Ch 8 (reprocessing) Flashcards
3 levels of disinfection?
-Low level
-High level
-Sterile
When would we use low level disinfection?
-Used to clean equipment in place
-Used for equipment that does NOT come into contact with mucous membranes/open wounds
-Used when there is no evidence of biological contamination on the equipment
What cleaning product do we use with low level disinfection?
Cavi-Wipe (or similar product)
When would we use high level disinfection?
-Used to clean equipment that HAS come into contact with mucous membranes, blood + bodily fluids
-Used to eliminate many or all pathologic organisms
What types of equipment would require high level disinfection?
-EV transducers
-Endocavitary probes
-Probes used during biopsies
Where do probes get cleaned with high level disinfection?
In a reprocessing room
(purpose built to ensure the cleanliness of the process)
What cleaning agents are used with high level disinfection?
Enzymatics, CIDEX, CIDEX OPA, Revital-OX, UV light
When would we use sterile disinfection?
-Used to clean reusable equipment that comes DIRECTLY into contact with mucous membranes, blood + bodily fluids
-Used to destroy all forms of microbial life
What types of equipment would require sterile disinfection?
In u/s department:
-Biopsy guns
-Metal biopsy trays
-Glassware
-Biopsy guides
What is the process of sterile disinfection?
Items are pre-washed with soap + water to remove gross solids before being placed in a bin to be picked up by the CPS/MDR staff
(central processing services/medical device reprocessing)
What is the low level disinfection process?
-Wipe off gel from probe
-Use cavi wipe to disinfect probe/machine + leave to air dry
-Ensure we wipe equipment within 5-10 mins of contact time to be fully effective
What happens if we use a wipe on equipment that is not an approved product?
We will VOID our warranty. The wipe can damage the equipment + u/s crystals
If there is blood or bodily fluids on our probe, what level of disinfection should we do?
High level
(can put any type of probe in the cleaning solution in the reprocessing room, not just EV)
If a probe has been covered with a probe cover, what level of disinfection should we do?
High level
What is the high level disinfection process?
-Wipe gel + blood off probe
-Scrub probe with an enzymatic sponge for 1-2 min in the dirty sink
-Rinse probe in dirty sink
-Dry probe with lint free cloth + place it into the cleaning solution/device (for 5-7 min)
-Rinse probe in clean sink + wipe with lint free cloth
-Place probe in plastic container or negative pressure storage (if available)
What must we check before we can place a probe into the cleaning solution?
-Test solution to ensure it is active
-Check temp to ensure it is warm enough
(some processes don’t require these steps)
How long should a probe soak in the cleaning solution?
5-7 mins
Equipment that requires sterilization will be processed where?
In a central reprocessing department of a hospital
3 sterile processes used?
-Autoclave (steam)
-Gas (ethylene oxide)
-Liquid chemicals
What type of process would be used for probes if they require sterile disinfection?
Gas or liquid chemicals used
(do not send a probe to the autoclave as they are sensitive to high heat!)
What must be done to the equipment before it can undergo the sterile disinfection process?
Equipment must have an enzymatic presoak/scrub to remove all biosolids prior to the sterilization procedure
4 steps in transporting clean probes?
-Wash hands + don gloves
-Clean probe removed from storage cabinet + placed in clean bin (with green cover over it)
-Probe now transported in the bin to the exam room
-Probe removed from bin + covered with probe cover to perform exam (for EV + biopsy procedures)
4 steps in transporting dirty probes?
-Remove probe cover + wipe gel off
-Place probe into bin + cover with red cover
-Transport bin to reprocessing room
-Place bin on dirty side next to dirty sink
What type of chemical disinfectant does camosun use?
Revital-Ox resert brand
What are 4 benefits of using revital-ox?
-Works in 5 min when temp is 20 degrees celsius or higher
-Low odor (2% accelerated hydrogen peroxide)
-Does not need special ventilation (as long as room has 10 air exchanges an hour)
-Is cheap + safe!
List other disinfection methods?
-UV light
-Trophon EPR
-CIDEX + CIDEX OPA
How does a UV light work?
Use light for 3 mins after an enzymatic rinse + drying
What are cons to using UV lights?
-Very expensive
-Bulbs need replacing
-Cycle time is longer (as bulbs age)
Where are UV lights used?
Comox + Campbell River
What is a trophon EPR?
A contained unit that uses accelerated hydrogen peroxide formula used with heat in order to disinfect
What are cons of using trophons?
-Very expensive per cycle
-Burns skin
Where are trophons used?
No longer used on island
What are cons to using CIDEX + CIDEX OPA?
-Carcinogenic
-Multiple heath effects
Where is CIDEX + CIDEX OPA used?
Rarely used anymore
What 2 associations describe how medical device reprocessing should be carried out?
-Sonography Canada Professional Practice Guidelines
-Canadian Standards Association
(the standards are used to develop reprocessing procedures within all u/s departments)
During decontamination, what must we wear?
PPE
(according to MSDS - material safety data sheets)
How do we go about removing a probe cover?
Remove with gloves + dispose of it immediately in the u/s room
(make sure you are using an approved probe cover)
Should we disconnect the probe from the system before or after we wipe it?
Disconnect it, than wipe the probe + cord afterwards
Why should the reprocessing room be separated from function work areas?
To maintain oneway flow from dirty to clean, this avoids cross contamination
If contaminated items are transported in an open cart, what must it have on it?
A waterproof cover, with containers that indicate contaminated medical devices (must be a design that allows for effective decontamination after each use)
What must be done prior to the high level disinfection process?
-Probe must be cleaned
-Entire cord must be wiped thoroughly
Why should we inspect transducers?
Look for damage - don’t use if any
When soaking a probe, what must we be careful of?
Ensure the cleaning solution does not enter the device or connector
After the probe is soaked in cleaning solution, what must we do?
Rinse it with water
To ensure adequate quality control, what must we do as part of the cleaning + decontamination process?
Documentation + monitoring
List of basic documentation?
-Disinfectant
-Test strip
-Probe
-Automated reprocessing machine info
What is on the transducer reprocessing record document?
-Date
-Transducer serial #
-Pt MRN
-Test strip (pass/fail)
-EXP of test strip
-Solution temp (20 or higher)
-EXP of solution
-Time in/out of solution (5 mins)
-Tech initials
