Ask an expert

Welcome to Isopharm's Ask an Expert section. Below, you'll see a list of questions our customers have asked and the answers our experts have given.

If you don't see the answer you need, feel free to ask a question of your own.

Question sent by Emma 15 October 2014

Should I use Pre-Soak for my instrument whilst I leave them over night?

Read our expert's reply

Answer: Instruments ideally should be clean as soon as possible after use, sometimes this is not possible. If you are taking the instruments to be immediately sterilised there is no requirement for a pre soak.

 

Instruments need to be kept moist prior to sterilisation in order to make them easier to clean if they are being left for period of time, in comparison to being left without moisture.

 

For instruments being left over night the duck bags are a recommendation rather than the pre soak. This is so the instruments are kept in a moist environment instead of being submerged, when instruments are kept in a submerged wet condition for a long period of time rust may start to develop. Keeping the instruments in a moist conidition prevents gross bioburden from drying on the instruments.

 

HTM 01-05 states that:
3.5  Instruments cleaned as soon as possible after use may be more easily cleaned than those left for a number of hours before reprocessing. Where this is not possible, water immersion or the use of a foam spray or gel intended to maintain a moist or humid environment are thought useful in aiding subsequent decontamination. Long periods of wet storage should, however, be avoided.

Isopharm offer both a pre-soak and duck bags in order to help our customer comply with HTM 01-05 guidelines.
Take a look for yourself >

Question sent by Rachael 15 October 2014

Is colour a restriction for the design of worktop surfaces? Will my worktop surface affect the sink I can have?

Read our expert's reply

 

Answer: There are lots of restriction on worktops, colour is not one of them.

 

Worktop surfaces should have seamless joints, meaning that you should use a solid surface worktop as the joints are welded and sanded - this cannot be achieved by using laminate. Solid surface worktop also means that the 'peeling' effect that occurs on laminate doesn't occur.

 

HTM 01-05 states that:
6.46  All work surfaces where clinical care or decontamination is carried out should be impervious and easily cleanable. They should be jointless as far as in reasonable; where they are jointed, such joints should be welded or sealed.
 

Work tops should ideally have an up stand fitted, depending on what you use depends on how high you can go.

 

Corian work surface can be moulded so that the up stand is seamless, this is not an absolute requirement, a seal is acceptable as long as it is ot permeable.

 

 

 

Answer: Depending on what type of work surface your practice has depends on what type of sink.

 

Moulded corian sinks are sometimes deemed as preferable but may show marks on the basin from the instruments, leaving the basin looking unsightly rather quickly.

 

Dropped stainless steel sinks are acceptable, and often prefered as they are cheaper.

 

Question sent by Pamela 02 June 2014

Can you confirm if our clinical staff need to change full uniform for outside of the practice? At a recent course we were advised that tunics only need changed but we currently change fully?

Read our expert's reply

 

HTM 01-05 states that:

 

6.32  Clothing worn to undertake decontamination should not be worn outside the practice; adequate changing and storage facilities that are accessible from the decontamination area should be provided. A similar approach is recommended for clinical clothing. 

 

There is a document referenced in HTM 01-05 entitled ‘Uniforms and Workwear: Guidance on uniform and workwear policies for NHS employers’ which is the overarching guidance on the wearing and laundering of uniforms.

 

Patients and the wider public should have complete confidence in the cleanliness and hygiene of their healthcare environment. The way staff dress is an important influence on people’s overall perceptions of the standards of care they experience. Uniforms should be clean at all times, and professional in appearance. In addition, although there is no evidence that wearing uniforms outside work adds to infection risks, public attitudes indicate it is good practice for staff either to change at work, or to cover their uniforms as they travel to and from work.

 

You can see that there Is potentially conflicting advise, however, my advise would always be to take the option that will create the most minimal risk, and that would be for staff to change into their WHOLE uniform at the practice, a lot of practices now are using scrubs, which are easy to wear but most people wouldn’t want to wear them outside of the practice anyway.

