Decontamination is not just one process but a combination of processes including cleaning, sterilisation or disinfection and storage used to render a reusable item safe. Disinfection, reduces the microbial load to level, which makes the disinfected object safe to handle Sterilisation is the killing and removal of all microorganisms including bacterial spores.
It is a requirement of the Provision and Use of Work Equipment Regulations 1998 that everyone who operates, supervises or manages work equipment must be trained adequately and that It is the responsibility of the User the dentist , hygienist, or therapist that the equipment they intend to use for a dental procedure is "fit for the purpose it is intended".
Keeping equipment clean and ready is an important part of its maintenance and there are a few thing you can do:
- Whenever possible decontamination should be carried out in a separate dedicated room, although it is appreciated that many practices do not have sufficient space to build or house a dedicated local decontamination unit. Under those circumstances an area in the surgery should be specifically designated for decontamination.
- Automation of instrument cleaning or validated manual cleaning
- Commissioning, validating, monitoring and maintaining of sterilisers-Improving the training of dental staff in instrument decontamination
- Segregation of dirty instruments and procedures from clean by zoning and work flows patterns.
A typical dirty zone contains :
- A setting down area for dirty instruments
- Secure storage containers for dirty instruments
- Ultrasonic bath
- Thermal washer disinfector (strongly preferred but optional)
- Automated pre-sterilisation dental handpiece cleaning machines (optional)
- A dedicated sink for instrument cleaning with preferably a separate sink for rinsing the instruments.
A clean zone contains :-
- A setting down area for machine-washed or manually disinfected instruments, with task lighting for inspection (for visible contamination and functionality/damage), instrument wrapping (if using a vacuum steriliser)
- Steriliser ( preferably a vacuum steriliser)
- Shelving or cupboards for storing sterilised instruments in trays, cassettes or pouches
- Sterile supplies-Storage area for PPE (personal protective equipment)
Finally it is vital that you ensure that all equipment is mantained and tested where possible to ensure that they are working correctly.