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SURG TESTS > Chapter 7 pt 3 > Flashcards

Chapter 7 pt 3 Flashcards

1
Q

4 types of sterilization

A

steam
chemical agents
high electricity bombardment
UV/ gamma radiation

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2
Q

what kind of sterilization is autoclave

A

steam sterilization
most common

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3
Q

how does autoclave work

A

uses pressurize moisture + heat
all microbes + spors
most dependable + inexpensive

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4
Q

what items can not be used with autoclave

A

items not heat, moisture, or temperate sensitive

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5
Q

6 autoclave critical factors ( to make it sterile)

A

time
contact
temperature
pressure
moisture
air

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6
Q

critical factors with autoclave: time

A

some microbes are harder to kill

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7
Q

how long do you autoclave instruments

A

wrapped instrument: 15 at 270
unwrapped no lumen: 3 mins at 270
unwrapped with lumen: 10 mins 270

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8
Q

how long does a wrapped and unwrapped inst take to dry

A

wrapped: 15 mins
unwrapped: 1 min

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9
Q

critical factors with autoclave: contact

A

remove bioburden from all surfaces
ensure drain is lint free/ preventing air from leaving
- make sure not wrapped too tightly
- proper placement

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10
Q

critical factors with autoclave: temperature + pressure

A

increasing pressure= increasing temp

pressure
- * raises temperature of steam*

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11
Q

critical factors with autoclave: moisture

A

catalyst to temperature
allows for lower temperature
steam 97-100% humidity
condensation against metal
97% steam w/ 3% water

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12
Q

critical factors with autoclave: air

A

must be completely removed
doesn’t mix with steam
removed via gravity/ prevac

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13
Q

3 basic components of autoclave

A

metal jacket - preheat if using outside steam

three pipes
- steam
- drain
- filter air ( dry time)

electromechanical switches (old)
- microprocessor system (new)

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14
Q

gravity displacement sterilizer

A

passively remove air from chamber
steam pushes air out the bottom
packing too tight- trap air
- more time than prevac autoclave

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15
Q

gravity displacement autoclave cycles

A

condition cycle- air is displaced
exposure cycle- temp maintained
exhaust cycle- steam removed
dry cycle- air revaporizes + removes moisture from packs

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16
Q

dynamic air removal autoclave

A

prevac
uses vacuum pump to remove air

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17
Q

prevac autoclave cycle

A

prevacuum - 90% of air
conditioning - steam injected
2nd prevacuum 90% of air again
exposure - steam enters + temp maintained
exhaust - steam leaves
dry - 90% vacuum removes moisture

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18
Q

advantages of dynamic air removal autoclave

A

more efficient at removing air
increases speed of operation
lower cycle time

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19
Q

what do you have to perform for dynamic air removal autoclave

A

bowie dick test
checks air entrapment
used first run of the day + after fix
placed horizontal over the drain
vacuum system not sterilization test

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20
Q

commercial name for bowie dick test

A

DART: daily air removal test

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21
Q

what is the steam flush pressure pulse cycle

A

part of dynamic air removal autoclav
four to five phases instead of two
eliminates need for bowie dick test
aids in removing air

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22
Q

immediate use steam sterilization

A

aka flash sterilization

most common sterilization method by STSR
sterilizes unwrapped items
only use it if you have to (ex inst falls)
never use on implantable items

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23
Q

sterilization monitoring

A

for quality assurance
monitor sterility or items

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24
Q

methods of monitoring

A

mechanical
chemical
biological
administrative ( documentation)

