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Practices require registration with CQC.
Cleanliness and inf control requirement
Decontamination processes should be audited
every 6 months (DH audit tool) (prev 3/12)
Aim to achieve reprocessed device fully
compliant with medical devices regs 2002
Special precautions for prion transmission not
necessary
Training essential (5 hours per CPD cycle)
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Written policy updated every 2 years
Blood borne transmission and sharps
Decontamination and storage
Procedures for cleaning, disinfection and sterilization
of instruments
Management and disposal of clinical waste
Hand hygiene
Reusable instruments and single use
PPE
Disinfectants-use, storage, disposal
Spillage procedures and COSHH
Environmental cleaning
training
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ASAP to avoid risk of drying (can immerse in
water or gels/sprays)
Containers should be
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Leak proof
Easy to clean
Rigid
Able to be closed securely
Robust to prevent instrument damage
Clearly marked
Transport outwith surgery for decon. requires noted
consignment
Domiciliary visits require record of date and vehicle used
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Essential prerequisite before sterilization
Best practice with WD
ASAP after use
New instruments cleaned & sterilized before
use, unless supplied as sterile
Cleaning practices should be validated
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Flush –remove gross contamination <45oC
Wash-detergent
Rinse-remove detergent
Thermal disinfection-80oC for 10 mins or 90oC for
1min
Drying
Crucial to load correctly-open hinges, no
overlapping, attach to irrigation
Inspect afterwards under lighting and
magnification
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Can be used prior to WD esp. for hinged
instruments
Should be immersed in cold water with detergent
first
Place instruments in basket, fully immersed
Do not overload, overlap or place on floor
Close lid and set timer
After cycle drain basket before rinsing in a
dedicated sink or bowl
Change solution when visibly contaminated or at
end of every session
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Wash hands
Wear PPE
Prepare sinks, equipment and setting down area
Fill the sink to level (marked on edge of sink) with water
and detergent
Ensure temp <45oC
Fully submerge and keep under water to prevent aerosols
Scrub using long handled brush with soft plastic bristles
Drain water
Rinse in separate sink (potable/RO/distiller water)
Drain (and dry if to be wrapped)
Visually inspect
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Saturated steam under pressure at the highest
temperature compatible with the product
Records required for every cycle
These should be copied as print outs fade over
time
All steam sterilizers subject to Pressure Vessels
Systems Safety Regulations 2000-must be
examined periodically by a competent person
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Type N: non-vacuum
Type B: vacuum
Type S: specific load
Must be:
Compliant with safety requirements
Installed, commissioned , validated and
maintained
Operated according to manufacturers instructions
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Reservoir should be filled at least daily with
distilled or RO water
Should be cleaned, drained and left empty with
door open at end of day
Testing required to ensure performance
Each sterilizer should have a logbook in which the
following are recorded:
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Maintenance
Validation
Faults
Modifications
Routine tests
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Before carrying out tests the user should:
Clean door seal
 Check chamber for cleanliness
 Fill reservoir
 Turn power source
• Daily tests consist of
• Automatic control test
• Steam penetration (vacuum) helix or Bowie-Dick
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Instruments should be cleaned and dried before
wrapping
With steam displacement (type N) instruments
should be wrapped after sterilization
With Type B instruments should be wrapped prior
to sterilization
Instruments should be dried using disposable nonlinting cloths
Instruments can be stored for up to 12 months
First in - first out principle helpful
Date should be marked on package
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Wrapped instruments may be stored for up to
1year
Unwrapped instruments in the clinical area 1 day
(must be dry and protected from contamination eg
in cupboard). These instruments should be
reprocessed at the end of day or next morning
even if not used
Unwrapped instruments in a non-clinical area 1
week
Wrapped instruments should be date
stamped/marked
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Dirty to clean workflow, clearly separated
Decluttered
Sealed, easily cleaned work tops
Should be wiped down after each decontamination cycle
Air flow from clean to dirty
Dirty zone receives instruments
Washing sinks should be next to receiving area.
