Ch21 sterilization

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What are the seven steps for instrument processing?

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DENA 54

136 Terms

1

What are the seven steps for instrument processing?

Transport, Cleaning, Packaging, Sterilization, Storage, Delivery, Quality assurance program

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2

What should an effective quality assurance program incorporate?

Training, Record keeping, Maintenance, Use of biologic indicators

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3

What are the classifications of patient care items?

Critical instruments, Semicritical instruments, Noncritical instruments, PPE

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4

What are critical instruments?

Instruments used to penetrate soft tissue & bone, must be sterilized

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5

Give examples of critical instruments.

Scalpels, bone chisels, scalers & burs

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6

What are semicritical instruments?

Instruments that come in contact with oral tissues but do not penetrate soft tissue or bone, can be sterilized or high-level disinfected

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7

Give examples of semicritical instruments.

Mouth mirrors, amalgam condensers, alginate impressions

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8

What are noncritical instruments?

Instruments that only contact intact skin, can be placed in intermediate to low-level disinfectants

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9

Give an example of a noncritical instrument.

X-ray heads

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10

What are the three basic ways to reduce the transfer of organisms between patients?

Sterilization, Disinfecting, Cleaning/sanitizing

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11

Why is adequate sterilization and disinfection important?

To protect the well-being of dental patients and dental staff

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12

What personal protective equipment should always be used when processing instruments?

PPE including utility gloves

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13

Can utility gloves be decontaminated, sterilized, and reused?

Yes

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14

What are the two areas involved in transporting/processing contaminated patient care items?

Contaminated area and sterilized area (clean)

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15

What should you never do with contaminated instruments?

Place them in the clean area.

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16

How should contaminated instruments be transported?

In a manner that minimizes the risk of exposure, using appropriate PPE and a rigid, leak-proof container.

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17

What are the different areas in the instrument-processing area?

Clean area, workflow pattern, contaminated area, preparation and packaging area.

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18

What are the steps involved in pre-cleaning and packaging instruments?

Holding solution, hand scrubbing, ultrasonic cleaning, automated washer/disinfectors, drying, lubrication, corrosion control, packaging instruments, sterilization of unwrapped instruments.

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19

What are the sections in the cleaning process?

Contaminated section, clean section, ultrasonic

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20

What is an ultrasonic cleaner used for?

Cleaning contaminated instruments and items.

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21

What should be worn when working in the contaminated section?

Utility gloves and safety eyewear.

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22

What is a holding solution used for?

To prevent bioburdens from becoming dry on contaminated instruments.

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23

What precautions should be taken when handling sharps?

Never take your eyes off the sharp, accidents can happen even when taking out the sterilizer, and there should be a sharps container in each treatment room.

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24

What can happen if blood or dental materials remain on instruments after ultrasonic cleaning?

They can become a protective barrier for pathogenic organisms.

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25

What color is the puncture-resistant container for sharps?

Red

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26

What is the least desirable method of cleaning instruments?

Hand scrubbing

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27

What protective eyewear should be worn during hand scrubbing?

Goggle-type eyewear

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28

What type of gloves should be worn during hand scrubbing?

Puncture-resistant gloves

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29

What should be worn during hand scrubbing to protect clothing?

Protective clothing

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30

Which direction should instruments be scrubbed away from?

Away from your body

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31

How many instruments should be scrubbed at a time?

One or two

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32

Is ultrasonic cleaning more effective than hand scrubbing?

Yes

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33

What does ultrasonic cleaning do to instruments?

Loosens debris

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34

What is the purpose of ultrasonic cleaning?

Minimizes handling of soiled instruments

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35

Which instruments should not be placed in the ultrasonic cleaner?

Dental handpieces

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36

What type of solution should be used for ultrasonic cleaning?

General purpose cleaner solution

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37

How should items be immersed in the ultrasonic cleaner?

Completely

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38

Where should dentures and partials be cleaned?

In a jar with general all-purpose cleaner solution

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39

What does the aluminum foil test determine?

If the ultrasonic cleaner is working properly

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40

What does the holding bath (pre-cleaning) do?

Removes gross soil

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41

Does ultrasonic cleaning replace other means of sterilization?

No

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42

What happens to carbon steel instruments and burs during steam sterilization?

They rust

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43

What cause ultrasonic cleanser?

Cavitation and implosion, implosion

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44

Which sterilization methods do not rust carbon steel instruments and burs?

Dry heat or chemical vapor sterilization

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45

What are the two areas in the sterilization processing room?

Contaminated area and sterilized area

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46

What should be worn in the sterilization processing room?

Full PPE, including utility gloves

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47

Where should contaminated instruments never be placed?

In the clean area

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48

In the clean are, Instruments be wrapped/package in what materials?

