Name the 3 recommended types of chemical disinfectants
- Chlorine compounds
What must the label state on a chemical disinfection solution container in order for us to use it?
- shelf life
- use life
- reuse life
- directions for activation
- type of container for storage
- toxic effects
What chemicals must be included in a chemical disinfection solution for us to use it?
What is the criteria for selecting a chemical disinfectant agent?
- EPA approved
- Chemicals included
Can chemical disinfectant solutions be altered by foreign materials?
How is disinfection achieved by use of chemical disinfectants?
by coagulation, precipitation, or oxidation of protein, or denaturation of enzymes of cells
What are chemical disinfectants used for?
- treatment area after appointment
Low level disinfectant
incactivates vegetative bacteria and certain lipid-type viruses, but does not destroy spores, tubercle bacilli, or non-lipid viruses
Intermediate level disinfectant
inactivates all forms of microorganisms, but does not destroy spores
High level disinfectant
inactivates spores, fungi, bacteria, and viruses, is a disinfectant, or a sterilizer
What are chemical disinfectants used for?
- surface disinfectants
- immersion disinfectants
- immersion sterilants
- hand antimicrobials
Why isn't chemical sterilization effective?
- Can't verify effectiveness with spore testing
- can't package instruments
- must rinse with sterile water
- must be completely immersed in solution (immersion)
How long does chemical sterilization take?
What are chemical sterilants used for?
items that can't be sterilized with heat
- no contact with pt. surfaces
- -low level disinfection
- doesn't touch mucous membrane (light, some x-ray materials)
- -low level disinfection
- touch intact mucous membrane (mirror)
- -sterilize or high level disinfection
Penetrates soft tissue or bone (needle, explorer, etc)
- penetrates soft tissue or bone. (needle, explorer, etc)
- -sterilize or dispose
What are the limitations of using gluteraldehydes?
- irritates skin and eyes
- corrosive to some instruments
- bad to inhale
How do you prepare Gluteraldehyde solutions?
mix 2 components to activate
How do gluteraldehydes disinfect?
- high level disinfectants (used in immersion disinfection)
- damage proteins and nucleic acids
What are the types of gluteraldehydes used?
- 2% nuetral
- 2% alkaline
- 2% acidic
How do chlorine compounds disinfect?
oxidation of enzymes, and cell wall components
What are chlorine compounds used for?
- water purification
- denture cleaning
what are chlorine compounds made up of?
sodium hypochloride 5.25% (household bleach)
What are the limitations of chloride compounds? And why are they so widely used?
- a. you must change it every day
- harmful and corrosive
- bad smell
- b. It's cheap and breaks things down easily
How do idophors disinfect?
Iodine is released slowly
What are idophors used for?
- surgical antisepsis
- liquid soaps
- mouth rinses
- surface antiseptics
what are idophors made up of?
- 1% 0-benzyl-pehlorophenol
- 9% 0-phenylphenyl
- diluted with distilled water
High concentration idophor
protoplasmic poison- destroys cell wall and precipitates protein
Low concentration idophor
- surface disinfectant- inactivates enzymes
- dilluted with distilled water
Describe typical care of sterile instruments
- store in package/wrapper
- put package in clean cabinet or drawer and make sure it's dated
- resterilize instruments after 3 months
How do chemical vapor sterilizers sterilize?
combination of alcolhols, formaldehydes, keytone water, and acetone heated under pressure produce gases that sterilize
what are chemical vapor sterilizers used for?
- low melting plastics
- heat sensitive hand pieces
What temperature is used for chemical vapor sterilization?
127-132 C (260-270 F)
What pressure is used for Chemical vapor sterilization?
Do instruments need to dry and cool after use of chemical vapor sterilizer?
Need to cool, but not dry
How often must you clean/ refill chemical vapor sterilizer?
once a week
What are the advantages of using a chemical vapor sterilizer?
- easy to use
- short amount of time
- corrosion and rust free
What are the disadvantages of using the chemical vapor sterilizer?
you need a lot of ventilation, the fumes are very dangerous
How does Dry Heat sterilizer sterilize?
Oxidation-from heat conducted from the outside to inside
What is the dry heat sterilizer used for?
- materials that can't be steam autoclaved
- small instruments that might be corroded or rusted
Does oil, debris, or grease protect microorganisms from sterilization in using Dry Heat sterilizer?
What temperature is used for Dry Heat sterilizer?
- 160 C (320 F) for 2 hrs
- 170 C (340 F) for 1 hr
- -sterilization/timing doesn't start til after machine preheated
What happens if the tempurater exceeds 160 C using Dry heat sterilizer?
it can ruin/destroy sharp edges
What are the advantages of using Dry Heat sterilization?
- useful for materials that can't be autoclaved
- if at right tempurature, good for sharp instruments
- no rust or corrosion
What are the disadvantages of using Dry heat sterilization?
- it takes a LONG time
- must maintain very high tempuratures
How does Moist Heat Steam under pressure (steam autoclave) sterilize?
- Heat destroys by inactivating cell proteins or enzymes
- moist heat coagulates proteins
What are steam autoclaves used for?
- materials except:
- or items that can't get too hot
What purpose does pressure serve in steam autoclave?
to increase temperature
Steriliztion in steam autoclave depends on what?
penetrating ability of steam
What are the conditions for packing and preparing instruments and steam autoclave?
- no air
- leave space between objects
- instruments are cleaned and air dried
What is the tempurature used for steam autoclave?
121 C (250 F)
What amount of pressure is used for steam autoclave?
15 lbs pressure
How long do you run steam autoclave?
- 15 min
- 30 min if load is heavy
What are the advantages of the steam autoclave?
- quick and efficient
- most economic method
What are disadvantages of using steam autoclave?
- no oils, liquids, powders, waxes, or materials that can't handle heat
what are the three tests for adequate sterilization?
- external chemical indicater
- internal chemical indicator
- biologic monitor
external chemical indicator
seals package and changes color if correct temperature of autoclave was reached (external on package)
internal chemical indicator
color change shows instruments exosed to heat and steam for the right time
tests that autoclave functions right-run organisms through machine then culture them
What microorganism is used for the biologic monitor test in the steam autoclave?
geobacillus stearothermophilus strips
How often must you perform the biologic monitor test?
once a week
all forms of life are destroyed
3 methods for sterilization
- dry heat
- chemical vapor
- steam autoclave
What are the causes for incomplete sterilization?
- inadequate preperation
- misuse of equipment
- inadequate maintenance
Describe the seal on the package for instruments
- indicator tape
- indicator strip changes color during sterilization indicating that auclave reached right tempurature for penetration, but it does not indicate in sterilized
- black strip should appear when done
When do you unwrap your instruments
Not until you are infront of your patient
What materials do you need to prepare for instrument packaging?
- sturdy wrapping to preven tears
- wrapping that permits steam or chemical vapor to pass through contents
what are the indications for thourgough drying?
- when sterilizing by dry heat, chemical heat, chemical vapor, or ethylene oxide
- nonstainless steal must predip in rust inhibitor before steam autoclaving
- packaging in paper wrap
How do you arrange you instruments when packaging?
- preplan and preload cassette for specific appointment
- date and mark tray or package
- use clear see through package
How long do you run the ultrasonic?
is the ultrasonic a substitute for sterilization?
How do instrument wahsers disinfect
high velocity, and hot water
How do instrument washers/thermal disinfectants and ultrasonics disinfect?
higher degree of temp and high velocity