elimination of large numbers of small capacity
ultrasonic baths and tabletop sterilizers in each DTR
can be replaced by the central sterilization approach
that has larger capacity centralized equipment.
Whether a centralized or individual sterilization
area is used, contaminated instruments and equipment
must be processed as described next.
Management of Contaminated Instruments
Following the completion of a patients treatment,
the dental assistant will take the contaminated
instruments and equipment directly to the CSR
technician in the receiving area of the CSR. Figure
10-3 illustrates a contaminated instrument pack that
has been placed in the designated drop-off location in
the receiving area. The CSR technician should take the
contaminated instruments and equipment and set them
in the receiving area that has been designated as a
temporary hold area until they can be processed.
Do not rinse, scrub, or unnecessarily handle
contaminated instruments or materials in DTRs or
other patient treatment areas. In the most extenuating
circumstances, only the CO (designee) or the infection
control officer (ICO) under written direction may
make exceptions to this requirement. This does not
include handpiece maintenance that will be performed
in the CSR or DTR depending on your clinics policy.
You should take contaminated instruments from
the receiving area wearing heavy duty puncture-
resistant gloves while handling all potentially
contaminated items. Break down all packs and place
disposable items and contaminated linens in
appropriate containers. All contaminated, reusable
items must be decontaminated by immersion in an
Enviormental Protection Agency (EPA) registered
disinfectant before further handling. This step can be
eliminated if these items are cleaned in an ultrasonic
cleaner (bath) with an EPA-registered disinfectant that
also is approved as an ultrasonic cleaning solution.
Process instruments using one of the following
methods. They are discussed in order of preference.
AUTOMATED WASHER PROCESSOR.
The automated washer processor is the safest method
and provides an effective cleaning process. It is
commonly used in hospitals or very large dental
clinics. Contaminated instruments are placed in
cassettes or baskets. Then they are run through the
units cycle of cleaning, rinsing, and disinfection at
temperatures high enough to provide at least a high
level of disinfection. This results in a not touch
system in which the potential for injury during
instrument processing is greatly reduced.
Figure 10-3.Contaminated instrument pack placed at the entrance of the receiving area in the CSR.