Sterile processing Flashcards
What kind of temperature is glutaraldehyde?
It is considered cold sterilization
true or false; glutaraldehyde sterilized items can be used later on
false; it is point of care use only
How long should instruments be immersed in glutaraldehyde?
10 hours
What is glutaraldehyde also known as?
cy dex
What are 4 downsides of glutaraldehyde?
- poor ease of use
- environmental problems
- Alters DNA synthesis
- Bad for instruments
What kind of sterilization is ethylene oxide?
cold and dry
What is ethylene oxide best used for?
for heat and moisture sensitive items?
What is the temperature of ethylene oxide?
99-145 degrees fahrenheit
What is the humidity of ethylene oxide?
45-75%
What is exposure time for instruments in ethylene oxide?
2-5 hours
What is the aeration time for instruments in ethylene oxide?
8-12 hours
What are downsides of ethylene oxide?
- human carcinogen
- lumens must be completely dry - causes antifreeze if not
- environmentally hazardous
What is important for personnel and exposure with ethylene oxide?
exposure limited to 1 ppm in an 8 hour period
What is low temp hydrogen peroxide plasma sterilization also known as?
Sterrad or V-PRO
What kind of items are used in low temp hydrogen peroxide plasma sterilization?
used for heat and moisture sensitive times
How does low temp hydrogen peroxide plasma sterilization work?
Turns electrical current into a plasma
Is aeration cycle needed in low temp hydrogen peroxide plasma sterilization?
no
Do things have to be completely dry in low temp hydrogen peroxide plasma sterilization?
yes
What is cycle time for low temp hydrogen peroxide plasma sterilization?
75 minutes
What is a positive of low temp hydrogen peroxide plasma sterilization?
good for environment
What is paracetic acid also known as?
automated endoscope reprossesor (AER)
What kind of items are sterilized in paracetic acid?
for items that can be immersed
What is 1 downside of paracetic acid?
corrosive to instruments and people
What is temperature of paracetic acid?
120-130 degrees fahrenheit
What is run time for paracetic acid?
20-30 minutes
What is a really important step after paracetic acid cycle? How many?
micron filtered tap water rinses. 4 of them
true or false; paracetic acid is for point of care use only
true
Does paracetic acid need to have sterilization log?
yes for patient safety
What kind of sterilization is ozone?
low temperature sterilization
How many manufacturers make ozone?
only 1
The FDA has cleared ozone for sterilization of what?
metal and plastic
What are 2 pros of ozone?
- environmentally sound
- no aeration cycle is necessary
What happens with exhaust and ozone?
passed through a catalytic converter
What kind of sterilization is dry heat?
high temperature
What is dry heat best for?
powders and oils
What can be put in dry heat?
- dental instruments
- burrs
- reusable needles
- glassware
Can you use tape with dry heat?
no
Items that are sterilized should be what with quality control?
should be traceable from the method of sterilization
For each item what should be documented?
- lot control number
- load or cycle #
- date and time
Sterile technique is founded in what?
individual’s surgical conscience
How many times should we do spore testing on gravity displacement and pre-vaccuum?
daily and weekly! Exam is weekly
What indicator should be done daily with pre-vacuum?
bowie dick
What does the uniform pattern indicate with bowie dick?
that the vacuum cycle has function properly
What item do you need to have a biologic with every time?
with every implant
What is important with biologic indicator and ethylene oxide?
needs to be one in every load
Where should the results of spore testing be on a log sheet?
at the top
What type of spore testing should be done with steam-gravity displacement and prevacuum
geobacillus stearothermophilus at least weekly and preferably daily
What type of spore testing should be done with prevacuum?
bowie dick done daily
What type of spore testing should be done with ethylene oxide?
bacillus atropheus with every load
What type of spore testing should be done with plasma?
geobacillus stearothermophilius done at the same interval as other sterilizers in the facility
What type of spore testing should be done with ozone?
geobacillus stearothermophilius done daily
What type of spore testing should be done with paracetic acid?
geobacillus stearothermophilus daily
What type of spore testing should be done with dry heat?
bacillus atropheus upon installantion and after any repair
Packaging must work with what?
with the type of sterilization
Packaging must all for identification of what?>
the contents
Weight of instruments in packages can not exceed what?
25 lbs
What should packages be free of?
- lint
- holes
Sterile storage areas must not exceed what temperature? what humidity?
- 75 degrees F
- 60% humidity
What should not be placed inside the tray?
no textiles, peel pouches or rubber mats
How should instruments be in packages?
- disassembled
- open, unlocked position
Where should the integrator be in a tray?
corner of the tray
Where should the indicator be in a try?
on the inside and outside of the tray
Where should counts be?
count sheets on the outside of trays
Peel pouches should not be what?
stacked inside of sterilization chamber?
How should peel pouches be stored and sterilized?
vertically
How should peel pouches be labeled?
write on plastic, not on the paper
Peel pouches are not to be used with what?
heavy times i.e. drills
What are 3 criteria for double pouching?
- with manufacturer’s instructions only
- inner pouch fits without being folded
- facing same direction
What should be done on the field with endoscopes?
manual cleaning on the field throughout procedure:
1. clear lumen with water
2. wipe exterior
How should endoscopes be kept during delay or transport to decontamination?
damp or wet but not submerged
Endoscopes should not be allowed to do what durin delay or transport to decontam?
not allowed to dry
Endoscopes should be cleaned within how long of use?
1 hour
Additional cleaning of endoscopes is used for what 4 things?
- simethicone
- radiographic medium
- lubricant/tissue adhesive
- poor bowel prep - emergent
What is wrong with simethicone on endosocpes?
it’s difficult to remove
What should you not do with simethicone?and instead do what?
don’t add it to the water bottle. Add low concentration directly into the working channel
What is important for cleaning with personnel?
hand-over process includes information about additional cleaning for difficult things
Clean endoscopes within what? or what?
clean within 1 hour or follow delayed processing instructions
What should there be from transporter to decontam with endoscopes?
hand over process that communcates about end of procedure time
What is done before endoscopes are placed in cleaning solutions?
leak testing
What is done after manual (scrub with brush) cleaning of endoscopes?
visual inspection
What is used for visual inspection of endoscopes?
use 10x magnification and borescope
Endoscopes are sterilized when possible?
true
Can we use disposable endoscopes or components?
yes
What should be done daily with sterilization of endoscopes? SWAB
- ATP testing, protein testing, hemoglobin etc.
What kind of high risk flexible endoscopes need to have ATP testing, protein testing, hemoglobin etc. with every use? SWAB
duodenoscopes, ultrasound endoscopes, bronchoscopes, ureteroscopes, cystoscopes
What is actively done with endoscopes after processing? for how long?
actively dried for minimum of 10 minutes or no visible moisture
How is drying measured with endoscopes?
borescope inspection or moisture detection test
Does automated air purge cycle AER count as drying with endoscopes?
no; unless extended time feature used
What should personnel have in processing area for endoscopes?
- ergonomics
- frequent breaks from hot PPE
- cooling devices
Where should endoscopes be stored?
drying cabinet
Where should endoscopes not be stored?
in procedure rooms
Is there a time frame for storage of endoscopes? What do you do instead
NO; rather risk assessment to establish storage times. CULTURES
What are 7 risk assessment things