 

Becky Blackmore Dental Business Development Manager

Question sent by Lyndsey R 24 April 2014

We are currently using the Insafe syringe and are struggling with disposal of the unit when full. Is there anything you know about the system? Ideally we would like an adaptor for the lid of our existing sharps bin but this doesn't seem to be on the market yet.

Read our expert's reply

I have spoken to the manufacturer and the advice is that the unit should be disposed of with your clinical waste contractor, The unit can hold up to 150 used needles until full but should be disposed of after 3 months, whichever comes soonest.

There is no plans that I am aware of to alter existing sharps bins as this would make the opening on the 'normal' sharps bins too large and therefore hazardous.

For further information, please consult your clinical waste provider.

You can take our FREE  waste disposal training course online here:

http://training.isopharm.co.uk/training/dental/online-training/waste-disposal

 

Becky Blackmore Dental Business Development Manager

Question sent by John O 23 April 2014

Do I need to carry out a daily automatic control test on my autoclaves if they are fitted with data-loggers? Surely the data-logger records all this information?

Read our expert's reply

In terms of performing the automatic control test, the actual empty cycle at the start of every day still needs to be performed, however you are correct the data logger records the necessary information and the MHRA states that the recording of the information in the machines dedicated logbook only needs to be transferred from the data logger/printout at the end of every week.

We would suggest using a class 6 indicator strip (also known sometimes as TST strip) in the first cycle of everyday so that your nurses have physical evidence that the automatic control test has passed without having to check the parameters of the data logger, the class 6 indicator would also prove that there was steam in the chamber.

One thing to note is that we are aware that some manufacturers are  in consultation as to wether the automatic control test does need to be performed on an empty cycle or if with the first batch of instruments, we haven't had anything specific from manufacturers to confirm this as of yet.

For more information on the testing of autoclaves please see the dedicated section of our website Benchtop Sterilisers 

Becky Blackmore Dental Business Development Manager

Question sent by Louise H 23 April 2014

At my practice all instruments are sprayed with Enzymatic foam spray straight after use. They are then transported to the decontamination room where we have two sinks. The first is for manual cleaning and the other is for rinsing the instruments prior to them being inspected and autoclaved. Please can you tell what sink we should use to rinse the enzymatic foam off the instruments before carrying out the cleaning

Read our expert's reply

The enzymatic  foam should be rinsed off in the first sink, the one you use for manual cleaning.

It is often easier to think of the sinks as the first being the Œdirty and the second being the Œclean rinse

So in the first sink all the Œdirty processes happen but in the second sink the instruments have already been through a cleaning process and are just being rinsed to clean off excess detergent. Because the liquid that is created from the enzymatic pre cleaning foam will be contaminated with the blood/debris that it has removed from the dirty instruments this will need to be disposed of down the first sink so as not to contaminate the second clean rinse sink more than necessary.

For more information on decontamination processes please visit the Isopharm website

www.isopharm.co.uk/dental/decontamination-processes

Becky Blackmore Dental Business Development Manager

Question sent by Stephanie W 22 April 2014

Do ultrasonic baths have to have a lid that cannot be opened? We have three ultrasonic baths but all 3 of them can be opened during a cycle, can you advise me on this please?

Read our expert's reply

HTM 01-05 (2013) asks that when you buy a new ultrasonic bath, or as part of your pre procurement due diligence that you ensure that the new bath has an interlocking lid, this is so that there is a fail safe method which ensures that instruments cannot be added to an ultrasonic cycle mid way through and therefore not be decontaminated correctly.

Historically, ultrasonic baths were not made with interlocking lids or even cycle interupt mechanismns. Our advise, so that perfectly good ultrasonic baths do not have to be replaced in the short term would be that:

A practice has a policy which states that all members of staff understand that the ultrasonic lid must NOT be removed during a cycle and they must NOT put their hands in the bath when it is mid cycle. This policy should be displayed in the decontamination room and also explained to all of the nurses in the practice to ensure that it is adhered to.

The reason for having this policy and procedure in place is so that all instruments are ensured a full cycle and that instruments cannot be added mid way through  and not benefit from the whole ultrasonic cleaning process.

