Dental Sterilization Procedures Policy Number VIM4(4)-10 Purpose The purpose of this policy is to ensure patient and employee safety when using instruments with potential for exposure to bloodborne pathogens and/or other infectious material. Sterilization is the process of destroying all microorganisms on an item by exposure to physical or chemical agents. Scope This policy applies to all personnel and departments that clean, prepare and/or sterilize items intended for patient care use. Policy Statement 1. Training / Competency a. All staff, including nursing and dental volunteers, who are assigned responsibility to sterilize equipment will be trained and complete an annual competency of each type of sterilization modality used. i. Training will be completed prior to personnel using the equipment. b. Annual competencies will be done by March 31 annually. Competencies will be documented in the logbook located in the Assistant Director s office. 2. Quality Control a. The autoclave performance will be monitored through an established quality control process using methods appropriate to the specified machine. b. Quality control procedures will be conducted according to manufacturer s specifications and documented in the Log located in Room 6. c. Test strips are mailed monthly to the manufacturer. d. Verification from the manufacturer acknowledges whether the machine passed or failed. e. For any piece of equipment that fails the control, the manufacturer will be called for guidance or repair. 3. Sterilization a. Prior to sterilization each item must be rigorously cleaned using water and a specified disinfector which meet the manufacturer s instructions. Cleaning to remove organic residue should occur as soon as practical after use. b. Instruments should be placed in the ultrasonic unit for 1-5 minutes. c. After an item is cleaned rinsing should be done according to manufacturer recommendations. d. All items to be sterilized must be placed in a packaging system that meets or exceeds the manufacturer's written instructions for compatibility with the method of sterilization used. e. The Autoclave must be loaded and operated in accordance with the manufacturer s written guidelines. Universal Precautions/Body Substance isolation will be followed for all procedures.
Sterilization Process Quick Reference Wear appropriate gloves when working with instruments to be sterilized. Move used instruments to Sterilization room (Room 6) as soon as practical. Remove any organic residue as soon as possible. If unable to clean immediately, leave instruments to soak in Miltex surgical instrument cleaner (purple bottle). Use brush or sponge to remove blood and organic residue. Place instrument in Ultrasonic Cleaner for 1-5 minutes. Use Brite Shield instrument cleaner in Ultrasonic machine. Rinse instruments with clear water after cleaning and lay on paper towel to dry. If instrument has moving parts spray Miltex Spray Lube on all moving parts. All dental hand pieces should be wiped down with a disinfecting wipe. NEVER PUT HAND PIECES IN WATER OR LIQUID CLEANER. Use K-Spray lubricant in all dental hand pieces before putting into autoclave. Place instruments in appropriate size sterilization pouch and seal pouch. Place into Autoclave and press pouches and then Start. Supplies Used during Sterilization Brite Shield use one scoop with warm water in ultrasonic cleaner. Miltex use one capful of solution in warm water in container to clean and soak instruments. Miltex use spray on moving parts of instruments. (e.g. Scissors) K-Spray Use in all dental hand pieces.
Competency Assessment: Instrument Cleaning, Wrapping/Packaging, and Sterilization Name: Date: Circle: Pass Fail Certifier Name: Certifier Signature: Critical Elements-Must Meet all Elements Met Not Met Pre-Cleaning: 1. Applies appropriate PPE for type of pre-cleaning 2. Cleans/wipes gross debris with wet cloth at point of use or immerses in approved enzymatic cleaner per manufacturer s directions. a. Discards pre-cleaning solution after use Cleaning: 1. Washes hands 2. Applies appropriate personal protective equipment (PPE); gloves, eyewear and mask or face shield and gown if needed. 3. Pre-rinses instruments under cold running water to remove any visible soil. 4. Places instruments in appropriate container with approved cleaning solution. * Leaves hinged instruments in open position and disassembles those with removable parts. * Instruments are soaked per manufacturer s guidelines 5. Scrubs all surfaces with scrub brush, pipe cleaners, or other cleaning tools, paying special attention to serrated edges, box locks, and other hard to reach places. 6. Discards enzymatic detergent after use 7. Rinses instruments thoroughly in cool tap water. 8. If Ultrasonic machine is used: * Runs cycle per manufacturer s recommendations * Removes instruments from pan when cycle is complete and rinses in tap or distilled water per manufacturer s guidelines. * Allows to air dry completely. Inspection: 1. Checks instruments for the following prior to packaging: * Hinged instruments for ease of opening and alignment of jaws and teeth. * Sharp or semi-sharp instruments of sharpness * All instruments for cracks, chips, sharp edges, worn spots, dents, bends or rust. 2. Uses appropriate spray on hinged instruments. 3. Uses appropriate spray on hand pieces Packaging for Sterilization: 1. Handles are placed into the open end of package first. 2. Curved tips are pointed in the same direction. 3. Dental instruments are packaged appropriately together. 4. Seals open end of package ensuring even seal without wrinkles and excessive air. Air acts as a barrier to heat and steam. Autoclave 1. Ensures biological monito result is on file and logged 2. Completes autoclave log each time autoclave is run and maintenance is performed. 3. Follows manufacturer s directions for the loading and operation of the autoclave ensuring the packs are loaded in a manner that allows for free steam and air circulation 4. Sets autoclave controls for the appropriate type of packaging 5. Follows planned daily, weekly and monthly maintenance of autoclave Comments:
Dental Water System Procedures Policy Number VIM4(4)-11 Purpose The purpose of this policy is to protect patient safety by ensuring that the dental waterlines remain free from contamination. Scope This policy applies to all staff and volunteers who are responsible for use and/or maintenance of the dental water system equipment. Policy Statement A. All volunteers and staff assigned responsibility to the dental clinic will be trained on the proper use and maintenance of the dental water system. B. Volunteers and staff must demonstrate an understanding and ability to clean the lines and maintain the equipment. a. Lines in each room must be flushed using appropriate evacuation solution and rinsed at the end of each day. This must be completed after either a dentist or hygienist has used the equipment. b. Filter must be cleaned at the end of each day. c. Lines must be flushed free of water at the end of each day. d. Water bottle must be removed and emptied daily. e. Guidelines and cleaning solutions will be used as set out in the Dental Water System Quick Reference Guidelines f. Documentation of cleaning must be logged into the Dental Log Book. C. Volunteers and staff must report in a timely manner any defects or issues with the equipment to their supervisor.
Dental Water System Procedures/Maintenance Quick Reference Guide The water lines should be cleaned at the end of the days either the Hygienist or Dentists are scheduled. Wear appropriate gloves when working with the equipment. Inspect all plastic bottles for damage prior to every use. Beginning of Day Only use distilled water in the equipment water bottle. Use one tablet Adec ICX in each bottle with fresh distilled water. Never touch the tube with gloved or ungloved hand when inserting tube into the bottle. End of Day: Clean Water Lines Used Use one scoop of Vac Attack in warm water in pan. (located under the sink) Dissolve completely Turn on equipment Hold dental unit hand pieces on top of water and begin to flush the lines. You want the water to cause the lines to move to help remove debris in the lines. Flush until all lines are cleaned and solution is gone. (Each unit will take at least one pan full of water.) Fill pan with fresh clear water and flush all the water lines again to rinse clean of all solution. Remove filter and clean. Replace filter. Empty water bottle and replace on unit. Allow empty dry bottle to re-pressurize. Purge the syringe water line and each hand piece water coolant line until only air flows through them. When performing an air purge, always allow the empty bottle to become fully pressurized before starting the purge. Wipe down all hand pieces, chair and lines with disinfectant wipes.