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NAVEDTRA 14295B: HM Manual > Chapter 10 - Disinfection and Sterilization > Flashcards

Chapter 10 - Disinfection and Sterilization Flashcards

0
Q

What is a less lethal process than sterilization, which kills diseases causing micro-organisms?

A

Disinfection

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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

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2
Q

Disinfection is archived by what two means?

A

Heat and Chemical

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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

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4
Q

The Environmental Protection Agency classifies disinfectants as?

A

High, intermediate, or low level.

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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

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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.

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7
Q

When selecting a product, what do you want to make sure on the label?

A

That it has an EPA registration number

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8
Q

What are the four most commonly used chemical agents?

A

Glutaraldehyde and chlorine dioxide based solutions, iodophors, and phenolics.

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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

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10
Q

What chemical agent disinfectant classification are Glutaraldehyde Solutions?

A

High-level disinfectants

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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

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12
Q

What levels of a Glutaraldehyde-based solution are FDA registered?

A

2-3.2%

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13
Q

What are the PPE’s to handling Glutaraldehyde Solutions?

A

Gloves (hand irritation), eyes wear, and proper ventilation (extremely toxic vapors).

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14
Q

Chlorine dioxide is an effective surface disinfectant and sterilant. True or False?

A

True

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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

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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

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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

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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).

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19
Q

What level of disinfection are iodophors and phenolics classified as?

A

Intermediate

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20
Q

The biocidal activity of iodophors is accomplished with how many minutes of exposure?

A

10 - 25 minutes

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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

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22
Q

These are useful in the preparation of oral mucosa for local anesthesia, surgical procedures, and hand washing?

A

Iodophor antiseptics

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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

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24
Q

All semi-critical category items should receive what level of disinfection?

A

High-level disinfection

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25
Q

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.

A

Semi-critical

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26
Q

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.

A

Non-critical

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27
Q

Anesthetic cartridges for non-surgical use should be dispensed under ______ ______ guidelines to prevent contamination of bulk supplies.

A

Unit dose

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28
Q

All non-critical category items require at least what level of disinfection?

A

Intermediate

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29
Q

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?

A

Central Sterilization Room (CSR)

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30
Q

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?

A

Functional Flow Chart

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31
Q

In receiving and cleaning step, who decides where hand maintenance (disinfection, cleaning, and lubrication of dental hand pieces) should take place?

A

Command policies

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32
Q

What step/area in the Central Sterilization Room (CSR) Functional Flow Chart where all the inspecting, sorting, wrapping, and packaging of contaminated materials occur?

A

Processing

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33
Q

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?

A

Sterilization

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34
Q

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?

A

Sterile Storage and Issue

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35
Q

In what area of the Central Sterilization Room (CSR) will the HM take contaminated instruments after completion of a patient’s treatment?

A

Receiving

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36
Q

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?

A

Commanding Officer (designee) or the Infection Control Officer under written direction.

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37
Q

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?

A

Ultrasonic cleaner (bath)

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38
Q

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?

A

Automated Washer Processor

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39
Q

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?

A

Ultrasonic cleaning

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40
Q

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?

A

Cavitation

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41
Q

How full does the ultrasonic cleaner reservoir have to be at all times?

A

1/2 - 3/4 full

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42
Q

How often are cleaning solutions that must cover the items completely for the ultrasonic solution to occur have to be changed?

A

Daily or as needed

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43
Q

What is the limit for the ultrasonic cleaning time to avoid damage to instruments?

A

5 minutes

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44
Q

How many sinks are needed to allow personnel to perform the manual scrubbing method?

A

3

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45
Q

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?

A

Manual scrubbing

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46
Q

You should remove the instruments for the ultrasonic unit by what means?

A

Mesh basket

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47
Q

After drying the instrument, what is the next step before sorting them out according to sets or packs?

A

Inspect instruments

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48
Q

What is the last step to the sterilization process?

A

Wrapping and packaging

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49
Q

Where are instruments usually placed before placing them into the sterilizers?

A

Packs on metal trays or perforated cassettes

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50
Q

Do not place surgical knife blades or suture materials inside linen packs or on instrument trays before sterilization. True or False?

A

True

51
Q

What is used to seal both paper materials: form of bags or flat disposable wraps?

A

Adhesive indicator tape

52
Q

What is the shelf life of an overwraped heat sealed plastic or nylon tubing (should only be overwraped after the pack has been sterilized)?

A

180 days

53
Q

How are hinged instruments arranged during packaging?

A

Open

54
Q

To allow steam to circulate freely, how should packs be wrapped?

A

Loosely

55
Q

What will happen to the indicator tape with the tabs down that is used to wrap instruments when exposed to the sterilization elements?

A

It will change color

56
Q

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?

A

True

57
Q

The period during which sterilized items are considered safe for use is known by what term?

A

Expiration date or shelf life

58
Q

What type of related shelf life presumes that after the expiration date the item is considered outdated and should not be used?

A

Time-Related Shelf Life

59
Q

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?

A

365 days

60
Q

What is the time-related shelf life for the following items: non-woven blue wrap and parchment paper or Dennison wrap?

A

30 days

61
Q

What is the time-related shelf life for glass test tubes with screw caps?

A

Indefinite

62
Q

What type of related shelf life presumes continued sterility until the package is damaged, wet, or torn?

A

Event-Related Shelf Life

63
Q

When using the event-related method, how often do all sterilizers must be biologically monitored?

A

Weekly

64
Q

Items must be dry before they are handled or stored. True or False?

A

True

65
Q

Freshly sterilized items are NEVER placed on metal or cold surfaces. If they are what happens to the packages?

A

Become damp from the condensation and become contaminated

66
Q

When storing sterilized items, how should they be arranged?