It is also critical that ultrasonic baths without interlocking lids have the ability to pass the validation tests set out in HTM 01-05

For further information on ultrasonic baths please see Ultrasonic Cleaning

Becky Blackmore Dental Business Development Manager

Question sent by Mark H 21 April 2014

Can alcohol still be used to disinfect in surgery?

Read our expert's reply

In answer to your question, It is a common misconception that alcohol wipes are not allowed to be used to clean and disinfect the surgery environment. However there are limitations/restrictions which should be duly noted

HTM 01-05 (2013) states that:

The use of disinfectant or detergent will reduce contamination on surfaces. If there is obvious blood contamination, the presence of protein will compromise the efficacy of alcohol-based wipes. 

Alcohol has been shown to bind blood and protein to stainless steel. The use of alcohol with dental instruments should therefore be avoided.

Ultimately this means if there is a large amount of blood present on instruments or on any stainless steel then alcohol should not be used because it has 'fixing' properties which allow the blood and protein to remain/fix to the stainless steel.

Alcohol wipes can often be preferred to non alcohol wipes as they tend to have a faster drying time and tend not to smear. Providing you follwo the correct application then there is no reason as to why they cannot be used.

To view the Isopharm range of wipes please visit the Infection Control section of our the Isopharm online shop

Becky Blackmore Dental Business Development Manager

Question sent by Kirsty E 20 April 2014

I have been informed that ultrasonic cleaning is best practice only: I understood it to be that if you didn’t have a washer disinfector it was essential requirements to use an ultrasonic as part of the manual cleaning process, can you tell me which is correct please?

Read our expert's reply

HTM 01-05 does not actually specify that you have to use an ultrasonic cleaner to achieve either essential quality requirements (EQR) or best practice.

There are 3 types of cleaning that a dental practice can carry out under EQR:

  • Manual Cleaning
  • Ultrasonic Cleaning
  • Washer disinfector cleaning.

As HTM 01-05 EQR allows you to manually clean your instruments: meaning you have no other equipment other than a steriliser, you do not need to use an ultrasonic bath.

However everything that you are doing to comply with HTM 01-05 needs to be evidence based and the reason that we would recommend you use an ultrasonic bath (when a washer disinfector is not available) is simply because the manual cleaning process cannot be suitably validated, There are no tests that can be performed and recorded unlike with an ultrasonic bath. Plus an Ultrasonic bath decreases the chances of needle stick injuries as although there may be some manual cleaning required prior to using the ultrasonic the need for this is again reduced using an ultrasonic.

For best practice compliance HTM 01-05 will only accept cleaning in a washer disinfector it is entirely up to the user/operator if they want to do this in conjunction with an ultrasonic as HTM 01-05 does not stipulate that this is mandatory. Again, we would recommend that an ultrasonic bath is used in conjunction with a washer disinfector as there are some instruments used in dentistry which are more effectively cleaned in an ultrasonic (re useable burs, intricate hinged instruments e.t.c.)

So in essence our advice would be to continue to use the ultrasonic bath as an additional cleaning method to allow you to provide evidence of your cleaning processes.

Click here for information on testing your ultrasonic cleaner

Becky Blackmore Dental Business Development Manager

Question sent by Terri P 20 April 2014

When you have worn heavy duty gloves for manual cleaning, I am aware they have to be changed weekly/when torn, however do they have to be cleaned in hot water and detergent after every use?

Read our expert's reply

Domestic household gloves, if used, should be washed with detergent and hot water and left to dry after each use to remove visible soil. Replace these gloves weekly or more frequently if worn or torn or if there is any difficulty in removing soil.

However, there is an opportunity to add a little common sense to this. Providing that your gloves are not covered in soiling and you are using a detergent to clean your instruments when manual cleaning, then you will not need to wash as such after each use.

We would suggest a rinse with hot water would be sufficient. However obviously if they are contaminated with blood then you should follow the advice and wash with detergent and hot water.

Becky Blackmore Dental Business Development Manager

Pages