CIC Cleaning

Question 1

Cleaning

Answer 1

• removal of visible soil (organic and inorganic)
• usually involves mechanical or manual methods
• uses detergents or enzymes, water

Question 2

Surgical hand antiseptics

Answer 2

• no jewelry below elbow
• agent order of effectiveness: alcohol, CHG, iodophors, tricolsan, plain soap
• combo agents, CHG/alcohol, most persistent activity to decrease boiburden

Question 3

Decontamination

Answer 3

-removal of pathogenic organisms so equipment safe to handle without PPE

Question 4

Antiseptic

Answer 4

-germicide applied to living tissue or skin

Question 5

Sterilization

Answer 5

• all microorganisms killed or destroyed, including spores

- physical or chemical methods

Question 6

germicide

Answer 6

• kills organisms

- includes antiseptics and disinfectants

Question 7

Disinfectant

Answer 7

-antimicrobial agents used for inanimate objects

Question 8

Disinfection

Answer 8

-all microorganisms, except spores, killed or disabled

Question 9

Spaulding Classification: critical items

Answer 9

• enter sterile tissues or vascular system

- sterilization required

Question 10

High level disinfection

Answer 10

• free of all vegetative microorganisms
• small number of spores may be present
• includes aldehydes, hydrogen peroxide, peracetic acid

Question 11

Intermediate disinfection

Answer 11

• destroys vegetative bacteria, mycobacteria, most viruses, most fungi, not spores
• includes phenolics, alcohols, iodophors

Question 12

Spaulding classification: Semi-critical items

Answer 12

• contact with mucous membranes or non-intact skin

- high level disinfection required

Question 13

Spaulding classification: noncritical items

Answer 13

• contact with intact skin

- intermediate or low level disinfection

Question 14

Low level disinfection

Answer 14

• destroys vegetative bacteria, some fungi, some viruses, not mycobacteria, not spores
• includes quat ammonias

Question 15

Prions

Answer 15

• organisms resistant to sterilization methods
• CJD
• body fluids/tissues should not be allowed to dry on instrument prior to cleaning and decontamination
• critical equipment requires intense sterilization methods, might need to be incinerated
• noncritical equipment: 1:10 bleach solution

Question 16

Biological indicators

Answer 16

• used in first daily load, or at least weekly

- Bacillus stearothermophilus or Bacillus subtillis

Question 17

Endoscope disinfection

Answer 17

• poor disinfection methods associated with outbreaks
• steps: clean, disinfect, blow with compressed air, alcohol rinse, hang to dry, store
• require high level disinfection

Question 18

Positive biological indicator response

Answer 18

• reported to IP, surgeon, OR manager

- remove & reprocess all questionable equipment

Question 19

Aseptic Technique

Answer 19

• hand antisepsis
• sterile gown and gloves
• sterile drape
• sterile field

Question 20

Peracetic acid & H2O2

Answer 20

• no activation necessary
• incompatibility with metals (caustic)
• potential skin/eye damage
• limited knowledge regarding use

Question 21

Glutaraldehyde

Answer 21

• published use studies
• inexpensive
• excellent compatibility
• slow bacterial activity
• respiratory & skin irritation, vapor monitoring needed
• blinds blood & tissues to surfaces
• sporicidal

Question 22

Hydrogen Peroxide (H2O2)

Answer 22

• no activation necessary
• enhances organism removal
• does not fix blood or tissue to surfaces
• incompatible with metals (caustic)
• eye damage with contact
• published use studies

Question 23

Peracetic acid (C2H4O3H)

Answer 23

• Enhanced organism and endotoxin removal
• environmentally friendly
• some material incompatibility
• immersible equipment only
• serious eye and skin injury with contact
• point of use system, not sterile storage
• sporicidal

Question 24

Sodium hypochlorite (bleach)

Answer 24

• inexpensive
• fast acting
• material incombatibility
• enhances organism removal
• bactericidal, virucidal, sporicidal
• not active in presence of organic material

Question 25

Orthophthalaldehyde (OPA)

Answer 25

• fast acting high level disinfectant
• no activation necessary
• excellent material compatibility
• does not fix blood or tissue to surfaces
• stains skin, mucous membranes, clothing, etc
• eye irritation with contact
• slow sporicidal activity

Question 26

Alcohol

Answer 26

• some material incompatibility
• non-sporicidal
• not a high level disinfectant
• quick bactericidal and virucidal activity

Question 27

Phenolics

Answer 27

• skin irritation
• bactericidal, virucidal, fungicidal, tuberculocidal
• NOT sporicidal
• associated with hyperbilirubinemia when used in newborn nurseries
• effective in presence of organic materials, ie blood

Question 28

Quat ammonias

Answer 28

• widely used hospital disinfectant
• fungicidal, bactericidal, virucidal (only enveloped viruses)
• NOT sporicidal, NOT tuberculocidal
• Usually compatible with cleaned materials

Question 29

Ultrasound cleaning

Answer 29

• useful for heat and moisture sensitive items
• implosion of bubbles might damage equipment
• soil dislodged by vacuum process of bubbles imploding (cavitation)
• items usually need to be rinsed to remove dislodged soil