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Chapter 21 Principles & Techniques of Instrument Processing and Sterilization
- SHORT-ANSWER QUESTIONS
- 1. Describe and discuss the seven steps involved in processing dental instruments.
- 1.transport 2.cleaning3.packaging4.sterilization5.storage 6.delivery 7.quality
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2. Describe the three most common methods of heat sterilization, and list the advantages and disadvantages of each.
- -Dry heat:ortho, oral surgery, 1 hour, dry fast, no corrosion
- disadvantage no plastic or fabric, cannot sterilized liquids
- -Chemical vapor sterilizer:Does not cause rust, 20 min
- disadvantage not environmental friendly, special solution, damage plastic & rubber
- -Steam autoclave: steam under pressure, short time, no corrosion, quick dry
- disadvantage damage plastic & rubber, uses distilled water, instruments must be dry.
- ?
- 3. Describe the precautions necessary when materials are packaged for sterilization.
- -keep bag sealed for instruments to remain sterile
- -Process indicators
- 4. Describe the steps required for sterilization of a high-speed dental handpiece.
- ? 1.remove and wipe debris off, flush water
- ? 2.remove bur and handpiece from hose
- ? 3.ultrasonic clean if recommended, drain, attach hose & operate
- ? 4.no ultrasonic recommended, scrub with brush, water & soap
- ? 5.lubricate if require
- ? 6.no lubricant, use non lubricant cleaner
- ? 7.follow manufacture instructions
- ? 8.re-attach hose
- ? 9.use cotton tip with isopropyl alcohol
- 10.flush water & air lines
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5. Explain the differences between process indicators and process integrators.
- ? indicators are placed outside package.
- integrators are placed inside.
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6. Describe when and how biologic monitoring is done.
- ? Weekly
- ? 1. PPE, place B1 strip in bundle of instruments & seal package
- ? 2. Place pack with B1 in center
- ? 3. Place reminder of packages
- ? 4. Remove PPE & wash hands
- ? 5. Record info date, time estc..
- ? 6. Remove B1 strip
- 7. mail spore test strip & control B1 to monitoring service
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7. Explain the primary disadvantage of ?flash? sterilization.
Can only use unwrapped instruments & unwrapped instrument are no longer sterile once removed. ?
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8. Describe the three forms of sterilization monitoring.
- ? -Physical: temperature, pressure, exposure time
- ? -chemical: change colors when exposed to certain conditions
- -biologic: only way to verify sterilization
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9. Explain how sterilization failures can occur.
- Improper instrument cleaning, packaging or sterilizer malfunction and timing.
- 10. Explain the limitations of liquid chemical sterilants.
- Rubber dam frames, shade guides, x-ray film-holding devices are damaged
- 11. Describe the classification of instruments used to determine the type of processing that should be used.
- critical, semicritical, noncritical
- 12. Explain the purpose of using a holding solution before instrument processing.
- If instruments cannot be cleaned immediately after procedure place in holding solution. To prevent drying of blood & debris
- 13. Describe the safety precautions necessary when one is operating an ultrasonic cleaner.
- PPE and set of tongs ?
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14. Describe the CDC Guidelines for sterilization and disinfection of patient care items.
- Use only FDA cleared medical devices.
- clean & heat sterile before use of instruments
- 15. Describe the CDC Guidelines for cleaning and decontamination of instruments.
- -Minimize handling of loose contaminated instruments during transport
- - clean debris
- - use automated equipment
- - heavy duty gloves
- - PPE
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16. Describe the CDC Guidelines for preparation and packaging of instruments for sterilization.
- -Use internal chemical indicator inside package
- - Use container wrapping
- - Before sterilization of critical & semi critical instruments inspect instruments cleanliness
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FILL-IN-THE-BLANK STATEMENTS
- Select the best term from the list below and complete the following statements.
- 1. event-related packaging means that it is assumed the contents of a package will remain sterile indefinitely unless the packaging is compromised.
- 2. A sterilant is an agent capable of killing all microorganisms.
- 3. The autoclave is a piece of equipment that is used for sterilizing by means of moist heat under pressure.
- 4. biologic indicators are vials or strips, also known as spore tests, that contain harmless bacterial spores and are used to determine whether a sterilizer is working.
- 5. The Chemical vapor sterilizer is a piece of equipment that is used for sterilizing by means of hot formaldehyde vapors under pressure.
- 6. An instrument used to penetrate soft tissue or bone is identified as a critical instrument.
- 7. Instruments that come in contact with oral tissues but do not penetrate soft tissue or bone are identified as semicritical instruments.
- 8. noncritical instruments are instruments that come into contact w/ intact skin only.
- 9. In the clean area ?of the sterilization center, sterilized instruments, fresh disposable supplies, and prepared trays are stored.
- 10. The contaminated area of the sterilization center is where contaminated items are brought for precleaning.
