Chapter 10 - Disinfection and Sterilization Flashcards
0
Q
What is a less lethal process than sterilization, which kills diseases causing micro-organisms?
A
Disinfection
1
Q
What is the highest level of contamination control because of its results in the total destruction of all forms of microbial life?
A
Sterilization
2
Q
Disinfection is archived by what two means?
A
Heat and Chemical
3
Q
The following criteria is what type of chemical disinfection:
- The degree of microbial kill or deactivation required.
- The composition and texture of the item being treated.
- The technical requirement and ease of use of the available agents.
A
Chemical
4
Q
The Environmental Protection Agency classifies disinfectants as?
A
High, intermediate, or low level.
5
Q
What are the two types of micro-organisms that are killed by all three levels of disinfection?
A
Lipid Viruses and Vegetative Bacteria
6
Q
What are the three factors that influence germicidal procedures?
A
Nature of the material, bioburden, organic debris present, and the type and concentration of the germicide.
7
Q
When selecting a product, what do you want to make sure on the label?
A
That it has an EPA registration number
8
Q
What are the four most commonly used chemical agents?
A
Glutaraldehyde and chlorine dioxide based solutions, iodophors, and phenolics.
9
Q
What type of chemical agent disinfectant classification is used chiefly on inanimate objects to destroy or inhibit the growth of harmful organisms or sterilants?
A
High-level disinfectant
10
Q
What chemical agent disinfectant classification are Glutaraldehyde Solutions?
A
High-level disinfectants
11
Q
Due to the excessive amounts of exposure time required, corrosiveness, skin sensitization, and odor, Glutaraldehyde Solutions are not to be used as this?
A
Surface disinfectants
12
Q
What levels of a Glutaraldehyde-based solution are FDA registered?
A
2-3.2%
13
Q
What are the PPE’s to handling Glutaraldehyde Solutions?
A
Gloves (hand irritation), eyes wear, and proper ventilation (extremely toxic vapors).
14
Q
Chlorine dioxide is an effective surface disinfectant and sterilant. True or False?
A
True
15
Q
Chlorine Dioxide Solutions may be used as what level of disinfectants on semi-critical items that are not subject to corrosion?
A
High-level
16
Q
How many minutes is the rapid action for disinfection does chloride dioxide solution have? How many hours for sterilization?
A
3 minutes for disinfection and 6 hours for sterilization
17
Q
Chlorine Dioxide Solution has the following disadvantages:
- Must be discarded daily.
- Has a 24 hour use as a sterilant.
- Does not readily penetrate inorganic debris.
True or False?
A
True
18
Q
What PPE’s must be used for chlorine dioxide solutions?
A
Gloves (skin irritation), eye wear (eye irritation), adequate ventilation (when using surface disinfection) and closed containers (corrodes aluminum).
19
Q
What level of disinfection are iodophors and phenolics classified as?
A
Intermediate
20
Q
The biocidal activity of iodophors is accomplished with how many minutes of exposure?
A
10 - 25 minutes
21
Q
What is the type of chemical agent that loses effectiveness when the color changes from amber to clear, unstable at high temperatures, and can have rapid loss of antimicrobial activity when inactivated by hard water or alcohol (distilled or softened water is recommended for dilution)?
A
Iodophors
22
Q
These are useful in the preparation of oral mucosa for local anesthesia, surgical procedures, and hand washing?
A
Iodophor antiseptics
23
Q
This type of chemical agent is useful on metal, glass, rubber,and plastic, and are less toxic and corrosive than Glutaraldehyde Solutions?
A
Phenolics
24
All semi-critical category items should receive what level of disinfection?
High-level disinfection
25
The following __________-_________ category items require chemical disinfection: three way syringe tips, High-Volume Evacuator (HVE) saliva ejector, radiographic positioning devices, nitrous oxide masks, and breathing tubes.
Semi-critical
26
The following ____-________ category items require chemical disinfection: dental delivery systems (DDS), consisting of chair, unit, and light; portable dental units; surgical table and chair; and x-ray apparatus.
Non-critical
27
Anesthetic cartridges for non-surgical use should be dispensed under ______ ______ guidelines to prevent contamination of bulk supplies.
Unit dose
28
All non-critical category items require at least what level of disinfection?
Intermediate
29
Healthcare Treatment Facilities must have a _________ _________ _________ with the design and outfitting that includes work areas for receiving, cleaning, processing, sterilizing, storing, and issuing of instruments and equipment?
