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Learn about sterilization monitoring, equipment testing methods, and the importance of proper sterilization in dental care. Discover the benefits of biological monitoring and how to choose a monitoring service. Stay compliant with OSDB mandates for weekly testing.
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STERILIZATIONMONITORING SERVICE Joen Iannucci Haring, DDS, MS Director, Sterilization Monitoring Service The Ohio State University College of Dentistry July 16, 2008
HANDOUT • OBJECTIVES • BACKGROUND INFORMATION • STERILIZATION MONITORING • MONITORING SERVICES • OSU SMS • APPENDIX
BACKGROUND INFORMATION • What is the difference between sterilization and disinfection? • What must be sterilized? • How are items sterilized? • What types of sterilizers can be used? • How do you know if the sterilizer is working?
STERILIZATION • Destruction of all forms of microbial life, including spores. • Bacterial sporesmust be killed. • Spores are themostheat-resistant microbial forms.
DISINFECTION • The inhibition or killing of pathogens. • Bacterial spores are not killed during disinfection.
STERILIZATIONQUESTIONS . . . • What must be sterilized? • How are items sterilized? • What types of sterilizers can be used ? (page 9)
HOW DO YOU KNOW IF YOUR STERILIZER IS WORKING ? • Equipment must be monitored for proper functioning. • Spore tests, or biological indicators (BI), are used to monitor sterilization equipment.
WHY MONITOR STERILIZATION EQUIPMENT ? • CDC recommendations. • ADA recommendations. • OSDB mandates weekly testing.
WHAT IS BIOLOGICAL MONITORING ? • Processing of highly resistant bacterial spores in a sterilizer. • Culturing of spores to determine if they have been killed. • A spore strip (BI) contains the spores used in monitoring.
WHAT IS A SPORE STRIP ? • Small piece of paper that contains spores. • Spores includeBacillus subtilisand Bacillus stearothermophilus. • A spore strip is enclosed in a glassine paper envelope.
HOW IS STERILIZATION CONFIRMED ? • Process spore strip in sterilizer. • Mail spore strip to monitoring service. • Spore strip is placed in culture media. • Incubated in culture media for 7 days. • Inspected each day for cloudiness.
TESTING Spore strips are placed in culture media. Testing is performed under a hood.
TESTING Spore strips are placed in test tubes filled with culture media using aseptic technique.
INCUBATION Spore strips in culture media are placed in an incubator for a total of seven days.
CHECKING FOR FAILURES Each day, all test tubes are inspected for cloudiness.
WHAT IS A FAILED TEST ? • Cloudiness in culture media indicates a failed test. • A Gram stain is prepared to identify Bacillus in the failed test. • A failed test means that the sterilizer did not kill the spores.
GRAM STAIN A Gram stain is used to rule out contamination & to verify the presence of the Bacillus organism.
WHAT CAUSES A TEST TO FAIL ? • See page 10 for a complete list. • Operator error is most common. • Examples: inadequate time or temperature/pressure, overloading the sterilizer or wrong packaging.
WHAT IS CHEMICAL MONITORING ? • Use of heat sensitive chemicals to assess physical conditions. • Does not indicate sterilization has taken place.
WHY USEA MONITORING SERVICE ? • Provides outside proof of testing via an independent testing entity. • Avoids “grading your own paper”.
HOW TO CHOOSE A MONITORING SERVICE ? • Cost? • Service? • Benefits? • Testing?
SMS FACILITY • Rooms 3127 & 3131 Postle Hall • Approximately 1200 clients • Process 62,000 tests / year • Net profits used to support clinics and research in the College
Educate staff Assign one person Establish a routine Testing calendar Mail tests promptly Maintain failure log Review reports Review problems Report to staff File reports Retain reports SMS TESTING CHECKLIST
IMPORTANT POINTS TO REMEMBER . . . • Sterilization vs. disinfection ? • What is biological monitoring? • Why is monitoring important ? • Biological vs. chemical monitoring ? • OSDB mandates weekly testing • SMS at OSU College of Dentistry
True/False Quiz 1. SMS services may report your failures to the OSDB. 2. You should close your office if a sterilizer fails. • OSDB does not perform random sterilization checks. • SMS’s have been proven many times to reduce infection transmission in dental offices. • OSDB can only use patient charts to prove infection control violations with the patient’s permission/consent. • You should inform patients of SMS failures. • SMS’s were mandated in response to AIDS hysteria.