Case study 1
Detail the process that you would take to prepare used items on an instrument tray containing used non-critical, critical, and semi-critical items for sterilisation. List your procedure from contaminated tray to readiness for sterilising. Include in your response any requirements for safe disposal of waste, use of correct bins for some items, and PPE requirements for yourself.
Case study 2
You have been asked to provide instruction on sterilisation processes at your dental surgery to a newly employed dental assistant. Included is how to load and unload the steam steriliser and the importance of monitoring and recording the sterilisation. In your own words, describe your sterilisation processes.
Case study 3
In order to maintain effective operation, washing, and sterilisation, equipment requires regular cleaning and maintenance that meets both manufacturer recommendations and Australian standards. Describe the daily, weekly, monthly, and ‘as scheduled’ maintenance procedures that should be undertaken for maintaining a steriliser. In your response, include the different testing methods used and the importance of ensuring quality assurance of sterilisation equipment.
Writing strategies and actions for future improvements
A case study is designed for you to demonstrate your skills in reading, accurately interpreting and providing workable responses and strategies.
1.Identification and clarification of the key issues. Discuss and provide some suggestions as to what has caused these
2.Key facts and information that is relevant and demonstrates your ability to provide solutions
3.Templates and resources that could assist managers in the future when managing their teams
The reprocessing of medical materials for sterilisation seems to be an easy process but if understood properly it is a complicated process that requires serious practices to ensure complete sterilisation.
As per infection prevention principles, biomedical services and occupational health instructions cleaning and disinfecting are reprocessing practices along with some PPE rules for workers that are strictly required before sterilisation.
The personal protective equipment (PPE) rules are very first requirement that workers should follow to carry on a proper reprocessing for sterilisation. The PPE requirement includes: -
Further, the cleaning process is performed before disinfection or sterilisation that involves proper sorting of as critical, semi-critical and noncritical items. The sterilisation performed for different categories are always different, for example- critical items undergo steam, chemical or liquid sterilisation, semi-critical involves thermal or chemical sterilisation and noncritical items are cleaned using detergent.
After cleaning disinfecting is performed where immerse instruments are disinfected as per the manufacturer manual. The instruments are fully covered and kept for disinfection followed by removal of disinfectant with water. Further, they are dried with cloth and disinfectant is completely thrown as waste.
For a newly engaged dental assistant, it is important to know that sterilisation is an essential and imperative part of dental practice. It is required for each and every dental worker to perform sterilisation as per Australian Standard AS4187 in his or her medical practice.
The following steps help to understand the complete sterilisation process in the appropriate manner.
Loading steam steriliser
Unloading steam steriliser
For proper maintenance of sterilisation, it is essential to record and monitor the complete process. This helps to detect faults, improve loopholes and missing essentials in the process. For record keeping and monitoring an operating manual, commissioning data copy and a log of the ongoing process, maintenance and calibration should be kept while performing sterilisation.
For getting a good quality performance of a steam steriliser it is essential to provide regular maintenance programme that ensures proper functionality. Any kind of malfunction in maintenance process can lead to damage to sterilise. The below provided are details of daily, weekly, monthly and as scheduled maintenance process that is required to maintain a steam steriliser.
Daily maintenance
Clean the steriliser regularly especially the rubber chamber seal, sterile trays and inner surface with mild detergent, warm water and a soft cloth. Further, rinse well before use.
Use nylon scourer to clean the metal surface of chamber seal very gently using mild detergent and water.
Weekly maintenance
Weekly clean the sterilisation chamber, tray racks, trays and outer surfaces using disinfectant, mild detergent and warm water
Water reservoir should be drained and flushed on weekly basis.
Monthly maintenance
Lubricate hinge and closing mechanism of door monthly if required using silicone-lubricating spray. However, try to use the lubricating spray very rarely.
Remove and clean debris from primary filters on monthly basis
As scheduled
Bacterial filters and chamber seals require periodic replacement depending on the brand, rate of usage, age and handling of steriliser. Therefore, this maintenance is required to be scheduled by the operator as per need.
Importance of quality assurance of sterilisation equipment
Quality assurance testing and servicing will ensure lifelong reliability and safety of sterilisation instrument. The regular servicing and validity test are two methods that ensure the quality of steriliser. Regular service via manufacturer or approved service company shall reduce breakdown frequencies ensuring the safe use of steriliser.
Further, below provided four validity tests ensure the validity of steriliser
Heat distribution test- Detect the coldest spot of the chamber
Penetration time test- Measuring the real time taken for challenge pack centre to reach active temperature of sterilisation
Cycle confirmation test - Validation single sterilisation cycle as per Australian standards
Biological test- This test confirms consistency of steriliser for medical functionality.
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