Chapter 7 - Sterilization Flashcards
1
Q
Definition of Asepsis
A
Absence of pathogenic microogranisms or disease
2
Q
Definition of Bacteriocidal
A
Substance that destroys/kills bacteria
3
Q
Definition of Bacteriostatic
A
Substance that inhibits the growth and reproduction of bacteria
4
Q
Definition of Bioburden
A
The number of microbes or amount of organic debris on an object at any given time
5
Q
What is event related sterility?
A
Sterility determined by how a package is handled and stored rather than time elapsed
6
Q
Definition of Pathogen
A
Any microbe capable of causing disease or infection
7
Q
Definition of a Spore
A
Resistant form of bacteria that can form a protective shell and remain dormant to survive in advanced conditions
8
Q
Name items to remain critically clean for the patient
A
Needles, catheters, implantable devices
9
Q
Name items to remain semi-critically clean for the patient
A
laryngoscopes, respiratory equipment
10
Q
Name items to remain noncritically clean for the patient
A
blood pressure cuffs, pulse ox, OR stretcher, furniture
11
Q
Definition of High-Level Disinfection
A
Kills all microorganisms except spores and prions (CJD)
12
Q
Definition of Intermediate-Level Disinfection
A
Kills most microorganisms, including bacteria, most viruses and fungi
13
Q
Definition of Low-Level Disinfection
A
Kills some fungi and viruses, and most bacteria, but is not effective against spores
14
Q
What is another name for Glutaraldehyde?
A
Cidex
15
Q
Can Cidex be used with lumens?
A
Yes, it can be completely submerged in
16
Q
What type of sterilant can be used in rigid and flexible endoscopes?
A
Cidex
17
Q
What is the shelf life of Cidex with and without a surfactant?
A
without - 14 days
with - 28 days
18
Q
What should instruments and scopes that were sterilized with Cidex be washed with?
A
Sterile water
19
Q
What is the time for Cidex to be a high-level disinfection?
A
20 minutes
20
Q
What is the time for Cidex to be a sterilant?
A
10 hours
21
Q
What is the generic name of Sodium Hypochlorite?
A
Household bleach
22
Q
What action odoes Sodium Hypochlorite do to the cell?
A
Disrupts cellular metabolism
23
Q
Where is Sodium Hypochlorite mainly used?
A
Surfaces, floors, and equipment- also cleaning blood and body fluid spills
24
Q
What is another name for Phenol?
A
Carbolic Acid
25
What is the action of Phenol?
It denatures enzymes and causes lysis of cells
26
What is the 2 types of Alcohol?
Isopropyl and Ethyl Alcohol
27
Where is Alcohol most useful in cleaning?
Disinfecting small noncritical surfaces
28
What is the action of Alcohol?
Denaturation, lysis, and metabolic interruption of cells
29
True/False
| You can clean surgical instruments with alcohol
False
| Highly corrosive to stainless steel
30
Can Alcohol be used on endoscopes?
No, it breaks down the cement
31
What type of cloth should be used for 'damp dusting'?
Lint free
32
How should damp dusting work?
Highest surface (OR lights) to lowest
33
A basin of __________ should be available within the sterile field for soaking and cleaning instruments
Sterile water
| Never use saline as it can cause corrosion of the metal
34
When should instruments be cleaned during the case?
Between each use
35
When should eye protection be worn?
On all cases
36
Where should the sharps be disposed?
In a puncture-proof sharps container
37
When is 'terminal cleaning' performed?
End of day
38
Do OR's have positive or negative pressure?
Negative pressure
39
How many air exchanges are there per hour in the OR?
10-15
40
What is the temperature of the OR?
64-70 F
41
What is the humidity of the OR?
35-72%
42
What where does the decontamination process begin?
In the OR at the point of surgical use
43
What type of cleaner are instruments put in during transport from OR to Decontamination?
Enzymatic solution
44
How should heavy instruments be placed in a tray?
At the bottom, lighter instruments on top
45
Definition of Chelation
Process of binding minerals, such as iron and magnesium, in the solution. Prevents their deposit on the surface of surgical instruments
46
Definition of Emulsification
The acting of dispersing 2 liquids not capable of being mixed
47
Instruments are soaked in cold/lukewarm/hot water with _________ with a high/neutral/low pH
lukewarm, detergent, neutral pH
48
Why can you not mix different metals in the Washer-Sterilizer?
An electrolytic conduction reaction can occur which can cause the instruments to fuse together
49
What is the temperature used during Steam Sterilization?
270F
50
Definition of the ultrasonic cleaner
removes small organic particles and soil from areas of instrumentation that manual or mechanical cleaning cannot reach
51
What is the term the ultrasonic cleaner does?
Cavitation
52
Why is Hydrogen Peroxide used in flushing a lumen?
The solution reacts with blood causing foam and will disappear when blood has been rinsed away
53
Definition of IUSS
Immediate Use Steam Sterilization
| Items are placed in an open tray or covered rigid container that is specially designed to allow rapid steam penetration
54
Which sterilizer is required for Tyvek wrapped items?
Hydrogen peroxide gas plasma sterilization
55
What material can Woven Textiles be made of?
Cotton or blends of cotton with synthetic polyester
56
What is the thread count of woven textiles?
180, 240, 272, 288
57
What item is placed between the instrument tray and barrier to absorb residual moisture?
Towel
58
What is Muslin wrappers made of?
Cotton
59
Name the thread count of Muslin wrap
140 thread count
60
Paper-Plastic combinations are used in ________ and _______ sterilization
Steam, Eto
61
Tyvek-plastic combination use _____ and _____
Eto, Sterrad
62
What is the max weight of muslin wrapped items?
