HLTINF002 Process reusable medical devices and equipment

Knowledge Questions v1.2 (2017/09/07)

HLTINF002 Process reusable medical devices and

equipment
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Assessment
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Knowledge Questions
Please carefully read through each question posed. In your response, please use terms and
phrases that you defined in your previous assessment. Reflect on your learning unit and your own
research. Please aim to present 180 words for each response to fully demonstrate your
knowledge in this area of study. A minimum of 150 words for each response is required.
Please note: Where the word count is not met, your submission will be returned to you for re-
working.

1. In your own words, describe the Spaulding classification. List and describe the three
categories as devised by Spaulding as well as the level of risk, application, and processes
associated with each category.

The Spaulding classification, first developed in 1957, is a commonly used method for
matching the disinfection and sterilisation of surfaces, especially those of reusable
medical/surgical instruments, with available techniques. It is a method of sterilising or
disinfecting inanimate items and surfaces based on the level of risk associated in their use.
Understanding the Spaulding Classification system is crucial to ensuring patient health and
safety. You may assist protect a patient's safety from healthcare-associated infection if you
completely grasp how to prepare any equipment for the next patient. Because the criteria
for high-level disinfection are variable and difficult to maintain constant (e.g., contact
duration, temperature, concentration, etc.), an automated TEE probe reprocessor is one of
the greatest weapons in an infection preventionist's armoury. Earle Spaulding, a
microbiologist, produced a report for Temple University in 1939 that established the
Spaulding Classification. He devised a technique for deciding which patient care objects
needed to be disinfected or sterilised in it. Spaulding classified patient care elements as
non-critical, semi-critical, or crucial. He also identified three germicidal activity levels: high,
middle, and low. By 1957, this approach had been renamed the Spaulding Criteria and was
widely utilised to further define these standards.
Spaulding classified patient care elements as non-critical, semi-critical, or crucial. I also

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identified three germicidal activity levels: high, middle, and low. By 1957, this approach had
been renamed the Spaulding Criteria and was widely utilised to further define these
standards. There are three degrees of sterilisation: high, middle, and low. During the highest
level sterilisation (HLD) process, every vegetative microbe, mycobacteria, lipid and non-lipid
illnesses, parasitic spores, and some bacterial spores are eliminated.

2. List at least three examples each of critical, non-critical, and semi critical items that you use
in the dental surgery.

Dental tools are classified into three types based on the risk of disease transmission. The
accompanying models determine the fundamental, semicritical, and noncritical classes:
The instruments which are used to penetrate fragile tissue or bone are considered critical
and should be cleaned after each usage. Steam under tension (autoclaving), dry hotness, or
hotness/synthetic fume are all common sanitization methods. Forceps, surgical blades,
bone etches, scalers, and brambles are all extremely useful tools.
Semi-critical equipment, for example, mirrors and mixture condensers, do not penetrate
delicate tissues or bone, but rather link with oral tissues. Following each use, these items
should also be cleaned. In various scenarios, cleaning is unthinkable, hence unquestionable
level sanitization is essential. A considerable level sanitizer is registered with the United
States Environmental Protection Agency (EPA) as a "sterilant/sanitizer" and should be
labelled as such.
Noncritical equipment, such as X-ray head outer components, come into touch with merely
undamaged skin. Because such devices provide no risk of disease transmission, they can be
reprocessed between patients using transitional or low-level sterilisation. A middle-of-the-
road sanitizer will be labelled for tuberculocidal action and EPA-registered as a medical
clinic sanitizer. The EPA lists a low-level sanitizer as an emergency clinic sanitizer, although it
is not recognised as having tuberculocidal action.

3. List how used items are prepared for strerilisation in an autoclave. Your response should
include preparation of critical and semi-critical instruments using trays and/or cassettes and
batch control identification measures. Be sure to provide the required BCI information that
is recorded for each cycle as well as the importance of accurate record keeping.

Use a hand brush to scrub used objects.