- 11. A piece of equipment used for sterilization by means of heated air is the dry heat sterilizer .
- 12. Use-life is the length of time that a germicidal solution is effective after it has been prepared for use.
- 13. The biologic monitor verifies sterilization by confirming that all spore-forming microorganisms have been destroyed.
- 14. Tapes, strips, and tabs with heat-sensitive chemicals that change color when exposed to a certain temperature are examples of a single parameter indicator.
- 15. An endospore is a resistant, dormant structure that is formed inside of some bacteria and can withstand adverse conditions.
- 16. The ultrasonic cleaner is a device that loosens and removes debris with the use of sound waves traveling through a liquid.
- 17. A multi-parameter indicator is an indicator that reacts to time, temperature, and the presence of steam.
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MULTIPLE-CHOICE QUESTIONS
- Complete each question by circling the best answer.
- 1. The instrument classifications used to determine the
- method of sterilization and disinfection are all of the above
- a. critical b. semicritical
- c. noncritical d. All of the above
- 2. What type of personal protective equipment is necessary when one is processing instruments?
- a. Goggle-type eyewear b. Sterile gloves
- c. Surgical scrubs d. Hairnet
- 3. The basic rule of the workflow pattern in an instrument processing area is .
- a. triangular b. square
- c. single-loop d. double-loop
- 4. If instruments cannot be processed immediately, what
- should be done with them? D . They should be placed in a holding solution.
- a. They should be kept in the dental treatment area.
- b. They should be wrapped in aluminum foil.
- c. They should be covered with a patient napkin.
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5. Which are methods of precleaning instruments? D.
- a. By hand scrubbing b. By ultrasonic cleaning
- c. With a thermal washer and disinfector d. All of the above
- 6. Which method of precleaning instruments is LEAST
- desirable?
- a. Hand scrubbing b. Ultrasonic cleaning
- c. Thermal washer d. Microwave
- 7. The ultrasonic cleaner works .
- a. by microwaves b. by sound waves
- c. by ultraviolet waves d. by light waves
- 8. Kitchen dishwashers cannot be used to preclean
- instruments because they are .
- a. not ADA approved b. not CDC approved
- c. not FDA approved d. not OSHA approved
- 9. Rusting of instruments can be prevented by .
- a. use of a disinfectant b. use of lubrication
- c. use of proper wrapping d. use of wax
- 10. Instruments should be packaged for sterilization to .
- a. maintain sterility b. identify them
- c. maintain organization d. make setup easier
- 11. Which of the following is a reason why pins, staples, and paper clips are not used on instrument packaging?
- a. The package becomes too hot to touch. b. You can?t record info on the package.
- c. They will damage the sterilizer. d. They will cause holes in the packaging.
- 12. Which is a form of sterilization monitoring? D.
- a. Physical b. Chemical
- c. Biologic d. All of the above
- 13. Where do you place a process indicator?
- a. Inside the package b. Outside the package
- c. Inside the sterilizer d. Outside the sterilizer
- 14. Another term for spore testing is .
- a. biologic monitoring
- b. single-parameter indicator
- c. multi-parameter indicator
- d. All of the above
- 15. Do multi-parameter indicators ensure that an item is
- sterile?
- a. Yes
- b. No
- 16. What is the best way to determine whether sterilization has occurred?
- a. Check the sterilizer. b. Use a process multi-parameter indicator.
- c. Use biologic monitoring. d. Use a single-parameter indicator.
- 17. What causes sterilization failures? D.
- a. Improper contact of sterilizing agent b. Improper temperature
- c. Overloading of the sterilizer d. All of the above
- 18. What are commonly used forms of heat sterilization? D.
- a. Steam b. Chemical vapor
- c. Dry heat d. All of the above
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Chapter 22 Regulatory and Advisory Agencies
- SHORT-ANSWER QUESTIONS
- 1. Explain the difference between regulations and recommendations.
- 2. List four professional sources for dental information.
- 3. Name the premier resource for safety and infection prevention information in dentistry.
- 4. Describe the role of the Centers for Disease Control and Prevention.
- 5. Explain the primary difference between OSHA and NIOSH.
- 6. Describe the role of the Environmental Protection Agency in relation to dentistry.
- 7. Describe the role of the U.S. Food and Drug Administration in relation to dentistry.
- 8. Describe the role of the National Institutes of Health.
- 9. Describe the role of the National Institute of Dental and Craniofacial Research.
- 10. Describe the role of the Public Health Agency of Canada.
- FILL-IN-THE-BLANK STATEMENTS
- Select the best term from the list below and complete the following statements.
- ADA
- CDC
- EPA
- FDA
- NIOSH
- OSAP
- OSHA
- PHAC
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1. The _______________ is a federal regulatory agency that is concerned with the regulation of sterilization equipment.
- 2. The federal nonregulatory agency that issues recommendations on health and safety is the _______________.
- 3. The _______________ is the professional organization for dentists.