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25
mechanical monitoring
measuring time, temp, and pressure over 24 hrs prints out stats per day used for permanent records
26
most important part of mechanical monitoring
*verifies sterilizer worked properly ( all parameters were met)*
27
chemical monitoring
aka indicators, integrators placed inside and outside packages to verify items were exposed to sterilizing conditions does not authenticate sterility
28
what does chemical monitoring indicate
machine malfunctions incorrect assembly/ wrapping incorrect loading
29
chemical monitoring classes
class 1: process- external exposed class 2: specific test - bowie dick test class 3: single variable - temp, pressure, steam class 4: multi variable - two or more parameters class 5: integrating - react to all parameters - most accurate emulating: all parameters of specific cycle
30
what do chemical monitors indicate
*chemical indicators indicate exposure*
31
types of chemical monitoring
tape internal steam indicators rigid containers indicato dots peel pack with an edge or dot
32
how long does biological indicator monitoring take
*20 min*
33
what is the difficult steam resistant spore called that BI tests kill
*geobacillus stearothermophilus*
34
which is the only guaranteed sterility test
biological indicator (BI) test
35
which spore is non harmful to humans
geobacillus stearothermophilus
36
how long + hot do you incubate BI test once its crushed
24 hours 131-140 degrees
37
how frequent do you test BI
ranges from every load to weekly whenever implantable item
38
what do the colors mean in a BI Test
red= negative yellow= positive (unsterile)
39
what is done at the end of the BI monitoring cycle
vial is crushed and intubated
40
troubleshooting
wet packs -contaminated via strikethrough or wicking action (inside or outside)
41
troubleshooting: wet outside of pack causes
condensation dripping from shelves dripping
42
troubleshooting: wet inside of pack causes
too many instruments in tray packed too tight without absorbent towels improper loading
43
steam purity
contaminated filters brown/ orange spots
44
ethylene oxide (ETO)
main chemical used for gas sterilization kills all microorganisms + spores
45
characteristics of ETO
non corrosive passes through woven materials
46
how do you move the ETO machine
*if you MUST move it, pull it instead of pushing it so fumes don't go in your face*
47
disadvantages of ETO machine
expensive toxic - must be aerated for 8 hours flammable
48
hydrogen peroxide gas plasma
aka sterrad uses gas at low temperature, for heat and moisture resistant items - scope and camera
49
*indicators of hydrogen peroxide gas plasma (sterrad)*
*biological indicators is bacillus atrophaeus* tape turns dark blue to pink
50
what can sterrad not be used for
narrow lumens - scopes light cords
51
what packaging is used for sterrad
tyvek - allows bacteria to move out but get trapped back in
52
sterrad processing pros
allows space around items doesn't require aeration, drying, or cooling time
53
how long is the sterrad cycle time
28-38 minutes
54
what are liquid chemical sterilization for
heat sensitive but moisture stable
55
glutaraldehyde (cidex) rules
must be dry prior to immersion or it all be diluted must be tested each day for concentration level
56
what does sterrad do
uses peracitic acid- strong sterilant used for flexible and rigid scopes
57
how long and hot is steris go for
23 minutes at 122 degrees
58
disadvantages of steris
expensive no shelf life, needs immediate use
59
ionizing radiation
produce thermal/ chemical energy disrupting DNA gamma rays or beta particles 100% commercially used, hospitals don't do it - implants
60
alternative sterilization methods
ozone gas - oxidized bacteria not cleared by FDA - vaporized hydrogen peroxide - chlorine dioxide gas
61
administrative centers of sterilization process
document everything!!!
62
what are the things you document with indicator
items patient team member result of indicator
63
what is the purpose of documenting
inspection ( joint commission ) infection control court of law
64
*what does event related sterility do*
replaces expiration dates in facilities where you sterilize the item outside sterilized items shipped in will have expiration date on them event related sterility trumps expiration date (hole in glove despite not expired, still unsterile)
65
event related sterility summarized
unless package is compromised, its sterile
66
AST standards of practice 1
have all necessary supplies to prepare sterile field for surgery beforehand
67
AST standards of practice II
everything should be positioned prior to opening sterile items
68
AST standards of practice III
sterile technique must be strictly adhered by team (open with surgical conscience)
69
AST standards of practice IV
traffic in and out of OR should be monitored and controlled when you begin opening sterile items
70
AST standard of practice V
sterile supplies should be opened as close to time of surgery as possible
71
AST standard of practice VI
limit your movements ( touch once move around little)
72
AST standard of practice for bowel technique 1
bowel instruments should be isolated for anything else ( cross contamination + SSI)
73
AST standard of practice for sterility of underside of mayo 1
only sterile members touch it, not CN
74
AST standard of practice for surgical drapes 1
only sterile drapes used
75
AST standard of practice for drapes II
hole in drape = contaminated
76
AST standard of practice for drapes III
drapes should be fluid resistant
77
AST standard of practice for surgical drapes IV
lint free
78
AST standard of practice for surgical drapes XII
reusable woven fabric drapes should have same barrier of non woven disposable drapes
79
reccomeneded standards for gowning and gloving 1
all sterile members need to have a gown in sterile field
80
recommended standards for gowning and gloving II
compromise of integrity of microbial barrier = contaminated
81
recommended standards for gowning and gloving IX
everyone put on gloves before going into field, prevents SSI
82
recommended standards of practice for gowning and gloving XI
double gloving
83
*what is typically not done but should be*
separate sterile surface should b used for gowning and gloving to avoid contamination of back table

SURG TESTS (24 decks)

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