A

Expiration, with later dates towards the rear.

67
Q

The word “sterile” means free from or the absence of all living organisms. True or False?

A

True

68
Q

What are the physical methods of sterilization?

A

Moist heat under pressure and dry heat.

69
Q

What are the chemical methods of sterilization?

A

Gas and liquid solutions

70
Q

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?

A

Steam under pressure (autoclave)

71
Q

A steam sterilizer may be referred auto by what other name?

A

Autoclave

72
Q

What are the two most common types of steam sterilizers used in the Navy?

A

Downward (Gravity) Displacement and Prevacuum

73
Q

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)?

A

Downward Displacement Autoclave

74
Q

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?

A

Allow steam free passage

75
Q

Articles that require the same amount of time and same final steps should be sterilized together. True or False?

A

True

76
Q

Pressure maintains temperature,it is not an indication of positive sterilization because other factors determine the pressure inside the sterilizer. True or False?

A

True

77
Q

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?

A

Prevacuum, High-temperature Autoclave

78
Q

What is one of the greatest dangers encountered when using saturated steam under gravity cycles?

A

Trapping of air

79
Q

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?

A

True

80
Q

At what temperature are all known organisms killed?

A

250 degrees F (121 degrees C)

81
Q

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)?

A

High speed (Flash) sterilizers

82
Q

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?

A

Bowie-Dick Test

83
Q

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?

A

Daily before being heated

84
Q

Who repairs the sterilizers if there are leaks in the lines and improperly functioning gauges, dials, thermometers, doors, drain strainers, and valves?

A

Bio-Medical Technician

85
Q

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?

A

Dry-Heat Sterilization

86
Q

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?

A

True

87
Q

What is the typical standard dry heat cycle?

A

90 minutes at 320-345 degrees F

88
Q

How often are biological monitoring performed for dry-heat sterilization?

A

Weekly

89
Q

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?

A

Chemical Vapor Sterilization

90
Q

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?

A

True

91
Q

What is the major disadvantage of the chemical vapor sterilization?

A

The need for adequate ventilation

92
Q

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?

A

STERRAD Sterilization Procedure

93
Q

Instruments being sterilized in the STERRAD do not have to be completely dry. True or False?

A

False

94
Q

How are trays placed on the STERRAD sterilizer rack and what should they not do with the sides of the chamber?

A

Placed flat and should not come into contact with the sides

95
Q

What type of material is used to wrap trays for the STERRAD sterilizer?

A

Polypropylene materials

96
Q

In the operating cycle, what stage removes air molecules and lower chamber pressure?

A

Vacuum Stage

97
Q

In the operating cycle, what stage introduces hydrogen peroxide into the chamber?

A

Injection Stage

98
Q

In the operating cycle, what stage do hydrogen peroxide vapor penetrate packages?

A

Diffusion Stage

99
Q

In the operating, what stage do radio frequency creates the electromagnetic field that converts the hydrogen peroxide into low temperature gas plasma?

A

Plasma Stage

100
Q

In the operating cycle, what stage permits air into the chamber to return to atmospheric pressure?

A

Vent Stage

101
Q

How many cells do each cassette hold and the remaining cells are indicated by the printout at the end of each cycle?

A

10 cells

102
Q

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?

A

True

103
Q

How many hours till the results are documented in the sterilization records and included in the monthly report to the Infection Control Officer?

A

48 hours

104
Q

How long are STERRAD sterilization stored for?

A

36 months

105
Q

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?

A

Ethylene Oxide sterilization

106
Q

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?

A

False

107
Q

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?

A

Glutaraldehyde

108
Q

The item must be totally submerged in Glutaraldehyde solution for how many hours and anything shorter than that is considered disinfected?

A

10 hours

109
Q

All critical category items require sterilization before turning them in for service or repair. True or False?

A

True

110
Q

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?

A

90 minutes at 320-345 degrees F

111
Q

What are the three most commonly used sterilization monitors in the Navy?

A

Physical, Chemical, and Biological Monitors.

112
Q

What type of monitoring involve looking at the gauges and readings on the sterilizer and recording the temperatures, pressure, and exposure time?

A

Physical Monitoring

113
Q

What type of monitoring has internal and external that involves the use of heat-sensitive chemical that changes color when exposed to certain conditions?

A

Chemical Monitoring

114
Q

What type of sterilization indicator will change color upon short exposure to sterilizing conditions such as steam, dry heat, or chemical vapor?

A

Internal Indicators

115
Q

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?

A

External Indicator

116
Q

First test: chemical indicator failed. Second test: chemical and biological indicators are place and chemical fails. If the indicator fails again, who are notified?

A

The Infection Control Officer (ICO) and biomedical repair personnel

117
Q

Only biological monitoring can tell the HM wether or not sterilization has actually occurred. True or False?

A

True

118
Q

Which type of monitoring a designed to assess whether sterilization actually occurred and to confirm that all bacteria and endoscopes have been killed

A

Biological Monitoring

119
Q

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?

A

Daily monitoring

120
Q

What does a pH indicator in the medium color change mean when the ampules of endospores germinate and produces acids?

A

Failure in the sterilization process

121
Q

The use of a “_______ _______” is most practical while processing an instrument pack.

A

Test pack

122
Q

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?

A

True

123
Q

Who would you notify if the biological monitoring is found positive?

A

Notify the Infection Control Officer (ICO) and record test results in the sterilization log.

124
Q

How many hours do instruments and equipments are to be put on hold after a negative biological test and then distribute them?

A

48 hours

125
Q

If the biological test fails multiply times, what would be the next step?

A

Secure sterilizer and notify biomedical repair technicians and the ICO

NAVEDTRA 14295B: HM Manual (25 decks)

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