instrument processing & sterilization ch 21

Question 1

critical instruments

Answer 1

touch bone or penetrate soft tissue, risk of disease transmission is very high

Question 2

semi-critical instruments

Answer 2

touch mucous membranes or non-intact skin. Sterilize with heat or high-level disinfect. Eg) mouth mirror, amalgam condensers

Question 3

non-critical instruments and devices

Answer 3

contact intact skin only.

Clean and disinfect using low to intermediate level disinfectant. Least risk of transmitting infection.

Question 4

t/f; should proceed in single loop/linear flow from dirty-clean-sterilized. Never double back to the contaminated area with sterilized instruments

Answer 4

true

Question 5

step 1- transport

Answer 5

transport instruments to the processing area using minimize the risk of exposure to others.
Use proper PPE

Question 6

Step 2- cleaning

Answer 6

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

Question 7

ultrasonic cleaner

Answer 7

used only to loosen and remove debris from instruments. DOES NOT disinfect or decrease microorganisms.

Question 8

how to know the ultrasonic is good

Answer 8

put foil about 5x5 inches, run for 20 secs. If working properly foil should be evenly marked with a tiny pebbling effect

Question 9

automated washer

Answer 9

use a combination of very hot water recirculation and detergents to remove organic material. And then are dried BUT still should be sterilized.

Question 10

manual cleaning

Answer 10

soak until ready to clean. Hand scrubbing contaminated instruments with a stiff bristle brush. NOT RECOMMENDED

Question 11

step 3 -packaging, each package of instruments must be labeled with

Answer 11

date, the sterilization load number, processors initials

Question 12

step 4- sterilization

Answer 12

load sterilizer
do not overload, overlap pouches
packs should be allowed to dry inside before removing/handling
do not open the package until needed

Question 13

step 3: packaging

Answer 13

instruments must be dry
assembled into trays
wrap in either pouches or poly bags
place proper indicators inside packs

Question 14

what should each cassette or pack include

Answer 14

external class 1 process indicator 
internal chemical indicator

Question 15

each handpieace motor must

Answer 15

be lubricated daily and then purged

Question 16

each handpiece must

Answer 16

be lubricated between each patient and then purged with air and water for 30 secs before sterilization

Question 17

how are handpieces sterilized

Answer 17

sterilized by steam or chemical vapor

Question 18

t/f: handpieces CAN withstand cleaning in ultrasonic cleaner or instrument washer

Answer 18

false, they cant

Question 19

what are the different sterilization techniques

Answer 19

steam sterilization (autoclave)
chemical vapor (chemiclave)
dry heat(dry heat oven)

Question 20

what is the temperature, pressure, and time of the steam sterilizer (autoclave)

Answer 20

temp- 121 degrees, 250 F
pressure- 15 PSI
time- 3-30 mins

Question 21

involves heating water to generate steam under pressure and produce a moist heat that rapidly kills organisms. Heat kills microorganisms not pressure

Answer 21

steam sterilizer (autoclave)

Question 22

what is the temperature, pressure, and time of the chemical vapor ( chemiclave)

Answer 22

temp- 131 degrees, 270 F
pressure- 20 PSI
time- 20-40 mins

Question 23

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

Answer 23

chemical vapor (chemiclave)

Question 24

operate by heating up air and transferring that heat from the air to the instruments.

Answer 24

Dry heat sterilizer

Question 25

what is the temperature of the dry heat sterilizer

Answer 25

160 -190 degrees, 320-375F

Question 26

similar to an oven, hot air rises, and static nonmoving air transfers to instruments 1-2 hrs

Answer 26

static air

Question 27

forced air

Answer 27

circulates hot air throughout the chamber at a high velocity of 6-12 mins.

Question 28

Perfomred at low temperatures, advantage for plastic and rubber items .

Answer 28

ethylene oxide sterilization

Question 29

how long does ethylene oxide sterilization require

Answer 29

4-12 hours and at least 16 hours after sterilization to remove gas molecules

Question 30

liquid sterilants

Answer 30

typically contain activated glutaraldehyde but instruments are immersed for 10 hours.

Question 31

flash sterilization

Answer 31

reprocessing loose instruments that aren't in wraps, cassettes, must only be used in emergencies.

Question 32

t/f; flash sterilization must never be used for implantable items or devices

Answer 32

TRUE

Question 33

step 5 storage

Answer 33

store in a clean, dry environment, rotate packages so those with the oldest sterilization get used first

Question 34

wicking

Answer 34

when bacteria from the air or contaminated surfaces are drawn through the wet packaging material and contaminate the instruments inside

Question 35

step 6 delivery

Answer 35

inspect package before using | check chemical indicator to insure that the package has been sterilized

Question 36

mechanical monitoring

Answer 36

measure & record time, temp , pressure

Question 37

chemical monitoring

Answer 37

change in color when the physical parameter is reached

Question 38

biological monitoring (spore test)

Answer 38

use biological spores to assess the sterilization process directly

Question 39

process indicators

Answer 39

(external) placed outside the instrument packages before sterilization. identify exposure to a certain temp

Question 40

process integrators

Answer 40

(internal) placed inside instrument packages. | Respond to temp, pressure, and time

Question 41

when do u have to do a bowie-dick test

Answer 41

if the clinic has a pre-vacuum(dynamic air removal) and every time it's used

Question 42

chemical indicators

Answer 42

to detect sterilization failures that resulted from incorrect packaging, loading of sterilizer

Question 43

biologic monitoring

Answer 43

the only way to determine if sterilization has occurred

Question 44

t/f; if growth of the spores occurs the medium changes color

Answer 44

true

Question 45

if spores survive the sterilization cycle a positive culture =

Answer 45

sterilization failure

Question 46

if spores are killed a negative culture =

Answer 46

successful sterilization

Question 47

sterilization

Answer 47

destruction of all life forms

Question 48

disinfection

Answer 48

is the destruction of some but not all microorganisms

Question 49

vials or strips, also known as spore tests that contain harmless bacterial spores used to determine whether the sterilizer is operating

Answer 49

biologic indicators

Question 50

verifies sterilization by confirming that all spore-forming microorganisms are destroyed

Answer 50

biologic monitor

Question 51

an indicator that reacts to time, temp and presence of steam

Answer 51

single parameter indicator

Question 52

tapes, strips, and tabs with heat-sensitive chemicals that change color when exposed to a certain temperature

Answer 52

multi- parameter indicator

Question 53

the ultrasonic cleaner works by

Answer 53

soundwaves

Question 54

2 examples of dry heat sterilization

Answer 54

static air, forced air

Question 55

best way to determine whether sterilization has occurred

Answer 55

use biologic monitoring