Central Sterilization Room (CSR)
30
What should all Central Sterilization Rooms (CSRs) have where equipment, instruments, and materials are first introduced into the receiving area, and work their way through to the issue area in a specific order?
Functional Flow Chart
31
In receiving and cleaning step, who decides where hand maintenance (disinfection, cleaning, and lubrication of dental hand pieces) should take place?
Command policies
32
What step/area in the Central Sterilization Room (CSR) Functional Flow Chart where all the inspecting, sorting, wrapping, and packaging of contaminated materials occur?
Processing
33
What step/area in the Central Sterilization Room (CSR) Functional Flow Chart where the space is determined by the available size, the degree of sufficient access for loading and unloading, and the ability to service the sterilizer occurs?
Sterilization
34
To protect and maintain all sterile items,the storage and issue areas should not be in the immediate vicinity of the contaminated processing areas is what step/area of the Central Sterilization Room (CSR) Functional Flow Chart?
Sterile Storage and Issue
35
In what area of the Central Sterilization Room (CSR) will the HM take contaminated instruments after completion of a patient's treatment?
Receiving
36
Who can make an exception to the "do not rinse, scrub,or unnecessarily handle contaminated instruments or materials in MTRs/DTRs or other patient areas?
Commanding Officer (designee) or the Infection Control Officer under written direction.
37
The step of all contaminated reusable items being decontaminated by immersion in an EPA-registered disinfectant before handling can be eliminated if the items are cleaned in what?
Ultrasonic cleaner (bath)
38
What is the safest method and provides an effective cleaning process, commonly used in hospitals or very large dental clinics, instruments are placed in cassettes or baskets, and results in "not touch" system to reduce potential injury?
Automated Washer Processor
39
What process of instrument cleaning is safer and more effective than manual scrubbing, eliminates possibility of puncture wounds, eliminates splatter of organism-laden debris and uses electrical energy to generate sound waves which extends the usage life of cutting instruments?
Ultrasonic cleaning
40
Ultrasonic cleaner produces a cleaning effect that generates sound waves that travel through liquid, where millions of bubbles form and burst continuously, which is commonly called what?
Cavitation
41
How full does the ultrasonic cleaner reservoir have to be at all times?
1/2 - 3/4 full
42
How often are cleaning solutions that must cover the items completely for the ultrasonic solution to occur have to be changed?
Daily or as needed
43
What is the limit for the ultrasonic cleaning time to avoid damage to instruments?
5 minutes
44
How many sinks are needed to allow personnel to perform the manual scrubbing method?
3
45
What instrument cleaning process would you use heavy duty utility gloves, face mask, plastic apron, and eye protection when placing instruments in a disinfectant solution, and then clean them under water?
Manual scrubbing
46
You should remove the instruments for the ultrasonic unit by what means?
Mesh basket
47
After drying the instrument, what is the next step before sorting them out according to sets or packs?
Inspect instruments
48
What is the last step to the sterilization process?
Wrapping and packaging
49
Where are instruments usually placed before placing them into the sterilizers?
Packs on metal trays or perforated cassettes
50
Do not place surgical knife blades or suture materials inside linen packs or on instrument trays before sterilization. True or False?
True
51
What is used to seal both paper materials: form of bags or flat disposable wraps?
Adhesive indicator tape
52
What is the shelf life of an overwraped heat sealed plastic or nylon tubing (should only be overwraped after the pack has been sterilized)?
180 days
53
How are hinged instruments arranged during packaging?
Open
54
To allow steam to circulate freely, how should packs be wrapped?
Loosely
55
What will happen to the indicator tape with the tabs down that is used to wrap instruments when exposed to the sterilization elements?
It will change color
56
After the packs, instruments, and supplies are wrapped or placed into containers and sealed, they must be labeled with the identification number of the sterilizer, the preparer's initials, the dates of sterilization and expiration before they are placed in the sterilizer. True or False?
True
57
The period during which sterilized items are considered safe for use is known by what term?
Expiration date or shelf life
58
What type of related shelf life presumes that after the expiration date the item is considered outdated and should not be used?
Time-Related Shelf Life
59
What is the time-related shelf life for the following items: paper envelope (sealed with sterilization tape); non-woven blue wrap, plastic covered, heat-sealed; and peel plastic packs, heat-sealed or self-sealed?
