instrument processing & sterilization ch 21 Flashcards
critical instruments
touch bone or penetrate soft tissue, risk of disease transmission is very high
semi-critical instruments
touch mucous membranes or non-intact skin. Sterilize with heat or high-level disinfect. Eg) mouth mirror, amalgam condensers
non-critical instruments and devices
contact intact skin only.
Clean and disinfect using low to intermediate level disinfectant. Least risk of transmitting infection.
t/f; should proceed in single loop/linear flow from dirty-clean-sterilized. Never double back to the contaminated area with sterilized instruments
true
step 1- transport
transport instruments to the processing area using minimize the risk of exposure to others.
Use proper PPE
Step 2- cleaning
use of a hands-free process such as ultrasonic cleaner or instrument washer is recommended.
If instruments cant be cleaned right away keep them moist , or use some foam or spray for the blood
ultrasonic cleaner
used only to loosen and remove debris from instruments. DOES NOT disinfect or decrease microorganisms.
how to know the ultrasonic is good
put foil about 5x5 inches, run for 20 secs. If working properly foil should be evenly marked with a tiny pebbling effect
automated washer
use a combination of very hot water recirculation and detergents to remove organic material. And then are dried BUT still should be sterilized.
manual cleaning
soak until ready to clean. Hand scrubbing contaminated instruments with a stiff bristle brush. NOT RECOMMENDED
step 3 -packaging, each package of instruments must be labeled with
date, the sterilization load number, processors initials
step 4- sterilization
load sterilizer
do not overload, overlap pouches
packs should be allowed to dry inside before removing/handling
do not open the package until needed
step 3: packaging
instruments must be dry
assembled into trays
wrap in either pouches or poly bags
place proper indicators inside packs
what should each cassette or pack include
external class 1 process indicator internal chemical indicator
each handpieace motor must
be lubricated daily and then purged
each handpiece must
be lubricated between each patient and then purged with air and water for 30 secs before sterilization
how are handpieces sterilized
sterilized by steam or chemical vapor
t/f: handpieces CAN withstand cleaning in ultrasonic cleaner or instrument washer
false, they cant
what are the different sterilization techniques
steam sterilization (autoclave) chemical vapor (chemiclave) dry heat(dry heat oven)
what is the temperature, pressure, and time of the steam sterilizer (autoclave)
temp- 121 degrees, 250 F
pressure- 15 PSI
time- 3-30 mins
involves heating water to generate steam under pressure and produce a moist heat that rapidly kills organisms. Heat kills microorganisms not pressure
steam sterilizer (autoclave)
what is the temperature, pressure, and time of the chemical vapor ( chemiclave)
temp- 131 degrees, 270 F
pressure- 20 PSI
time- 20-40 mins
combination of chemicals to create a vapor does not rust, dull, or corrode dry metal instruments. A wide range of items can be sterilized routinely without damage
chemical vapor (chemiclave)
operate by heating up air and transferring that heat from the air to the instruments.
Dry heat sterilizer
what is the temperature of the dry heat sterilizer
160 -190 degrees, 320-375F
similar to an oven, hot air rises, and static nonmoving air transfers to instruments 1-2 hrs
static air
forced air
circulates hot air throughout the chamber at a high velocity of 6-12 mins.
Perfomred at low temperatures, advantage for plastic and rubber items .
ethylene oxide sterilization
how long does ethylene oxide sterilization require
4-12 hours and at least 16 hours after sterilization to remove gas molecules
liquid sterilants
typically contain activated glutaraldehyde but instruments are immersed for 10 hours.
flash sterilization
reprocessing loose instruments that aren’t in wraps, cassettes, must only be used in emergencies.
t/f; flash sterilization must never be used for implantable items or devices
TRUE
step 5 storage
store in a clean, dry environment, rotate packages so those with the oldest sterilization get used first
wicking
when bacteria from the air or contaminated surfaces are drawn through the wet packaging material and contaminate the instruments inside
step 6 delivery
inspect package before using
check chemical indicator to insure that the package has been sterilized
mechanical monitoring
measure & record time, temp , pressure
chemical monitoring
change in color when the physical parameter is reached
biological monitoring (spore test)
use biological spores to assess the sterilization process directly
process indicators
(external) placed outside the instrument packages before sterilization.
identify exposure to a certain temp
process integrators
(internal) placed inside instrument packages.
Respond to temp, pressure, and time
when do u have to do a bowie-dick test
if the clinic has a pre-vacuum(dynamic air removal) and every time it’s used
chemical indicators
to detect sterilization failures that resulted from incorrect packaging, loading of sterilizer
biologic monitoring
the only way to determine if sterilization has occurred
t/f; if growth of the spores occurs the medium changes color
true
if spores survive the sterilization cycle a positive culture =
sterilization failure
if spores are killed a negative culture =
successful sterilization
sterilization
destruction of all life forms
disinfection
is the destruction of some but not all microorganisms
vials or strips, also known as spore tests that contain harmless bacterial spores used to determine whether the sterilizer is operating
biologic indicators
verifies sterilization by confirming that all spore-forming microorganisms are destroyed
biologic monitor
an indicator that reacts to time, temp and presence of steam
single parameter indicator
tapes, strips, and tabs with heat-sensitive chemicals that change color when exposed to a certain temperature
multi- parameter indicator
the ultrasonic cleaner works by
soundwaves
2 examples of dry heat sterilization
static air, forced air
best way to determine whether sterilization has occurred
use biologic monitoring