12 pounds
63
What is the max weight of instrument trays?
25 pounds
64
How are basins placed within the autoclave?
Nested within each other, a towel must be placed between each space
65
What is the max weight of wrapped basin sets?
7 pounds
66
Name the key components required to be on the packaging label for sterilized instruments
Name of tray, date of sterilization, sterilizer used, cycle/load number, employee initials, department item belongs to
67
Definition of Julian Date
indicates the date of sterilization (1-365)
| March 1, 2015 is 60
68
Why is steam sterilization mostly used?
Dependable, inexpensive
69
Gravity Displacement Steam Sterilization
| What is the temperature and duration used for wrapped instrument sets?
250 F - 30 minutes
270 F - 15 minutes
Drying time is 15-30 minutes
70
Gravity Displacement Steam Sterilization
| What is the temperature and duration used for unwrapped instruments, no lumen
270 F - 3 minutes
| Drying time is 0-1 minute
71
Gravity Displacement Steam Sterilization
| What is the temperature and duration used for unwrapped instrument set with some lumens
270 F - 10 minutes
| Drying time is 0-1 minute
72
What is the time and temp used to killed Geobacillus stearothermophillus?
12 minutes, 250 F under steam sterilization
73
What is the ratio of steam to water in the autoclave?
97% steam to 3% water
74
How does steam get into the autoclave?
A jacket around the chamber
75
How does a Gravity Displacement Sterilizer work?
Relies on gravity to passively remove air from the sterilization chamber
76
In Gravity Displacement Sterilization, ______ is heavier than ______
Air is heavier than steam
77
What sterilization method uses the Bowie-Dick test?
Prevacuum-type sterilization cycle
78
What does the Bowie-Dick test check for?
In vacuum sterilization cycles to check for air removal and entrapment
79
When is the Bowie-Dick test performed?
Daily, at the end of the first run of the day
80
What was the old term for IUSS?
Flash
81
What is the purpose of the IUSS?
To process sterilizing unwrapped instruments, such as items that have been dropped during surgery
82
Can you use IUSS on implantable devices?
No
83
What are the most common temperatures for Gravity Sterilization?
250 - 275 F
| 121 - 135 C
84
What is the psi for gravity sterilization?
15-17 psi
85
What are the common temperatures for prevacuum sterilizers?
270-275 F
| 132 - 135 C
86
What is the psi for prevacuum sterilizers?
27-30 psi
87
What are the 4 methods of monitoring steam sterilization?
Mechanical, Chemical, Biological, Administrative (documentation)
88
Where are chemical indicators used?
Externally and internally
89
What does the chemical indicator indicate?
The item was introduced to a specific temperature, humidity, and sterilant
90
Name an example of a chemical indicator
Autoclave tape
91
What are internal steam chemical indicators and where are they placed?
Indicate items been introduced to sterilization and are placed in the center of the tray. Items include peel packs, packages, and instrument trays
92
On rigid instrument containers, what does color does the chemical indicator dot change to?
Black
93
Definition of a biological indicator
A device that contains a specific type of microorganism that is killed when exposed to the sterilizing conditions
94
Why is the biological indicator so important?
This is the only test that guarantees items are sterile and the conditions for sterilization has been met
95
What bacterial spore does the biological indicator contain?
Geobacillus stearothermophilus
96
How long are BI's incubated for?
24 hours
97
What temperature is the steam BI incubated in?
131-140 F
| 55-55 C
98
Which organizations monitor the BI?
AAMI, AHA, AORN, CDC, and TJC
99
In sterilization, what is considered contaminated?
If an item is wet or moisture occurs within item
100
What is the term for microorganisms finding a pathway from the outside inside?
Wicking
101
What is the name of the sterilization method EtO?
Ethylene Oxide
102
When should EtO be used?
To process materials that cannot be processed using steam sterilization such as heat or moisture sensitive materials
103
Why is EtO not used often?
Very risky to personnel, very expensive, takes 16 hours to sterilize, and items must be 'aired out' before use
104
Why is EtO risky?
The gas is flammable and very toxic ranging from skin irritation to respiratory difficulty, headaches, and nausea
105
How is EtO damaging to Earth?
It produces CFCs, chlorofluorocarbons which can damage the ozone layer
106
What temperature is used in EtO sterilization?
85-145 F
107
What is the humidity range for EtO sterilization?
30-80 %
108
What chemical forms if lumen instruments are wet when they go through the EtO process?
Antifreeze
109
Name the color change of the EtO chemical indicator
Green to Brown
110
What is the Biological Indicator for EtO
Bacillus atrophaeus
111
How long are EtO's BI's incubated for?
48 hours at 95-98.6 F
112
What is the common name for Hydrogen Peroxide Gas Plasma?
Sterrad
113
How is Sterrad and EtO similar and not?
Uses gas at low temp to sterilize heat/moisture sensitive items. Sterrad is safer to use
114
Can you use Sterrad in lumen items?
No, it is too difficult to reach through the lume
115
What type of wrapping can be used with Sterrad?
Polypropylene or other synthetic, nonwoven material, Tyvek
116
What is the chemical indicator color change for Sterrad?
Dark blue to pink
117
What are the cycle time ranges for Sterrad?
28-38 minutes
118
What are the two Liquid Chemical Sterilization Process?
Steris (peracetic acid) and Cidex (glutaraldehyde)
119
Name the duration of a Steris cycle
23 minutes
120
What is the temperature for Steris on flexible or rigid endoscope sterilization?
122 F (50 C)
121
What is the Biological Indicator for Sterris?
Geobacillius Stearothermophillus
122
What is Event Related Sterility?
When an item was rendered sterile, not the expiration date