In appropriate materials

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49

What should be placed inside the package next to the instruments?

Chemical indicator

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50

What should be done if an indicator is not visible on the outside of the package?

Place an external process indicator on the package.

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51

What are suitable packaging materials for sterilization?

Biofilm and paper bags.

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52

What should be done before sterilization?

Precleaning, rinsing, and drying.

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53

What are some examples of items that can be placed in a sterilizer?

Instruments, sterilized instrument tray set ups.

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54

What can instruments be grouped into for packaging?

Special setups.

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55

What are some characteristics of biofilm packaging materials?

Different sizes, small ones are for burs, sealant, and they are see-through.

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56

What can be found in the clean section?

Sterilizers, sterilized instruments, sterilized instrument tray set ups.

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57

What is another name for sterilization of unwrapped instruments?

Flash sterilization.

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58

When should flash sterilization be used?

Only under certain conditions, when instruments are needed immediately.

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59

What are the 6 major methods of sterilization?

Steam under pressure sterilization, steam (flash) autoclave sterilization, unsaturated chemical vapor sterilization, dry heat sterilization, rapid heat sterilization, liquid chemical sterilization.

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60

What instruction should you follow to operate sterilizer?

Follow the manufacturer's instructions.

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61

What should be done before removing packages from the sterilizer?

Allow them to cool.

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62

What can be used to handle hot packages?

Sterile forceps or hot pads.

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63

What is the most effective method of infection control for critical and semi-critical instruments?

Sterilization.

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64

What happens to all forms of microorganisms during sterilization?

completely destroyed.

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65

What is the dental assistant's responsibility in sterilization?

To ensure proper sterilization of items that touch the skin or mucosa, or are used in invasive procedures.

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66

What choices are available for sterilization?

Several choices.

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67

Who decides which method to use for sterilization and disinfection?

The DDS (dentist).

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68

What is the best method of sterilization?

Autoclave

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69

What is the temperature and pressure for steam under pressure sterilization?

249.8 F (121 C), 15 psi

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70

What are the advantages of steam under pressure sterilization?

10-30 minutes, good penetration of steam, commonly used in dental offices, easily monitored

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71

What are the disadvantages of steam under pressure sterilization?

Rusts nonstainless (carbide) steel instruments & burs, 15 min. drying cycle, corrosive effect on carbide steel

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72

What instruments can go into the autoclave?

Surgical burs, all surgical instruments, stainless steel instruments, dental rotary handpieces

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73

What is the temperature for steam (flash) autoclave sterilization?

270-273 F (132C)

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74

What are the advantages of steam (flash) autoclave sterilization?

Easily monitored, sterilized in 3 min unwrapped

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75

What are the disadvantages of steam (flash) autoclave sterilization?

Instruments should be used promptly, requires distilled water

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76

What is the temperature for chemical vapor sterilization?

270F (132C)

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77

What are the advantages of chemical vapor sterilization?

20 min to sterilize, very reliable & easily monitored, no corrosion on carbide & non-stainless steel

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78

What are the disadvantages of chemical vapor sterilization?

Requires formaldehyde & alcohol, must be vented, instruments must be thoroughly dry before sterilizing

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79

What instruments can go into chemical vapor sterilization?

Carbon steel/non-stainless steel, surgical burs, surgical instruments, stainless steel instruments

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80

What is the purpose of physical monitoring?

Ensures proper tech & operation

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81

What should be maintained for each sterilizer?

Records

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82

What are biological monitors?

Most accurate way to assess sterilization occurred

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83

How are biological monitors utilized?

Utilize harmless spores

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84

How often should biological monitors be verified?

Weekly

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85

What should be done if a positive report is received from biological monitoring?

Corrective procedures must be taken immediately

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86

What are process monitors?

Printed on packaging or indicator tape

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87

What happens to process monitors when exposed to correct heat?

Changes color

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88

Do process monitors indicate sterilization has taken place?

No

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89

Where are records of all biological monitoring kept?

On file as part of the documentation of the practice's 'Infection Control Program'

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90

What is physical monitoring?

Looking at gauges and readings

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91

What is chemical monitoring?

Heat sensitive

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92

What do process indicators indicate?

That the package has been processed

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93

Where are process indicators placed?

Outside on the package, autoclave tape

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94

What do process integrators respond to?

Combination of pressure, temperature, and time

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95

How often is biological monitoring done?

Weekly

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96

What does biological monitoring verify?

Sterilization is happening

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97

What is another name for biological monitoring?

Spore test

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98

What must be followed for handpiece sterilization?

Manufacturers instructions

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99

What may be lodged in the head of the handpiece?

Blood, saliva, tooth fragments, and dental materials

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100

Can the handpiece be emerged in liquid?

No

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