SECTION 4 - STERILIZATION PROCESS Flashcards
You are working in a busy hospital sterilization department, and the printer connected to your autoclave runs out of ink mid-shift. However, the spare ink cartridges are stored in a different building that requires at least a 20-minute round trip. What would be the best course of action?
A. Continue the operations and verbally communicate the results to colleagues.
B. Stop all operations and retrieve the ink immediately.
C. Make a note to order the ink at the end of the shift.
D. Record the results manually until the end of the shift, then replace the ink.
The correct answer is B. Even though it may be inconvenient, it’s important to maintain accurate and reliable record-keeping. Hence, retrieving and replacing the ink immediately is the best course of action. Answer A is incorrect as verbal communication could lead to errors. Answer C is not a good choice as it doesn’t address the immediate problem. While manually recording the results (Answer D) is a possibility, it may lead to errors and isn’t as reliable as printer records.
Biological tests/process challenge devices (PCDs) need to be placed only once a week to verify sterilization efficacy.
True
False
The correct answer is False. Biological tests/PCDs should be used for every sterilization cycle that includes an implant, and at least once daily for all other types of sterilization cycles. The frequent use of PCDs helps to assure that conditions necessary for sterilization have been met.
You’re a Central Service Technician and while processing surgical instruments, you find that the biological indicator (BI) for the steam sterilization process has turned positive. What should be your immediate course of action?
A. Run the sterilization cycle again immediately with the same instruments
B. Discard the biological indicator as it might be faulty
C. Report the incident, quarantine the load, and reprocess all items
D. Use a chemical indicator to confirm the result
The correct answer is C. Report the incident, quarantine the load, and reprocess all items
Explanation: A positive BI indicates that the sterilization process was unsuccessful. In this situation, the technician should report the incident, quarantine the load, and reprocess all items (C) to ensure patient safety. Simply running the sterilization cycle again (A) or using a chemical indicator to confirm the result (D) would not adequately address the potential for non-sterile instruments. Discarding the BI (B) ignores a serious process failure.
A failure to change color by a biological indicator always means the sterilization process was unsuccessful.
True
False
The correct answer is B. False. While a failure to change color by a biological indicator may indicate a sterilization process failure, it does not always mean the process was unsuccessful. It could be a malfunction of the biological indicator itself. However, it warrants an investigation to determine the cause and reprocessing of the load.
A Central Service Technician is required to sterilize a load containing both wrapped instrument trays and non-porous containers. In this situation, how should the load be arranged?
A. Wrapped instrument trays at the top, non-porous containers at the bottom
B. Non-porous containers at the top, wrapped instrument trays at the bottom
C. Wrapped instrument trays and non-porous containers should not be mixed in the same load
D. Arrangement does not matter as long as there is sufficient space for steam circulation
The correct answer is A. Wrapped instrument trays at the top, non-porous containers at the bottom
Explanation: In a mixed load, wrapped instrument trays should be placed at the top and non-porous containers at the bottom (A). This arrangement allows for more effective steam penetration. Placing non-porous containers at the top (B) would impede steam circulation to the items below. Although it is preferable not to mix different types of packaging in one load, it is sometimes unavoidable (C). The arrangement does indeed matter (D) because effective sterilization requires good steam circulation.
Sterilization cycles do not need to be regularly tested as long as the sterilizer is functioning properly.
True
False
The correct answer is B. False. Regardless of how well the sterilizer appears to be functioning, sterilization cycles should be regularly tested using biological indicators to ensure that they are effectively killing microorganisms.
You are a CRCST and noticed that some packages, immediately post-sterilization, appear damp on the outside. The sterilization cycle was correctly performed. What should be your course of action?
A. Ignore it, as the moisture will evaporate eventually.
B. Immediately use the packages, assuming the inside is still sterile.
C. Re-sterilize the packages, because dampness can affect the integrity of the package.
D. Discard the packages as they are no longer usable.
The correct answer is C. Re-sterilize the packages, because dampness can affect the integrity of the package. Post-sterilization, packages should be dry because moisture can compromise their sterility, potentially allowing the growth of microorganisms. A) is incorrect as ignoring damp packages can compromise sterility. B) is incorrect because using the damp packages could risk infection. D) is incorrect because the packages can be re-sterilized and do not necessarily need to be discarded.
Which of the following factors can cause sterilization failure in an ethylene oxide (EtO) sterilizer?
