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Sterilization and proper use of Autoclaves

Sterilization and proper use of Autoclaves. By (alphabetical order) Sarah Coulter Jessica Indalecio Shirley Neuebaumer Xin Xie. What is Sterilization? . Destroys all living organisms , including highly resistant bacterial spores .

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Sterilization and proper use of Autoclaves

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  1. Sterilization and proper use of Autoclaves By (alphabetical order) Sarah Coulter Jessica Indalecio Shirley Neuebaumer XinXie

  2. What is Sterilization? • Destroys all living organisms, including highly resistant bacterial spores. • Offers highest level of assurance that no pathogenic organisms remain on instruments and devices. • Stops the transfer of microorganisms from one client to a subsequent one by destroying them.

  3. Sterilization of dental instruments

  4. In the real world of dental practice • In 1998, a study in the UK shows that among 401 dental offices participating in an autoclave performance survey, 73.1% checked their autoclave routinely. And only 5 (1.2%) used aspore test.[1]

  5. Why autoclave?/Quiz time • Safe, no chemical vapor involved • Efficient • Kills both bacteria and spores • Easy handling Q: What is wrong with the lady? Q: What is the difference between sterilization and disinfection? • Sterilization kills all microbes while disinfection reduces the amount.

  6. Midmark AutoclaveProcedures for proper use

  7. Preprogrammed Settings Reason: To avoid operator error • Before first use: Sterilize new instruments. • New instruments from manufacturer– not sterile ( J Can Dent Assoc. 2009)

  8. Loading and Unloading • PPE, including utility gloves • Load packages face down • Paper towel to touch outside of autoclave • Water level in green zone (distilled) • Start/change sign to clean • End of cycle, oven mitts or clean hands • Put in cubbies • End of day- Proper clean/dirty sign on top • Unplug/ power off • Don’t leave clinic until cycle complete!

  9. Storage • Drying stage complete to be sterile! Don’t open door! • Dampness– microbial growth • Loosely stored, clean dry cubby or open shelving • Away from direct sunlight, heat, waste and water

  10. Maintenance Weekly- Mail Spore test to testing company – Thursdays Monthly- Flush • Drain, fill distilled water + 1 oz speed-Clean Sterilizer Cleaner • RunPOUCH cycle (no instruments) • Drain reservoir, cool • Refill distilled water • RunUNWRAPPED cycle • Drain reservoir, cool • Clean gaskets- Clean Sterilizer Cleaner + distilled water, brush

  11. Occupational Safety with Autoclave • Protection through use of PPE • Protective Eyewear • Surgical Mask • Gown • Heavy-Duty Utility Gloves • Protect from exposure to bloodborne pathogens

  12. Cassette Impact on Safety • Cassettes allow instruments to remain intact through entire sterilization process • Reduce risk of accidental injury to user • Permits sterilization process through the holes in the cassette

  13. Avoiding Cross-Contamination • Utility gloves contacting the autoclave handle or buttons will contaminate the system • Precautions should be taken to avoid cross-contamination • Use paper towel to contact the autoclave

  14. Undercover Bosses- Dental Edition (Foothill College) • http://www.youtube.com/watch?v=1QGynQeDG64 • http://www.youtube.com/watch?v=1QGynQeDG64&feature=youtube_gdata

  15. Legal and Ethical Considerations • What ethical principles did the employee violate? Legal considerations: Lawsuitsagainst dentists regarding the spread of infectious diseases such as HIV and hepatitis. • Reusing needles and improperly sterilizing instruments • Genetic testing for viral strains

  16. What are all the ethical principles we learned? • Veracity • honesty in our interactions with patients, insurance companies and colleagues • Justice • just and fair treatment for all • Autonomy • self-determination (Informed consent, HIPAA) • Beneficence • duty to benefit patient

  17. Ethical Principles • Maleficence • Do no harm • Universality • Did we come to the same conclusion? • Complementarity • Follow the Golden Rule • Responsibility • “I didn’t know” is not acceptable.

  18. Having fun using the autoclave!

  19. References • Johnson R., Quinn B. Dental Nursing. Instrument management: Cleaning and sterilization in the dental setting. [Internet]. 2010 [cited 2013 Nov 1]; 6(9): e504–509 • —Morrison A., Conrod S., Dental burs and endodontic files: are routine sterilization procedures effective? J Can Dent Assoc. [Internet]. 2009 [cited 2013 Oct 1]; 75(1): e39. • Burke FJT, Coulter WA, Cheung SW, Palenik CJ. Infection Control Autoclave performance and practitioner knowledge of autoclave use: A survey of selected UK practices. Quintessence Int I998;29:23l-238 • Viana A. C. D., Gonzalez B. M., Buono V. T. L., Bahia M. G. A. Influence of sterilization on mechanical properties and fatigue resistance of nickel-titanium rotary endodontic instruments. International Endodontic Journal [Journal]. 2006 [cited 2013 November 3]; 39(9)

  20. References • Scheutz, F., Reinholdt, J. Outcome of sterilization by steam autoclaves in Danish dental offices. Scandinavian Journal of Dental Research [Internet] 1998. [cited 2013 Oct. 2]; 96:[167-170]. • Adkins, S. Dentist in Springettsbury put patients at risk for Hepatitis, HIV, state says [internet] . York Daily Record; 2013 June [cited 2013 November 30] Available from: http://www.ydr.com/ci_23386397/state-springettsbury-dentist-put-patients-at-risk-hepatitis • Zimmerli M., Widmer AF., Dangel M., Filippi A., Frei R., Meyer J. Methicillin-resistant Staphylococcus aureus (MRSA) among dental patients: a problem for infection control in dentistry? Clin Oral Invest. 2009 [cited 2013 July 12]; 13(4): 369-73.

  21. References • Centers for Disease Control and Prevention [Internet]. Atlanta, GA: National Center for Health Statistics. July 10, 2013. Infection Control Frequently Asked Questions - Sterilization — Monitoring [cited 2013 Nov 1]. Available from http://www.cdc.gov/Oralhealth/InfectionControl/faq/sterilization_monitoring.htm

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