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STERILIZATION MONITORING SERVICE. Joen Iannucci Haring, DDS, MS Director, Sterilization Monitoring Service The Ohio State University College of Dentistry July 16, 2008. HANDOUT. OBJECTIVES BACKGROUND INFORMATION STERILIZATION MONITORING MONITORING SERVICES OSU SMS APPENDIX.
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STERILIZATIONMONITORING SERVICE Joen Iannucci Haring, DDS, MS Director, Sterilization Monitoring Service The Ohio State University College of Dentistry July 16, 2008
HANDOUT • OBJECTIVES • BACKGROUND INFORMATION • STERILIZATION MONITORING • MONITORING SERVICES • OSU SMS • APPENDIX
BACKGROUND INFORMATION • What is the difference between sterilization and disinfection? • What must be sterilized? • How are items sterilized? • What types of sterilizers can be used? • How do you know if the sterilizer is working?
STERILIZATION • Destruction of all forms of microbial life, including spores. • Bacterial sporesmust be killed. • Spores are themostheat-resistant microbial forms.
DISINFECTION • The inhibition or killing of pathogens. • Bacterial spores are not killed during disinfection.
STERILIZATIONQUESTIONS . . . • What must be sterilized? • How are items sterilized? • What types of sterilizers can be used ? (page 9)
HOW DO YOU KNOW IF YOUR STERILIZER IS WORKING ? • Equipment must be monitored for proper functioning. • Spore tests, or biological indicators (BI), are used to monitor sterilization equipment.
WHY MONITOR STERILIZATION EQUIPMENT ? • CDC recommendations. • ADA recommendations. • OSDB mandates weekly testing.
WHAT IS BIOLOGICAL MONITORING ? • Processing of highly resistant bacterial spores in a sterilizer. • Culturing of spores to determine if they have been killed. • A spore strip (BI) contains the spores used in monitoring.
WHAT IS A SPORE STRIP ? • Small piece of paper that contains spores. • Spores includeBacillus subtilisand Bacillus stearothermophilus. • A spore strip is enclosed in a glassine paper envelope.
HOW IS STERILIZATION CONFIRMED ? • Process spore strip in sterilizer. • Mail spore strip to monitoring service. • Spore strip is placed in culture media. • Incubated in culture media for 7 days. • Inspected each day for cloudiness.
TESTING Spore strips are placed in culture media. Testing is performed under a hood.
TESTING Spore strips are placed in test tubes filled with culture media using aseptic technique.
INCUBATION Spore strips in culture media are placed in an incubator for a total of seven days.
CHECKING FOR FAILURES Each day, all test tubes are inspected for cloudiness.
WHAT IS A FAILED TEST ? • Cloudiness in culture media indicates a failed test. • A Gram stain is prepared to identify Bacillus in the failed test. • A failed test means that the sterilizer did not kill the spores.
GRAM STAIN A Gram stain is used to rule out contamination & to verify the presence of the Bacillus organism.
WHAT CAUSES A TEST TO FAIL ? • See page 10 for a complete list. • Operator error is most common. • Examples: inadequate time or temperature/pressure, overloading the sterilizer or wrong packaging.
WHAT IS CHEMICAL MONITORING ? • Use of heat sensitive chemicals to assess physical conditions. • Does not indicate sterilization has taken place.
WHY USEA MONITORING SERVICE ? • Provides outside proof of testing via an independent testing entity. • Avoids “grading your own paper”.
HOW TO CHOOSE A MONITORING SERVICE ? • Cost? • Service? • Benefits? • Testing?
SMS FACILITY • Rooms 3127 & 3131 Postle Hall • Approximately 1200 clients • Process 62,000 tests / year • Net profits used to support clinics and research in the College
Educate staff Assign one person Establish a routine Testing calendar Mail tests promptly Maintain failure log Review reports Review problems Report to staff File reports Retain reports SMS TESTING CHECKLIST
IMPORTANT POINTS TO REMEMBER . . . • Sterilization vs. disinfection ? • What is biological monitoring? • Why is monitoring important ? • Biological vs. chemical monitoring ? • OSDB mandates weekly testing • SMS at OSU College of Dentistry
True/False Quiz 1. SMS services may report your failures to the OSDB. 2. You should close your office if a sterilizer fails. • OSDB does not perform random sterilization checks. • SMS’s have been proven many times to reduce infection transmission in dental offices. • OSDB can only use patient charts to prove infection control violations with the patient’s permission/consent. • You should inform patients of SMS failures. • SMS’s were mandated in response to AIDS hysteria.