Ultrasonic cleaner next and then WD
After the cleaning/disinfection area should be an inspection
area
Sterilizer should be well away from other activities
Set down clean area adjacent to this
Separate wash hand basin for hand washing
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Crucial to prevent spread of infection and
decontamination
Should be carried out:
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Before and after each treatment session
Before and after removal of PPE
Following washing of dental instruments
Before contact with instruments that have been steam
sterilized
After cleaning or maintaining decontamination devices
After toilet visits
Before and after contact with food
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Mild soap should be used, not bar soap.
Apply soap to wet hands
Dry with disposable paper towel
Hand cream (water based) should be used at the end of
session
Rings, bracelets and watches should be removed
Fingernails should be kept clean and short with no polish
The basin used should not have a plug or overflow
It should have a mixer tap-lever or sensor operated
Taps shouldn’t discharge directly into the drain (to prevent
aerosols)
A cleanable poster dictating hand wash method should be
displayed above every clinical wash hand basin
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Infection control policy should specify when
PPE should be worn and changed
Gloves:
Protect hands from contamination, chemicals and to
minimise cross infection risk
 Glove integrity can be damaged by isopropanol or
ethanol, therefore alcohol rubs shouldn’t be used
with gloves
 Domestic household gloves, if used should be
washed with detergent and hot water and left to dry
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Plastic single use aprons should be worn during all
decontamination processes
Face masks are single use
Visor or face shield should be worn
Footwear should be enclosed
Clinical clothing should not be worn outside the
practice
Short sleeves should be used (can wear disposable
sleeves)
Uniforms should be washed at hottest temperature
suitable for fabric
Clean uniform should be worn every day
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Items should be removed in the following
order
Gloves first
 Plastic apron
 Face and eye protection
 Face mask
 Wash hands thoroughly
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DAILY
Steam penetration B
Automatic control test B & N
WEEKLY including daily tests plus
Air leakage B
Residual air test N
QUARTERLY (by engineer)
Thermometric tests
ANNUALLY (by engineer)
Thermometric tests - Small load, Large load
Dryness tests - Small load, Large load
Validation is needed for new equipment at installation and annually thereafter. Also
after any repairs
DAILY
Remove and clean strainers and filters - Ensures filters and strainers are clean
Cleaning efficacy - Visual examination of all load items
WEEKLY including daily tests plus:
Protein residue test - Confirms that cleaning process retains the capability of removing
protein
Safety checks - Check condition of door seal
QUARTERLY
Safety checks
Automatic control test
Cleaning efficacy test
Chemical dosing
Thermometric disinfection test
ANNUALLY
Completion of all validation tests above
Validation is needed for new equipment at installation and annually thereafter. It will also be
necessary to validate equipment after any major repairs have been carried out
DAILY
Remove and clean strainers and filters - Ensures filters and strainers are clean
Drain machine at end of day/ session
Cleaning efficacy - Visual examination of all load items
WEEKLY
Safety checks - Check condition of door-seal
Protein residue test
QUARTERLY
Automatic control test
Verification of calibration
Cleaning efficacy test
Ultrasonic activity test
ANNUALLY
Completion of all validation tests above
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The use of hypochlorite at 1000 ppm available
chlorine is recommended. Hypochlorite should be
made up either freshly using hypochloritegenerating tablets or at least weekly in clean
containers. Contact times should be reasonably
prolonged (not less than five minutes).
A higher available chlorine concentration of 10,000
ppm is useful, particularly for blood
contamination. The process should be initiated
quickly and care should be taken to avoid
corrosive damage to metal fittings etc. The use of
alcohol within the same decontamination process
is not advised.
Needles must not be recapped after use unless
the employer’s risk assessment has identified
that recapping is itself required to prevent a risk
(eg to reduce the risk of contamination of
sterile preparations). In these limited cases,
appropriate devices to control the risk of injury
to employees must be provided. For example,
needle-blocks can be used to remove and hold
the needle cap and so allow safe one-handed
recapping.
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