365 days
60
What is the time-related shelf life for the following items: non-woven blue wrap and parchment paper or Dennison wrap?
30 days
61
What is the time-related shelf life for glass test tubes with screw caps?
Indefinite
62
What type of related shelf life presumes continued sterility until the package is damaged, wet, or torn?
Event-Related Shelf Life
63
When using the event-related method, how often do all sterilizers must be biologically monitored?
Weekly
64
Items must be dry before they are handled or stored. True or False?
True
65
Freshly sterilized items are NEVER placed on metal or cold surfaces. If they are what happens to the packages?
Become damp from the condensation and become contaminated
66
When storing sterilized items, how should they be arranged?
Expiration, with later dates towards the rear.
67
The word "sterile" means free from or the absence of all living organisms. True or False?
True
68
What are the physical methods of sterilization?
Moist heat under pressure and dry heat.
69
What are the chemical methods of sterilization?
Gas and liquid solutions
70
What is the most dependable and economical method of sterilization that is the method of choice for metalware, glassware, most rubber goods, and dry goods?
Steam under pressure (autoclave)
71
A steam sterilizer may be referred auto by what other name?
Autoclave
72
What are the two most common types of steam sterilizers used in the Navy?
Downward (Gravity) Displacement and Prevacuum
73
What type of sterilizer was designed to force air downward in the chamber from the top of the chamber and the actual timing does not begin until the temperature is above 245 degrees F (118 degrees C)?
Downward Displacement Autoclave
74
What is allowed when you place all packages on edges, with large packs at the bottom of the chamber, and small packages in an upper layer crosswise to the lower layer?
Allow steam free passage
75
Articles that require the same amount of time and same final steps should be sterilized together. True or False?
True
76
Pressure maintains temperature,it is not an indication of positive sterilization because other factors determine the pressure inside the sterilizer. True or False?
True
77
What type of sterilizer was designed to overcome the trapping of air in the chamber and is the most modern and economical autoclave to operate and requires the least time to sterilize a single load?
Prevacuum, High-temperature Autoclave
78
What is one of the greatest dangers encountered when using saturated steam under gravity cycles?
Trapping of air
79
When errors are made by improperly packaging items or overloading the sterilizer chamber, cool air pockets may form resulting in items not being sterilized. True or False?
True
80
At what temperature are all known organisms killed?
250 degrees F (121 degrees C)
81
What are all operating rooms using to sterilize wrapped, covered, opened instruments placed in perforated trays for 3 minutes at 270 degrees F (132 degrees C)?
High speed (Flash) sterilizers
82
What was developed as a daily test for pre-vacuum sterilizers to determine if the air has been removed from the chamber during the pre-vacuum stage?
Bowie-Dick Test
83
How often is the interior of the steam sterilizer cleaned because if not done _______ the chamber walls will collect mineral deposits and may become greasy?
Daily before being heated
84
Who repairs the sterilizers if there are leaks in the lines and improperly functioning gauges, dials, thermometers, doors, drain strainers, and valves?
Bio-Medical Technician
85
What is the least expensive form of heat sterilization and operates by heating up air and transferring that heated air into the chamber with the instruments?
Dry-Heat Sterilization
86
The disadvantages of dry-heat sterilization are high temperatures destroy many rubber and plastic based materials, melt the holder of most metal impression trays, and weaken some fabrics, as well as discolor other fabrics and paper materials. True or False?
True
87
What is the typical standard dry heat cycle?
90 minutes at 320-345 degrees F
88
How often are biological monitoring performed for dry-heat sterilization?
Weekly
89
This sterilization process requires 20-40 minutes at 270 degrees F with 20 psi and the use of a mixture of the chemicals, including alcohol, formaldehyde, ketone, acetone, and water?
Chemical Vapor Sterilization
90
The advantages of of chemical vapor sterilization are:
- No corrosion, rusting, and dulling of instruments since water content is only 15 percent (if instruments are dry when placed in chamber).
- Prevents destruction of dental items.
- Instruments are dry at the end of the cycle.
True or False?
True
91
What is the major disadvantage of the chemical vapor sterilization?
The need for adequate ventilation
92
What type of sterilization uses plasma state hydrogen peroxide to sterilize products unable to withstand steam sterilization parameters and have been approved in writing by the medical device manufacturer?