Clean again with an ultrasonic cleaner to limit the possibility of contamination from spatter.
Using a paper towel, pat dry the things that have been cleaned with an ultrasonic cleaner.
Use a self-sealing sack to pack and package cleaned and dried articles of a mix of delicate
and sharp or heavy instruments.
Once all materials have been properly organised into instrument trays or cassettes, wrap
trays or cassettes with sterilise wrap or crepe paper.
Prior to sterilisation, label a package on the laminated side of the box. The date of
processing must be stated on labels put on wrapped objects.
Fill the autoclave with objects that have plenty of room.
All sterile objects in a bundle should be labelled with an essential cluster control ID (BCI).
BCI connects a group of instruments used on a patient to a specific cleaning cycle, allowing

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dental administrators to show basic dental equipment used on a patient a specific cleaning
cycle with irrefutable performance data. The following must be included in the BCI: A code
for identifying the steriliser, i.e. which device was utilised.
The sterilisation date.
A batch, cycle, or load number is a number that is assigned to a batch, cycle
Load contents, both packaged and unwrapped goods.
Time and temperature are cycle parameters.
Identification of the operator who authorises the usage of the load.
Batch numbers and dates can be hand-written on packages with an indelible pen, a self-
inking stamp, or adhesive labels from a labelling gun.
The steriliser cycle record book is a crucial legal written record that will be used as evidence
if accusations of poor sterilising techniques are made. As a result, maintaining accurate
records is critical.
4. There is a range of chemical indicators that can be stored inside packages or attached to the
outside of the wrapped package prior to sterilisation. What are chemical indicators? List
and describe the intended uses for the six chemical indicator types.

Process Indicators - Class 1.

External signs show if an instrument set has been thoroughly exposed to the sterilising
procedure. Class 1 chemical indicators include indicator tape and labels put on the outside
of a peel pack.
Indicators of Class 2 for use in certain examinations.
Chemical indicators of this sort are utilised in certain operations prescribed by sterilisation
standards. Bowie Dick tests, for example, are performed on a steam steriliser with a pre-
vacuum cycle to assess the effectiveness of air removal and steam penetration in the
autoclave chamber.
Indicators with a single variable are classified as Class 3 indicators.
These chemical indicators respond to one of the important parameters of the sterilisation
process (e.g., time, temperature, pressure) and show exposure to a sterilisation cycle at
specified values of the relevant parameters.
Multivariable Indicators - Class 4.
These chemical indicators react to two or more essential parameters of the sterilisation
process and show cycle exposure at specified levels of the selected parameters. Time and
temperature are two examples of important factors for a steam sterilisation procedure.
Integrating Indicators (Class 5)
These chemical indicators are intended to respond to all essential parameters throughout a
predetermined number of sterilisation cycles. The performance of Class 5 indicators has
been linked to that of biological indicators.
Emulating Indicators - Class 6.
Chemical indicators of this sort are intended to react to all important parameters for certain
sterilisation cycles. Each Class 6 chemical indicator for a steam sterilisation, for example,
monitors the particular temperature and duration of a selected sterilisation cycle.

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5. List three possible reasons why a pouch that has just been removed from a completed
autoclave tray would be considered unsterile and needs to be reprocessed. In the event of
the autoclave not functioning within regulation, how and to whom would you report and
document the fault/malfunction?

A sterilisation pouch is a disposable that is used in combination with a sterilising device,

