How to maintain the good quality of the sterilization?

  During the disinfection and sterilization, we should be noted the nature and characteristics of the method, and also pay attention to the usable method and external factors about the disinfection efficacy. 

    Regardless of which method we use to disinfection or sterilization, the disinfection effect will be affected by many factors, so if we can control and use the advantage of these factors, it can increase the disinfection effect. Otherwise, it will lead the disinfection or sterilization to failure.

The main factors are the following points:

1) Sterilize dose:

      The sterilize dose is the basic condition to kill microorganisms, include the strength and time. If increase the sterilize strength, also can increase the speed of the sterilization. While decrease the sterilization time, it also decrease the efficacy. Of course, if the sterilize strength is lower than the standard, it can’t reach the sterilize goal even if increase the time.

2)The types and quantities of microbial contamination:

     According to the different types of biology, so there are the different disinfection effects. In addition, the number of microbes also affect the result. So before the disinfection, we should be noted the types and quantities of microbes contamination. In general, the microbial resistance is stronger or more serious pollution, then the disinfection is also more difficult.

3) PH value:

      Changing the PH value can affect the results of some sterilizations. One side, the disinfectant will be impacted by the PH value, it result of increased or decreased the disinfectant activity. On the other hand, the PH value will impact the microorganism.

4) Antagonism:

    For the chemical disinfection, pay attention to the interference about the antagonistic substances. For example, the quaternaries effects will be neutralized by the soap or anionic detergents. And acidic or alkaline disinfectant will be neutralized by the alkaline or acidic substances, then decrease the disinfect efficacy.

5) Penetration:

   When the instruments are disinfected, the bactericidal factors must be applied to the microorganism itself directly. Otherwise, it won’t have the bactericidal effect. For example, UV disinfection effect only can apply the microorganisms on the surface and shallow liquid, a piece of paper can reduce 95% the bactericidal effect.

Finally, there are many factors will affect the efficacy of disinfection and sterilization. No matter which method we use, we must check whether there is any factor will affect the result or not.

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Are you sure that your sterilizer conform to the standards?

        Along with the time progresses, continuous development, the develop of globalization also become the trend. Then, the globalization will increase the interpersonal have more contact, it induce the new disease and mutant bacteria will be more and more indirectly. In order to avoid and decrease the chance to contact or spread the contagious disease, the medical standard are also become more strict and careful. According to the acceptance criterion, the instruments and materials must have proper sterilization, so the sterilizer monitoring become an essential part of the medical approval standard.

        The sterilizer monitoring means that periodically checked the instruments are really clean and sterility after the sterilization or disinfection. But it is impossible to check each processed item for sterility. Instead, a set of monitoring processes increase the probability that sterilization did occur. There are three types of the sterilizer monitoring. But using a combination of physical, chemical, and biological indicators is the best way to monitored.

sterile equipment

1) Physical Indicator:

The handlers should record the cycle time, the temperature, and the pressure which is displayed on the sterilizer gauges for each sterile equipment. To make sure the all standards are accomplished.

2) Chemical Indicator:

Use the chemical indicators, such as visual indicator tapes. This indicators will change color after exposure to the proper sterilization environment. But this is not the reliable indicator, because when the temperature increased, the indicator color will be changed. But it does not display how long had been maintained at the highest temperature. So this indicator can’t ensure the temperature and the time whether accomplish the approval standard during the sterilize process, and it also can’t make sure the steam have infiltrated into the sterilization pouches.

Chemical Indicator

 Biological Indicator

3) Biological Indicator:

The biological indicator is use for the high-pressure steam sterilizers and dry-heat sterilizer. This process uses the pouch which include highly resistant, nonpathogenic bacterial endospores as microbial challenges, and put this pouch on the center space of the sterilizer. After the sterilization, we culture this endospore pouch in the suitable environment. If the positive spore test result indicates that the pouch still grew the bacteria, it means this examine process failed, either the sterilize time or the temperature is not enough.

        According to the control disease center, they recommended the medical equipments should be examined by the biological indicator every week. In addition, if the biological indicator test is positive, or the physical or chemical test results indicate failure, the sterilizer should not be used until the reason for failure has been identified and corrected.


References: 
Picture 2: Chemical Indicator http://www.danaproducts.com/index.html
Picture 3:  Biological Indicator  http://www.bge.com.tw/BIOINDI/BIOINDI/engEZS6.htm

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Keeping the operating environment clean to protect both the patient and dentist.

       The clinical or hospital is the place which need very strict and serious requirements for disinfection and isolation. The probability of cross-infection between people and objects is relatively higher. So the hospital how control effectively the problem of cross infection and nosocomial infection is an important symbol.

       For the dentistry is easier to contact the infection than other professional. We must pay more attention to the infection both the patient and dentist, so we should remember many ways that can decrease the probability of the infection. 

Take the gloves and mask 

Before the treatment, we should clean all the tables or instruments before the patient sit in the dental chair. But we should take the gloves and mask before we use the detergent to clean the device.

 Use the detergent on the paper and wipe the dental chair

1) We use the detergent on the paper and wipe the dental chair, because the dental chair is the most contact to the patient.

Clean the table

     

  2) Because we always put the materials on the table and the instruments which we use and put into the patient’s mouth, so we also need to clean the table, it decrease the contact with the bacteria.

Clean the operating lam

3)  We always use the operating lamp, we should clean the handle of the lamp. This part is very easy forget to clean it.

Clean the suction and the tube

 4) We suck the wastewater from the patient’s mouth by the suction. So we don’t forget to clean the suction and the tube.

5)After  the treatment, we should clean the infected instruments by the brush. Then, we put the instrument into the box which fill the glutaraldehyde solution for few minutes. The glutaraldehyde solution make further to clean the bacteria on the instruments.

  6) After the instrument immerse the glutaraldehyde solution for few minutes. We take out the instruments and use the paper wipe the excess water. Final, we encase the instruments in the sterilization pouches. Bring all the sterilization pouches to do the sterilization.

 Finally, it’s important to keep the operating environment clean and decrease the probability to contact the bacteria. The medical personnel should make sure the instruments are clean and asepsis for the patients. We should change the gloves for the different patient and we should not touch other objects when we wear the gloves. Those behaviors is not only to protect the patients, but also to protect ourselves when we doing the treatment.

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