STERRAD Sterilization Procedure
93
Instruments being sterilized in the STERRAD do not have to be completely dry. True or False?
False
94
How are trays placed on the STERRAD sterilizer rack and what should they not do with the sides of the chamber?
Placed flat and should not come into contact with the sides
95
What type of material is used to wrap trays for the STERRAD sterilizer?
Polypropylene materials
96
In the operating cycle, what stage removes air molecules and lower chamber pressure?
Vacuum Stage
97
In the operating cycle, what stage introduces hydrogen peroxide into the chamber?
Injection Stage
98
In the operating cycle, what stage do hydrogen peroxide vapor penetrate packages?
Diffusion Stage
99
In the operating, what stage do radio frequency creates the electromagnetic field that converts the hydrogen peroxide into low temperature gas plasma?
Plasma Stage
100
In the operating cycle, what stage permits air into the chamber to return to atmospheric pressure?
Vent Stage
101
How many cells do each cassette hold and the remaining cells are indicated by the printout at the end of each cycle?
10 cells
102
A biological pack will be placed on top of an instrument set and placed on the bottom shelf to the rear of the chamber with each load. True or False?
True
103
How many hours till the results are documented in the sterilization records and included in the monthly report to the Infection Control Officer?
48 hours
104
How long are STERRAD sterilization stored for?
36 months
105
What type of sterilization uses low temperatures and sterilization is achieved in 4-12 hours at 120 degrees and also requires at least 16 hours of aeration after each cycle?
Ethylene Oxide sterilization
106
Because of the serious Occupation Safety Health Agency (OSHA) problems with Ethylene Oxide (ETO) Gas, Healthcare facilities should purchase new ETO equipment. True or False?
False
107
What is the only liquid chemical, if properly used, is capable of rendering an item sterile and is extremely caustic to skin, mucous membranes, and other tissues?
Glutaraldehyde
108
The item must be totally submerged in Glutaraldehyde solution for how many hours and anything shorter than that is considered disinfected?
10 hours
109
All critical category items require sterilization before turning them in for service or repair. True or False?
True
110
One accepted method of sterilization for burs and diamonds are to place them in screw cap glass test tube or aluminum foil wrapped bur block and dry heat sterilize for how many minutes?
90 minutes at 320-345 degrees F
111
What are the three most commonly used sterilization monitors in the Navy?
Physical, Chemical, and Biological Monitors.
112
What type of monitoring involve looking at the gauges and readings on the sterilizer and recording the temperatures, pressure, and exposure time?
Physical Monitoring
113
What type of monitoring has internal and external that involves the use of heat-sensitive chemical that changes color when exposed to certain conditions?
Chemical Monitoring
114
What type of sterilization indicator will change color upon short exposure to sterilizing conditions such as steam, dry heat, or chemical vapor?
Internal Indicators
115
What type of sterilization indicator are chemical dyes that change color upon short exposure to sterilizing conditions, generally printed on packaging materials or supplied in tape form, and not sensitive enough and should not be used?
External Indicator
116
First test: chemical indicator failed. Second test: chemical and biological indicators are place and chemical fails. If the indicator fails again, who are notified?
The Infection Control Officer (ICO) and biomedical repair personnel
117
Only biological monitoring can tell the HM wether or not sterilization has actually occurred. True or False?
True
118
Which type of monitoring a designed to assess whether sterilization actually occurred and to confirm that all bacteria and endoscopes have been killed
Biological Monitoring
119
The Centers for Disease Control and Prevention (CDC), the ADA, and the Organization for Safety and Asepsis Procedures (OSAP) recommend at least weekly. What is preferred?
Daily monitoring
120
What does a pH indicator in the medium color change mean when the ampules of endospores germinate and produces acids?
Failure in the sterilization process
121
The use of a "_______ _______" is most practical while processing an instrument pack.
Test pack
122
Biological spore strips or ampules should be placed between several layers of folded wrapping material, and then the test pack is double-wrapped in the normal manner. True or False?
True
123
Who would you notify if the biological monitoring is found positive?
Notify the Infection Control Officer (ICO) and record test results in the sterilization log.
124
How many hours do instruments and equipments are to be put on hold after a negative biological test and then distribute them?
48 hours
125
If the biological test fails multiply times, what would be the next step?
Secure sterilizer and notify biomedical repair technicians and the ICO