A. High humidity levels
B. High gas concentration
C. Short exposure time
D. Low temperature
The correct answer is C. Short exposure time
Explanation: Short exposure time (C) can cause sterilization failure because adequate time is needed for EtO to penetrate materials and kill all microbes. Although high humidity levels (A) and high gas concentration (B) can pose risks, they are actually necessary for effective EtO sterilization. Low temperature (D) can affect sterilization, but EtO sterilization operates at a relatively low temperature compared to other methods.
You notice that a sterilization pouch with an external chemical indicator has not changed color after a sterilization cycle. What should you do?
A. Release the item for use, as the color change of external indicators is not mandatory.
B. Run the sterilization cycle again with the same pouch.
C. Check the internal indicator, if the color is changed, release the item for use.
D. Treat the item as not sterilized and reprocess it correctly.
The correct answer is D. Treat the item as not sterilized and reprocess it correctly. External indicators are used to identify items that have been exposed to the sterilization process. If the indicator has not changed color, it means the sterilization process may not have been effective. Answers A and C are incorrect because even if the internal indicator has changed color, the item should not be released for use if the external indicator has not. Answer B is incorrect because re-running the sterilization cycle without ensuring the load configuration and sterilizer function are correct may not resolve the problem.
When sterilizing wrapped items in a sterilizer, which statement about loading is correct?
A. Place heavy packages on top of lighter ones.
B. Place packages tightly together to maximize space.
C. Allow for free circulation of the sterilant around each package.
D. Always place packages with the indicator facing downwards.
The correct answer is C. Allow for free circulation of the sterilant around each package. For effective sterilization, there must be free circulation of the sterilant around each package. Answer A is incorrect as placing heavy packages on top of lighter ones could damage them. Answer B is incorrect because placing packages tightly together may prevent sterilant from reaching all surfaces. Answer D is incorrect as the position of the package does not typically affect sterilization but placing the indicator downwards may make it difficult to read.
You notice a pack just out of the autoclave is visibly wet. This is considered a process failure because:
A. Wet packs can promote bacterial growth.
B. Wet packs indicate that the sterilization cycle was too short.
C. Wet packs show that the temperature was too high.
D. Wet packs can’t be opened safely due to risk of scalding.
The correct answer is A. Wet packs can promote bacterial growth. Moisture within a sterilized pack can provide an environment conducive to microbial growth, thus compromising the sterility of the pack. B, C, and D are incorrect because the presence of a wet pack does not specifically indicate a short cycle, high temperature, or a safety risk when opening.
You are working in a busy hospital, and the operation theater has requested an immediate turn-around on a particular instrument that is heat sensitive and cannot be steam sterilized. Which of the following sterilization methods would be best for this scenario?
A. Steam sterilization.
B. Dry heat sterilization.
C. Ethylene oxide sterilization.
D. Gas plasma sterilization.
The correct answer is C. Ethylene oxide sterilization. Ethylene oxide sterilization is used for heat-sensitive and moisture-sensitive devices that cannot withstand the high temperatures of steam or dry heat sterilization. This method is ideal for this scenario. A, B, and D are incorrect because these methods involve heat and, in the case of A and D, moisture as well, which would be damaging to the types of items in question.
As a CRCST, you have noticed that one of your colleagues consistently forgets to document the sterilization date in the load log. What should you do in this situation?
A. Ignore the issue, as the sterilization date is not important
B. Add the date yourself whenever you notice it is missing
C. Remind your colleague of the importance of including the sterilization date and report the issue to a supervisor if it continues
D. Remove your colleague’s loads from circulation until they correct their documentation habits
The correct answer is C. Remind your colleague of the importance of including the sterilization date and report the issue to a supervisor if it continues. While it’s good to take proactive steps to ensure the documentation is complete, adding the date yourself may not be sustainable or accurate, especially if you weren’t the one who performed the sterilization. Ignoring the issue or removing loads from circulation are extreme measures that could result in additional problems. The best approach is to address the issue directly and escalate it if necessary.
Which of the following sterilization cycles is most suitable for items that can tolerate exposure to moisture and high temperature?
A. Gravity cycle.
B. Dry heat sterilization.
C. Ethylene oxide sterilization.
D. Gas plasma sterilization.
The correct answer is A. Gravity cycle. The gravity cycle uses steam at a high temperature and is suitable for items that can tolerate exposure to moisture and high temperature. B is incorrect because dry heat sterilization doesn’t involve moisture. C and D are incorrect because both methods are typically used for items that are sensitive to heat and/or moisture.
A manual load log sheet and a computer-based log serve the same purpose and contain the same types of information.
True
False
The correct answer is True. Whether the load log is maintained manually on paper or through a computer system, the purpose remains the same: to document crucial details about the sterilization process for each load. This typically includes the operator’s name, the contents of the load, the sterilization date, and the sterilization parameters.
