Sterile Processing Flashcards
Ultrasonic cleaning
Called cavitation
uses high frequency sound waves
-generate tiny bubbles in the solution to get into the crevices of the instruments that are
impossible to clean by other methods
-bubbles expand until they become unstable and collapse
-implosion generates minute vacuum areas that dislodge soil
The surgeon performed a biopsy during the bronchoscopy. The specimen is appropriately prepared and transported to the lab. After the procedure the cutting accessory and bronchoscope are processed.
What level of processing is recommended by the Spaulding Classification System?
The biopsy forceps are a critical item. The bronchoscope is semi-critical. The Spaulding Classification System does not address how this combination should be processed and so AORN recommends a multidisciplinary team decide and write policy for the facility
This corrosive solution can quickly cause chemical burns when in contact with skin. Once diluted in water it can be discarded by dumping it down a regular drain.
Paracetic acid
in its packaged form is corrosive and can blister the skin. However, when mixed with water it becomes vinegar and can be discarded in the regular drainage system.
Care is taken prior to aeration when working with Ethylene Oxide Sterilizers. Exposure to Ethylene Oxide is limited to…
1 pmm in an 8-hour period
According to the AORN Guidelines, how should endoscopes be stored?
In the storage area inside a positive pressure drying cabinet
When preparing a tray for sterilization, where should the internal chemical indicator be placed?
In the top of the tray according to manufacturer’s instructions
internal indicator should be placed where it
is immediately visible upon opening the tray without touching the contents. The number and placement of the indicator should be according to manufacturer’s instructions.
A disadvantage of hydrogen peroxide gas plasma sterilization is which of the following?
Long narrow lumens such as tubing may not be completely penetrated.
Brand name: Sterrad or V-PRO
Ex: endoscopes
There are accessories to use with the machine to force sterilant into the lumen that must be used for these devices according to manufacturer’s instructions.
Spaulding classification system- Critical
Must be sterile
Will enter sterile tissue or vascular system
Ex: instruments, needles, cutting endoscopic accessories and endoscopes, cardiac catheter
Urinary catheters (can be clean technique at home)
Spaulding classification system- Semi-critical
Should be sterile but high lever disinfection (kills everything except spores) acceptable if manufacturers instructions require
Contact broken skin or mucous membranes
Ex: respiratory therapy/anesthesia equipment, bronchoscopes/GI endoscopes
Spaulding classification system- Non-critical
Intermediate or low level disinfection or cleaning
Will come in contact to skin
Ex: OR bed, linens
Steam sterilization
Pre-vacuum autoclave (Dynamic air-removal)
Sucks air out of chamber
Clean drains are essential
270 to 276*F (132-135.5 *C)
-porous/lumen items in 4 min (plastic or wood)
-nonporous in 3 min
Steam sterilization
Gravity displacement autoclave
Steam forces air from chamber (steam lighter than air)
Thermometer closes drain
270-276 *F (132-135.5 *C)
-porous/lumen items in 10 minutes
-nonporous in 3 min
Unsterile if..
Condensation is present
Items still assembled
Glutaraldehyde
-Chemical sterilant for high level disinfection
-“cold sterilization”
What uses cavitation to remove fine soil from crevices and lumens of complex instruments and from the box locks and serrations of instrumentation?
Ultrasonic cleaner
Biologic indicator testing for sterilizer functioning should be performed at least
Weekly
Preferably each day that it’s used
What are the methods of sterilization?
Thermal
Chemical
Radiation
Physical parameters that should be monitored at the end of the sterilization cycle include
-time
-temperature
-Sterilant concentration
-pressure
-Humidity 
Ethylene oxide aeration time
8-12 hours
-Insufficiently aerated items can cause skin irritation and tissue burns
Bowie-Dick indicator
Used to detect air leaks and ineffective air removal in dynamic air removal sterilizers 
Chemical integrators- Class one
Heat
Ex: Tape changing colors
External indicators
Chemical integrators– class two
Pressure
Bowie dick with dynamic air removal sterilizer
Chemical integrators – class three
Single parameter
Quality of steam, pressure, temp, or time
Made by manufacturer 
Chemical integrators – class four
Multi parameter
Made by manufacturer
Chemical integrators – class five
Integrated
All four parameters (steam, pressure, temp, time)
Indicators in sets
Chemical integrators – class six
-Emulating indicator, changes color
-All parameters of a particular cycle
-Specific to sterilizer by manufacturer
Glutaraldehyde soak time
-Requires up to 10 hours
Glutaraldehyde exposure limit
-Exposure limit 0.2 ppm
-Use in well ventilated areas or fume hood
-PPE: nitrile gloves, goggles, mask, and impervious gown
Ethylene oxide sterilization
-Cold, dry form of sterilization
-For heat and moisture sensitive items
-Great for long lumens 
Ethylene oxide sterilization soak time
2 to 5 hours 
Dry heat
Best for heat stable powders and oils
Dental instruments, burrs, reusable needles, and glassware
Bowie dick
Done daily
Placed front and center at bottom of chamber
Uniform pattern indicates that the vacuum cycle has function properly
Bacillus atropheus
Type of testing for: Ethylene oxide and dry heat
B.D.E 🍆🌶️🌽
Geobacillus stearothermophilus
Type of testing for:
-steam
-plasma
-ozone
-peracetic acid
Endoscopes need additional cleaning, and this should be included in handover process, if using
-Simethicone
-Radiographic medium
-Lubricants/tissue adhesive
-Poor bowel prep (emergent)
Endoscopes cleaning, leak test is performed..
-before placed in cleaning solutions
-Visually inspected after manual cleaning
Use 10x magnification and borescope
-sterilization validation daily
Cleaning of instruments
Process in which soil and organic debris are removed in preparation for further processing/use
Decontamination
Any chemical or physical process in which microorganisms are removed or reduced in sufficient numbers to render instruments or equipment safe to handle (ex: mechanical or manual)
Disinfection
Process in which pathogens and other micro organisms are killed
May not be affective against spores/large numbers of microbes
Sterilization
Process in which all microbial life, including pathogens, non-pathogens, and spores, are killed
Critical water
Treated to remove microorganisms and material to meet quality parameters
-if it doesn’t meet standards, can affect:
-Effectiveness of cleaning agents
-Finish on instruments
-pH 
Utility water
Obtained from tab, used for flushing/washing
At a minimum, how often should the ultrasonic be cleaned?
Every day
Toxic anterior segment syndrome (TASS)
Entry of a non-infectious material in the anterior segment of the eye
-occurs 12-48 hours post surgery
-inflammation, Gram stain and culture negative
High level disinfection
For items that can’t be sterilized and are compatible with HLD chemicals
-Increased risk for disease transmission as all pathogens are not killed
Sterile supplies should never be stored:
-under sink
-in uncover carts
-next to clean supplies