such as an autoclave, to sterilise precise equipment that must be maintained clean and free
of contamination. Dental professionals, nail technicians, tattoo artists, beauticians, and
scientific laboratory employees are the most popular consumers of these sterilising pouches
for their instruments.
The steam autoclave is the most often used sterilising technology. The majority of self-
sealing sterilisation pouches are breathable, allowing steam to permeate and fully sanitise
your items. While a steam autoclave can sterilise a wide range of items, not all materials can
be disinfected in the same way. For example, if you use your autoclave's gravity cycle to
sterilise wrapped medical tools, sterilising steam may not reach every portion of your
instruments.
If the autoclave malfunction then:
Report any concerns with the equipment, such as odd commotions, vibrations, or odours, to
the person in charge of coordinating overhauling to the professionals.
Ensure that all personnel who will use the autoclave have been instructed on the most
effective way to work autoclaves safely.
All administrators should get training on the autoclave's safe operation before using it.
Preparation may be assigned to a qualified professional, but it is the director's responsibility
to guarantee that their kin are appropriately prepared.
Wear appropriate personal security hardware on a consistent basis. Wear closed-toed
shoes, sterile coats, and protective gloves when dealing with autoclaved goods. When there
is a sprinkle risk, face shields and coverings should be worn.

6. Explain why you need to completely remove all blood, saliva, and other debris from
instruments before sterilisation can take effect. Describe the methods that may be used in
removing all debris prior to sterilisation, including the advantages and disadvantages of each.
Which method/s lessen the chance of contamination via aerosol or splatter?

It is critical to remove any adhering items that might obstruct sterilising. Otherwise, blood,
saliva, and other instrument debris may isolate or protect germs from sterilising chemicals.
1. Scrubbing the hands Scrubbing instruments by hand is a conventional cleaning procedure
that is generally good in removing dirt. Scrubbing, on the other hand, is risky and less
successful than mechanical deaning procedures.
2. Cleaning using ultrasonic waves Ultrasonic cleaning may limit direct contact with
contaminated tools, as well as the likelihood of cuts and puncture wounds. It is typically
more successful since it employs ultrasonic to clean, which creates a cleaning turbulence of
imploding bubbles. Furthermore, dental professionals can thoroughly clean more devices in
a given amount of time. Ultrasound can be used to clean both loose instruments and those
housed in cassettes; however, dental handpieces must be hand-cleaned. Furthermore,
solidified permanent cements will not be removed by ultrasonic cleaning.
3. Automated washing machine An automatic washer is another means of cleaning
mechanical instruments. Washers use hot water-detergent sprays followed by high-
pressure spray rinses to clean instruments. As a result, it may lessen the risk of

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contamination from spatter and be safer than hand cleaning. It cleans thoroughly every
time, however not all instruments are suitable with automatic washers. A mechanical
device, such as ultrasonic cleaning and/or an automatic washer, might reduce the possibility
of contamination from aerosol or spatter.

7. There are many different types of chemical waste produced at the dental workspace. These
vary between types of equipment and specific cleaning product in use. Safety Data Sheets
should be always be referred to when assessing risks. What information do SDS sheets
contain?

Areas 1–8 recall general information about the material, such as identifiable proof, hazards,
structure, safe care procedures, and crisis control measures. This information should be
useful to folks who need data rapidly. Segments 9 through 11 and 16 include further
specialised and logical data, such as physical and synthetic properties, stability and
reactivity information, toxicological information, openness control information, and other
information, such as the date of creation or last modification. When the preparer is unable
to locate relevant data for any needed component, the SDS should additionally state that no
suitable data was discovered. Another component comprises data, openness control data,
and other information, such as the date of readiness or the most recent update. Segments
12 through 15 of the SDS are also included to comply with the UN Globally Harmonized
System of Chemical Classification and Labeling.
Dental (Medical) trash is defined as any trash generated by a medical or health-care facility.
The garbage generated by the dentist office is diversified in terms of materials, sizes,
shadings, and forms. There are dentistry fluid squanders, for example, X-beam (engineer
and fixer) squanders, as well as various synthetics and medications generated inside dental
or clinical offices in general. Waste can also emerge as solids produced during human
discovery, inspection, and treatment, as well as during animal research. The dental clinic's
strong garbage is classified into two types: contaminated waste and non-irresistible rubbish.
The ways of treating this waste differ greatly in terms of man's and his current situation's
health. Clinical/dental trash producers are those who generate more than 23 kg of
controlled clinical/dental rubbish each month.