We’ve started to look at things that need to be considered when setting up a squat practice and in particular the need for a Local Decontamination Unit (LDU). Now I wanted to take a look at the exact equipment that you will require in order to be compliant.
Once you have chosen the room that you are going to use its time to think about the equipment. The room that you design must have a flow that moves from Dirty to Clean to avoid any cross contamination. A lot of people ask me ‘where exactly does the dirty room finish and clean start?’. After the Washer disinfector there must be an illuminated Inspection lamp, this is the point that the dirty and clean cross, typically from left to right.
Within England and Wales HTM and WHTM talk about ‘Best Practice’ and as we are aware there is currently no deadline date for achieving this standard. Where this becomes the exception is when setting up a squat practice.
The first piece of equipment that needs to be factored into the room is the Washer Disinfector. Its important, when considering which unit to purchase, that you have a discussion with someone that understands how WD’s work.
Try to have an understanding of the number of patients you typically see in a day and also the treatment types. If you have an understanding of the number of instruments you are typically getting through it will help with identifying the ideal washer. Don’t fall into the trap of purchasing a washer that is too large for your requirements as you will wait a long time to fill it up and vice versa don’t purchase a WD that is too small for your requirements.
By speaking to someone that understands WD’s and the decontamination process you can be guided into purchase the unit that maximises throughput and efficiency.
You then need to purchase the autoclaves, with at least one being a vacuum. For every washer that is purchased the minimum number of autoclaves will be 2. The bottle neck, in a Decon room, won’t happen at the WD stage, but rather the autoclave. Its important that you have autoclaves that can, at least, accommodate the same number of instruments processed through the washer.
By having 2 autoclaves if one goes down, or during servicing/ validation, you always have another that can be used. There are 3 pieces of equipment that a surgery needs to be able to function, Dental Chair, Compressor and Autoclave. If any of these are down, and no back ups available, then the practice can’t operate.
The next piece of equipment that needs to be purchased is either a water distiller or RO unit. These units will be placed in the clean side of the LDU.
The final equipment purchase is the illuminated magnifying lamp for checking instruments that have been processed through the WD. You need to perform a spot check of random instruments for any visible debris or damage. Instruments that are damaged are thrown away, where as if visible debris is found then the full load needs to be re-processed.
Once you have your equipment its also important to nominate yourself a Decon Lead who’s responsibility is to oversee full compliance within the Decontamination process. In a future article I plan to go through the roles and responsibilities of this incredibly important role.
Once you have the equipment its also important that you make sure you have the correct tests and selection of log books for storing.