Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3. Transfusion > IBTS - Environmental Monitoring > Flashcards

IBTS - Environmental Monitoring Flashcards

1
Q

Why is EM important?

A

To ensure that the environment in which the products are produced has a reduced risk of contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does EM do in the IBTS

A

Carry out tests which count the bioburden on surfaces and in the air
This allows the IBTS to spot and track trends e.g. seasonal bacteria etc
Collecting this data allows for corrective action and prevention methods e.g. retraining a staff member associated with bacterial contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the four types of trends seen

A

Shift (temporary) e.g. once off contamination by E.Coli
Shift permanent e.g. increased contamination associated after hiring new staff member
Cyclical e.g. seasonal contamination
Drift e.g. as months get warmer etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What products is EM particularly vital for?

A

Transplantation of sterile cells and tissues e.g. Heart valves and stem cells

Information on EM is required in order for the cells/tissues to be released for transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who might look for EM info during audits and why might they require these?

A

The Health Products Regulatory Authority might look for EM data to ensure nothing unexpected occurred during processing, and that there is compliance with the regulations

e.g. heart valves cannot be released without certification that the cleanroom is within spec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is EM carried out in the IBTS

A

Collection clinics -> donor arms, equipment, fridges etc
Cleanrooms -> blood processing equipment
Blood storage and issue areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does MODA do>

A

Used to keep track of EM samples e.g. plan scheduling EM, acquisition of samples, incubation, result entry etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the LIS management system used for EM in the lab

A

MODA -> Laboratory information management system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do we monitor the blood donation clinic

A

Apheresis clinic monitored on a 4-week rotation where different beds/locations are monitored

Normal clinics monitored monthly and equipment is rotated etc

Venepuncturists carry out a competency check every 6 months

We will carry out a bacterial check on the donors arm post disinfection of the donor site -> assuring VP is trained correctly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is the donors arm disinfected

A

We use Chloraprep or Frepp

Both contain 1.5mls of 2% chlorohexidine gluconate (IPA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the acceptance criteria for EM on the donor’s arm

A

,5 Colony forming units on 95% of the arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the main sources of contamination in cleanrooms?

A

Surfaces, Equipment and Water - 10%
Air -15%
Personnel - 75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can personnel contaminate cleanrooms?

A

Skin flakes, hair, cosmetics, bacteria, viruses, skin cells, cellulose fibres from clothes etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do we control our clean rooms

A

We do so by minimising the generation and retention of particles in the room using several different methods depending on the grade of sterility of the room

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do we grade cleanrooms

A

Grade A - cleanest to grade D being a normal laboratory room

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give some ways of maintaining a cleanroom

A

Hand washing & hygiene
Tacky mats - Dycem mats
Gowning and behaviour of staff
Cleaning/use of sterile materials
Design of the room/regular cleaning etc
Heating, Ventilation, Air conditioning systems (HVAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does HVAC differ in a grade A/B lab than in a grade D/C

A

Turbulently ventilated in a grade D/C
Laminar flow/unidirectional in a grade B/A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How our the grade D labs controlled in the IBTS (not normal hospital)

A

Non sterile garments e.g. labcoat
Blue scrubs
Mobcap
Gloves
Lab coat
Lab safety shoes/shoe covers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do we control a grade A/B lab

A

Sterile garments - spacesuit scrubs
y-irradiation sterilised:
- boots, hood, suit, long sleeved tunic, face mask and gloves
- goggles and socks (yellow) also introduced
- staff must be recertified every 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How are the different labs in the IBTS graded

A

Production = grade D
Tissue bank;
- depending on area (grade A, B and D)
- Cryobiology: (grade A, B and D)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do we carry out particle counts

A

We use a Lasair particle counter
This counts particles between 5um and 0.5um
Detects both viable and non-viable particles
Measures 1 m^3 of air
Testing is performed at several locations in a single room

20
Q

What do we use settle plates for

A

Used to detecct viable particles -> alive
We use TSA for bacteria and SDA for yeasts and moulds
The settle plates are exposed for 4 hours