- 4. The federal regulatory agency that enforces regulations that pertain to employee safety is _______________.
- 5. _______________ is the premier resource for safety and infection prevention information in dentistry.
- 6. _______________ is the federal agency that is responsible for conducting research and making recommendations for
- the prevention of work-related disease and injury.
- 7. The _______________ is the federal regulatory agency that deals with issues of concern to the environment or public
- safety.
- 8. The _______________ is the main federal agency responsible for public health in Canada.
- MULTIPLE-CHOICE QUESTIONS
- Complete each question by circling the best answer.
- 1. What is the primary role of the CDC in dentistry?
- a. Public health
- b. Research
- c. Drugs
- d. Employees
- 2. What is a primary role of the FDA?
- a. Fund research projects
- b. Provide public health information
- c. Regulate medical and dental devices
- d. Protect employees
- 3. What is the primary role of the EPA?
- a. Research
- b. Public health
- c. Employees
- d. Environment
- 4. What is the primary focus of OSHA in dentistry?
- a. Public health
- b. Employees
- c. Environment
- d. Research
- TOPICS FOR DISCUSSION
- The dentist in your office asks you to be responsible for maintaining OSHA compliance in the office and to provide
- training on infection prevention to the new employees. A high school student will be coming in to help with sterilization,
- and you must provide her with appropriate
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Chapter 23 Chemical and Waste Management
- SHORT-ANSWER QUESTIONS
- 1. Describe potential long-term and short-term effects of exposure to chemicals.
- 2. Explain the components of the OSHA Hazard Communication Standard.
- 3. Describe three common methods of chemical exposure.
- 4. Describe the components of a Hazard Communication Program.
- 5. Explain the purpose of a material safety data sheet.
- 6. Describe the difference between chronic and acute chemical exposure.
- 7. Identify four methods of personal protection against chemical exposure.
- 8. Describe how chemicals should generally be stored.
- 9. Discuss the record keeping requirements of the Hazard Communication Standard.
- 10. Identify types of regulated waste generated in a dental office.
- 11. Identify types of toxic waste generated in a dental office.
- 12. Discuss the packaging of regulated waste for transport.
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FILL-IN-THE-BLANK STATEMENTS
- Select the best term from the list below and complete the following statements.
- acute exposure
- chemical inventory
- chronic exposure
- contaminated waste
- Hazard Communication Standard
- hazardous waste
- infectious waste
- material safety data sheet (MSDS)
- regulated waste
- toxic waste
- 1. The _______________ is an OSHA standard regarding an employee?s right to know about chemicals in the
- workplace.
- 2. A form that provides health and safety information regarding materials that contain chemicals is a _______________.
- 3. _______________ is repeated exposures, generally of lower levels, over a long period.
- 4. _______________ exposure pertains to high levels of exposure over a short period of time.
- 5. Waste that has certain properties or contains chemicals that could pose a danger to human health and the environment
- after it is discarded is _______________.
- 6. A(n) _______________ is a comprehensive list of every product used in the office that contains chemicals.
- 7. Items that have had contact with blood, saliva, or other body secretions are called _______________.
- 8. Waste that is capable of causing an infectious disease is _______________.
- 9. _______________ is infectious waste that requires special handling, neutralization, and disposal.
- 10. Waste that is capable of having a poisonous effect is _______________.
- MULTIPLE-CHOICE QUESTIONS
- Complete each question by circling the best answer.
- 1. What body systems could develop health-related
- problems as a result of inhalation exposure to
- chemicals in the dental office?
- a. Neurologic
- b. Senses
- c. Respiratory
- d. Endocrine
- 2. What is (are) primary method(s) of chemical
- exposure?
- a. Inhalation
- b. Ingestion
- c. Skin contact
- d. All of the above
- 3. Acute chemical exposure involves _______________.
- a. short-term exposure in large quantity
- b. repeated exposure in small quantity
- c. short-term exposure in small quantity
- d. long-term exposure in small quantity
- 4. What is a method of personal protection against
- chemical exposure?
- a. Ventilation
- b. Disinfected surfaces
- c. Inhalation protection
- d. Hair protection
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a. 1 year
- b. 5 years
- c. 10 years
- d. 20 years
- 15. An example of regulated waste is a _______________.
- a. patient napkin
- b. contaminated needle
- c. dental dam
- d. 2- 3 2-inch gauze
- CASE STUDY
- Pamela is a dental assistant who is in charge of preparing chemical labels for containers in the office. She needs to
- prepare a label for a product that is highly flammable, reactive, and toxic. Pamela is also missing some material safety
- data sheets for other products in the office.
- 1. What types of containers will Pamela need to label?
- 2. What number will Pamela write in the blue triangle?
- 3. What number will Pamela write in the red triangle?
- 4. What number will Pamela write in the yellow triangle?
- 5. Where can Pamela get a material safety data sheet for other products in the office?
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