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SURG TESTS > Chapter 7 pt 2 > Flashcards

Chapter 7 pt 2 Flashcards

disinfection, decontamination, sterilization

1
Q

disinfection

A

microorganisms on inanimate surfaces are destroyed

reduces 99% of pathogens in room

not including spores

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2
Q

antisepsis

A

most but not all microorganism on animate surfaces are destroyed

surgical scrub, surgical site

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3
Q

antiseptic

A

surgically clean animate surfaces

cannot fully kill everything

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4
Q

sterilization

A

destruct all microorganisms + spores on inanimate surfaces

anything used on wound needs to be sterile, even if they don’t come in direct contact (basin)

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5
Q

CDC/ FDA system does what (classification of pt care items)

A

rates degree of risk for infection
- how item will be used
- where items will be used

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6
Q

classification of patient care items

A

indicates appropriate method of disinfection/ sterilization to be used

  • critical (sterilisation)
  • semi- critical (high level disinfect)
  • non- critical (low level disinfect)
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7
Q

critical items

A

invasive/ vascular access
high potential for SSI
- monitors/ probes/ vascular or urinary/ implantable

STERILIZED!!!

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8
Q

semi critical items

A

mucous membrane or non intact skin within mucous
- natural orifices

lesser risk of infection
- laryngoscopes, endoscopes, resp eq

at minimum, high level disinfectant

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9
Q

non critical items

A

pt intact skin or clean equipment
least risk for SSI
- bp cuff

low level disinfectant

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10
Q

disinfection principles

A

safety when utilizing disinfecting agents
- never mix solutions
- use PPE when handling
- ventilated storage areas
- throw out expired solutions
- use for intended purpose

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11
Q

what do cleaning agents do

A

physically removing blood, body fluids bioburden

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12
Q

disinfecting agents

A

destroy pathogenic microorganisms by direct exposure to agents

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13
Q

3 levels of disinfection

A

high level - all microorganisms (not spores + prions)
intermediate level - most microorganisms + TB
low level - kills some virus, most bacteria
- ineffective against spores prions and TB

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14
Q

sterilizing agents

A

destroy all microorganism (spores but not prions)
- steam (most common) + chemical agents

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15
Q

disinfectant efficiency factors

A

concentration level of disinfectant
- high concentration increases level of disinfect

bioburden

contact time - contact with all surfaces, disassemble multiple part items

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16
Q

disinfection efficiency factors

A

selection based on item + classification
- critical, semi, non

manufactures recommendations - temp+ PH

exposure time
- 20- 30 minutes (high)
- 10- 15 minutes ( intermediate)

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17
Q

disinfectant compounds

A

high level:
- cidex aka glutaraldehyde
- household bleach aka sodium hypochlorite

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18
Q

intermediate or low level disinfectant compounds

A

phenol (carbonic acid)
alcohol

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19
Q

environmental decontamination

A

design is conductive to minimizing microbial counts
- washable floors and walls
- easily cleaned furniture
- prevent cross contamination

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20
Q

decontamination of the operating suite pre op

A

prior to first procedure
clean all surfaces especially horizontal ones
damp dusting:
- begin with the highest surface you can reach
remove mattress pads
clean fluids from floor
clean cabinet doors

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21
Q

decontamination of the operating suite inter op

A

basin with sterile water available
instruments not easily cleaned kept in basin
instruments with lumen periodically flushed
wet lap on mayo to wash instruments in between use

never use saline!!