21
Q

What is TSA

A

Tryptic Soy Agar for bacterial sedimentation EM

22
Q

What is SDA

A

Sabouraud Dextrose Agar for yeasts and moulds sedimentation Em

23
How do we EM using active air
We use an SAS active air sampler to detect viable particles which works by pulling air down onto an agar plate
24
How would you decide what type of EM to use
Contact plates are used for flat surfaces -> they contain a grid so results can be expressed as CFU/cm^2 Swabs are used for irregulat surfaces -> TSA pour plates used for enumeration i.e. swab on plate for counting
25
What do the TSA contact plates contain
Naturalisers like Tween and lecithin which work against disinfectants
26
What kind of microbes would you expect to detect?
Gram positive microorganisms (skin commensals) Gram negative microorganisms (eyes, ears and mucus) Common environmental fungi anf yeasts
27
Give some examples of skin commensals you would expect to find
S. epidermidis S. capitis S. hominis S. aureus Micrococcus species Bacillus species
28
Give some examples of GNM you would expect to find
P. aeruginosa E. coli
29
Give some examples of yeasts/moulds you would expect to find
Penicilium species Candida species
30
What kind of water do we use
Water sterilised with ozone (O3) formed by passing oxygen through UV light
31
Why do we use ozone sterilised water
Its an oxidising agent toxic to most waterborne organisms No odour produced from it Creates less harmful by-products than chlorination
32
How do we control our growth media
The European Phaemacopeia lists the tests, incubation condiitons and the microorganisms required for each type of media We use ATCC control strains e.g. S, aureus or Candida albicans as our controls 10-100 CFU/ml inoculum made up for each media -> growth must be detectable on the media within a certain timeframe Passing criteria (>50% and <200%)
33
What is ATCC
American Type Culture Collection
34
What product in particular required screening
Platelet screening has been a mandatory tests since 2004
35
How many platelets does the IBTS supply
25,000 platelets (pooled + apheresis)
36
What is the shelf life of platelets
7 days
37
Talk about storage of platelets
Stored at 22 degrees celsius - too low promotes phagocytosis - too high increases bacterial risk Agitation and breathable bags necessary
38
What are the three main sources of platelet contamination
Bacteria present on/in the skin of the donor Donor bacteraemia - in blood Contamination of the blood pack itself
39
What percentage of platelets are contamination
Between 1 in 1000 and 1 in 3000
40
What safety measures are in place for platelet donations
HLQ Questionnaire Arm cleansing Diversion pouch on pack Overnight hold of blood Leucodepletion of pack Bacterial testing Donor notification -> if donor feels unwell 24 hours after donation Platelets not issued until 60 hours after collection as most significant BacT positives <24 hours post collection
41
What does the BacT do
An automated blood culture system Screens for bacteria in all platelets Allows for the continuous monitoring of platelets over their shelf-life i.e. continuous monitoring Also used for testing products associated with suspected transfusion reactions
42
How does the BacT system work
Two samples taken - one in an aerobic bottle and one in an anaerobic bottle Any microorganisms multiply in the media generation CO2 As CO2 increases, the sensor in the bottle turns from grey/green to yellow Colorimetric sensor detects this colour change by measuring reflected light every 10 minutes REES alarm connected to BacT instrument to notify on call personnel
43
What bacterial has the longest BacT time?
Cutibacterium - takes 97 hours
44
What is done with positive blood cultures
Gram stain and subculture on to Blood (aerobic and anaerobic), chocolate and SDA agar Retest any platelet and associated products Isolates sent for ID in St. James' Isolates frozen and stored indefinitely Follow up on the donor -> treat infection Follow up on venepuncturists -> training records etc
45
What is the majority of bacteria identified
Propionibacterium (45%) Coag neg staph (33%)
46
How would a patient present with bacterial contamination
Febrile reaction -> increase in temp of 1.5 degrees Chills Hypotension (decreased bp) All occuring within 2 hours of transfusion
47
How is bacterial contamination in transfusion treated
Stop transfusion Take patient blood cultures Administer IV antibiotics Perform inspection and testing on blood pack
48
How do you examine the blood pack
Look for: - abnormal colour - hameolysis - clots/leaks Microbiology testing on: - pack contents - segment line - administration line ( not done anymore)
49
How do you follow up on bacterial transfusion reactions
Confirm Transfusion transmitted infection -> same bacteria in blood pack and blood culutre Molecular typing to establish strain and route of transmission Follow up with donor depending on the type of bacteria identified
50

3. Transfusion (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions