ON PRINTING UNITED STATES CONGRESS UNITED STATES GOVERNMENT PUBLISHING OFFICE WASHINGTO...

More info »
Monthly Energy Review – April 2019

Monthly Energy Review – April 2019

DOE/EIA ‐ 0035( 2019/4 ) April 2019 Monthly Energy Review www.eia.gov/mer

More info »
FY 2019 PB Green Book

FY 2019 PB Green Book

NATIONAL BUDGET DEFENSE ESTIMATES FOR FY 201 9 OFFICE OF THE UNDER SECRE TA RY OF DEFENSE (COMPTROLLER) APRIL 201 8

More info »
Out of Reach 2016

Out of Reach 2016

No Refuge for Low Income Renters MADE POSSIBLE BY THE GENEROSITY OF:

More info »
Fourth National Report on Human Exposure to Environmental Chemicals Update

Fourth National Report on Human Exposure to Environmental Chemicals Update

201 8 Fourth National Report on Human Exposure to Environmental Chemicals U pdated Tables, March 2018 , Volume One

More info »
FEMA 508 2, Incident Management Resources

FEMA 508 2, Incident Management Resources

U.S. Department of Homeland Security Federal Emergency Management Agency   Typed Resource Definitions Incident Management Resources FEMA 508-2 July 2005

More info »
2013 01073

2013 01073

Vol. 78 Friday, No. 17 January 25, 2013 Part II Department of Health and Human Services Office of the Secretary 45 CFR Parts 160 and 164 Modifications to the HIPAA Privacy, Security, Enforcement, and ...

More info »
Little”

Little”

The Economic Benefits of More Fully Utilizing Advanced 2 201 M ay Practice Registered Nurses in the Provision of Health An Analysis of Local and Statewide Effects on Care in Texas: Business Activity T...

More info »
Out of Reach 2018

Out of Reach 2018

2018 of OUT REACH THE HIGH COST OF HOUSING MADE POSSIBLE BY THE GENEROSITY OF:

More info »
CityNT2019TentRoll 1

CityNT2019TentRoll 1

STATE OF NEW YORK 2 0 1 9 T E N T A T I V E A S S E S S M E N T R O L L PAGE 1 VALUATION DATE-JUL 01, 2018 COUNTY - Niagara T A X A B L E SECTION OF THE ROLL - 1 CITY - North Tonawanda TAX MAP NUMBER ...

More info »
Annual Energy Review 2011   Released September 2012

Annual Energy Review 2011 Released September 2012

D / E I A - 0 3 8 4 ( 2 0 1 1 ) E | S e p t e m b e r 2 0 1 2 O 1 1 0 2 w e i v e R y g r A n n u a l E n e . r a / v o g e a i e . w w w

More info »
RIE Tenant List By Docket Number

RIE Tenant List By Docket Number

SCRIE TENANTS LIST ~ By Docket Number ~ Borough of Bronx SCRIE in the last year; it includes tenants that have a lease expiration date equal or who have received • This report displays information on ...

More info »
vol9 organic ligands

vol9 organic ligands

C HERMODYNAMICS HEMICAL T OMPOUNDS AND C OMPLEXES OF OF C U, Np, Pu, Am, Tc, Se, Ni and Zr O ELECTED WITH RGANIC L IGANDS S Wolfgang Hummel (Chairman) Laboratory for Waste Management Paul Scherrer Ins...

More info »
2019 05 01+ST+BOD+ +Updated+5 1 2019

2019 05 01+ST+BOD+ +Updated+5 1 2019

2019 D IRECTORS B OARD OF C G , C HAIR AROLE ROOM K C M V ICE , HAIR ARYL ATSUMOTO R C OLLINS ON M F RASER ARINA R OSE UILBAULT G D P INE AVE J OSH OWELL P P R ATTO ETER C TONE S HARLES A G E N D A J ...

More info »