I get asked a lot of different questions, through social media or by email, around a variety of different subjects of Infection Prevention and Control and Decontamination. With this in mind I thought I would start to produce a series of articles outlining these questions.
Last month we took a recap of the Safer Sharps regulation 2013 and the main implications of this on dental practices. This month I wanted to carry on with some of the Frequently Asked Questions that are asked by many members of the dental team.
Do we need an ultrasonic cleaner?
There is no requirement to have an ultrasonic cleaner, however, they can be useful as an additional pre-cleaning stage prior to manual cleaning or washer disinfector. They also aid with the reduction in possible sharps injuries. If your practice is not using a Washer Disinfector then I would certainly advise the use of an Ultrasonic Bath as a way of helping to reduce the need to manually clean.
Why do I need a Vacuum Autoclave?
Many dental instruments have internal lumens or are air retentive. Due to the nature of these instruments the air must be removed before full sterilisation can take place. Class N autoclaves are only suitable for solid, non-air retentive instruments. EN13060 outlines the different classifications of small benchtop sterilisers and what load types they are suitable for. As a Non-vac, or passive displacement, autoclave has no vacuum pump these units have no way of evacuating air from hollow or air retentive instruments. The only way to remove the air from such instruments is with the use of a Class B (Vacuum) or suitable Class S autoclave. By being able to fully remove the air steam is then able to fully penetrate all areas thus guaranteeing sterility.
Why do we need to use a washer disinfector?
Moving to an automated process is the recommended method for cleaning re-usable medical devices. The reasons for this are: to increase safety for staff who process the instruments; automated systems can be validated and tested to ensure they are consistently effective. Washer Disinfectors usually incorporate up to 5 cleaning stages, before they then Thermally Disinfect which renders instruments safe to handle. Once these stages have been completed they will then dry them ready for processing through the autoclaves. Due to Washers being consistent in their cleaning there is only a requirement to inspect instruments, with illuminated magnifying lamp, at random rather than the entire load as is required with Manual and Ultrasonic cleaning, which in turn saves extra time.
When manual cleaning do I need to have 2 sinks?
It is desirable, if possible, to have 2 sinks for Washing and Rinsing, to ensure complete separation of the instruments. If space is an issue then it is acceptable to have 1 sink with a removable bowl, which is used for the rinsing. It is important to ensure that this is followed with a written protocol. The sinks that are made available need to be fitted with surgical style taps, have no overflows fitted, a tap spout not discharging directly into the plug hole and a trap/ u-bend not directly under the plug hole.
Could you please clarify what tests are required on ultrasonic baths?
The tests that are required are manufacturer led and will vary from bath to bath. Typically, according to UK guidance, the tests required would be the weekly protein test, quarterly Cleaning Efficacy Test (Soil) and Ultrasonic Activity Test (Foil). Which test and the frequency would then be adapted depending on the manufacturer requirements. In the absence of any manufacturer guidance then you should always follow those tests outlined in the guidance.
Next month I will outline some more of the FAQ’s that are received along with answers to them.
We have created a Testing & Validation Guidance Handbook to support the wider Dental team who are looking for answers to questions such as these. The handbook has been developed to provide help and support with all things around the decontamination process including what to do if tests fail.
If you need any help or support with anything outlined in these articles then please do not hesitate to get in touch with me by email at info@deconpete.co.uk or visit the website www.deconpete.co.uk