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22
Q

turnover steps

A

clean
damp dusting
soak instruments no saline
mop
wash hands
clean up case cart

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23
Q

routine schedule for OR surfaces to clean

A

scrub sink, cabinets, floors, walls, ceiling

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24
Q

concurrent cleaning

A

by circulator
ASAP after cases

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25
reusable linen
handle as little as possible leakproof biohazard bags not rinsed or sorted on OR wear appropriate PPE
26
decontamination practices prior to first procedure
damp dust disinfectant solution horizontal surface, highest remove pads on OR table move OR table to mop under floor cabinet doors
27
decontamination practices intraop
soak clean instruments no saline periodically flush lumen
28
what to do for sharps in turnover
STSR responsibility puncture proof sharps container - no overflow
29
endoscopic to open case
order in which things are opened is CRITICAL for flow of surgery
30
things you HAVE to have in case cart
*blade bovie suction tip lap songe*
31
phrase for instruments needed in every case
start, control, and stop the bleeding
32
who recommends that the OR be cleaned between procedures
CDC
33
weekly cleaning routine
literally everything
34
what do do with a dirty case (infection/ disease)
last case of day clean with phenolic detergent cleaned with 70% alcohol rubber/ plastic tubing replaced
35
instrument cleaning cycle
operating room (in use) decontamination assembly + sterilize sterile storage repeat
36
decomtam room
filtered exhaust to outside negative pressure seperate from clean room
37
how much humidity + temp in decontamination
64-70 degrees 35- 72%
38
how many air exchanges in decontamination
10 time/ hr
39
cleaning instruments
soak proteolytic- gets blood
40
decontamination room purpose
remove physical debris
41
what kind of water does decontamination room use
neutral pH to not damage
42
cleaning solutions used in decontamination room
-chelation - prevents spots -enzymatic - break down tissue -emulsification - disperse 2 liquids that can't mix -solubilization - increases dissolvablty
43
characteristics of 1st sink for manual cleaning
*lukewarm, pH neutral, enzymatic cleaner* use soft brush ratchets + box locks change solution frequently
44
process of manual cleaning
clean with sink, 2nd sink used to rinse, dried for spots
45
mechanical cleaning
eliminates manual cleaning process 3 types of equipment prepare instruments
46
3 types of cleaning equipments
washer - sterilizer washer - decontaminator ultrasonic cleaner
47
washer disinfector phases
hands off processing 1 pre rinse 2 cleaning: detergent solution 3 final ringe: 185 degrees 4 dry: using high temp
48
washer sterilizer
requires manual cleaning - bakes on bioburden requires proper arrangement neutral pH instruments safe to handle
49
washer sterilizer phases
prerinse injects detergent fill total emergence wash- agitation post rinse steam sterilization - 270 degrees milking drying
50
ultra sonic cleaner
removes small particles in hard to get places used last usually
51
how the ultra sonic cleaner works
high sound waves convert to bubbles, bubbles get too big, unstable, implode- pulls particles off instrument to surface of solution
52
special care instruments
follow manufacture instruction flush lumen with hydrogen peroxide
53
cleaning power instruments
*do not submerge* *h20 only, never alcohol* - causes drying/ cracking lukewarm water oiling may be necessary - run 30- 60 seconds
54
cleaning rigid endoscopes
soaked in enzymatic solution stored dry avoid denting
55
*definition of sterility*
*absence of all living microbes, including spores* no grey area tissues are sterile
56
what are instruments checked for
function and integrity, prepared f or sterilization
57
where do you check function of instruments
CSPD
58
FDA + cosmetic act requirements for instrument packing and wrapping
packing material maintain sterility until use opened easily, prevent contamination sterilizing agent must be able to each all surfaces of the item
59
4 option of packing materials
woven non woven pouch packing (peel pack) rigid instrument container
60
what are woven textiles made up
cotton, or cotton blend reusable
61
woven textile ply
single ply (wrap x2), or double ply (x1) *towel may be placed in between instruments and wraps to assist with moisture absorption*
62
thread count range
140- 288 tc higher thread count, lower bacteria penetration
63
non wovan wrap characteristics
single use made of plastic synthetic fibers stored laid out flat
64
paper wrap characteristics
single use extreme memory, not flexible easily penetrated by steam
65
what is tyvek- plastic packaging used for
EtO and sterrad - steam will melt material and damage contents
66
what is the most common type of pouch packaging
*paper- plastic* at least 2mm- not flimsy
67
what is paper plastic packing used with
steam and EtO
68
why is correct size important for paper plastic packs
too big- compromise sterility too small- can tear, difficult to remove air
69
what is the order to put when double pouch packing paper plastic
paper to paper, plastic to plastic
70
what do we use to protect the tips with paper plastic pouching
commercial tip protector or foam sleeves ( no latex)
71
when do you label paper plastic pouching
prior to sterilization on plastic only
71
where on basket do you put paper plastic pouching
*placed on edge in perforated basket* all in the same direction
72
rigid instrument container characteristics
reusable: metal or plastic stackable + easily storable locking lids - chemical indicator assure sterility, can't be torn
73
what is used to return contaminated items to CSPD
rigid instrument containers
74
sterilization recommendations for rigid inst pans
placed on shelves (in autoclave) beneath absorbable items
75
in what conditions are woven fabrics stored
68-73 degrees 30-60% humidity 2 hours to rehydrate
76
what is AAMI max muslin wrap
12x12x20 - not exceed 12 lbs
77
how are linens packed in general packing
linens packed loose -allows steam to penetrate double wrap - single ply x2
78
what is the max weight for instrument pans and who sets it
25 lbs AAMI and ANSI
79
how large does the instrument set have to be
large enough to have 6" below on 4 sides of table or stand
80
how thick are instrument pan dust covers
2-3 mm thick - clearly marked if sterile
81
steps of preparation of instrument sets and basin sets
inspect reassemble preparation
82
inspection process of scissors/ trocars
look for cracks or scratches
83
inspection process of ratchets
ensure they don't spring
84
inspection process for clamps
make sure they stay locked jaws align
85
what do we need to ensure for preparation when reassembling
sterilant contacts all surfaces item will be protected until use items weight is evenly distributed in packaging
86
*preparation regulations of large loose instrument*
*minimal movement heavier on bottom may use a towel to separate layers*
87
*preparation regulations of basins*
*nested with towel between*** *no more than 7lbs fold is down during sterilization****
88
*preparation regulation for light handles*
*down for drainage*
89
*preparation regulation for trays*
*contain all instruments for procedure* *autoclaved flat to allow steam/air removed via perforations*
90
two kinds of folds for preparation
envelope - small trays+ individual items square fold (parallel folding) - large trays
91
what does a Label provide
content quality assurance inventory control rotation of stock
92
what do you label before sterilizing
everything
93
labeling options
permanent marker label gun bad code scanning labels
94
Julian date
of calendar days no year needed due to event related sterility ex: 1- 365

SURG TESTS (24 decks)

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