Sterilization and Disinfection Flashcards by Christine Parascandola

Disinfection is defined as the reduction or destruction of ______ pathogenic microorganisms on ______ (nonliving) objects.

most, inanimate

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Disinfectant is defined as chemical agents that reduce ______ _____ on ______ objects.

microbial load, inanimate
is a chemical agent

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Sterilization is defined as the elimination of ____ microbes on an inanimate object

all

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Antiseptic is defined as the chemical agents that ______ microbial load or inhibit ______ of microbes on _____/_____ objects.

reduce, growth, living, animate
e.g. what we use to clean a patient during surgery

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Sterility is defined as the absence of _____ forms of microbial life only _____ objects

all, inanimate

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Which words should be paired together?

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Examples of low level contamination
Don’t require disinfection unless they are really dirty

• Reception desks
• Offices
• Walls
• Doors

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Examples of high level contamination
Minimum thorough cleaning
Drying agent followed by a low level disinfectant

• Kennels/housing
• Exam tables
• Operating tables/floors

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When selecting a disinfectant, what should you consider?

What level of disinfection is required?
• critical
• semi-critical
• non-critical
Is it compatible to the item you want to disinfect?
Is it user friendly?
Is it cost effective?

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“Critical” level of sterility and disinfection applies to equipment or implants entering ____, ____ tissue, ____, or ______. This includes (4).

body, sterile, cavity, bloodstream

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“Semicritical” level of sterility and disinfection applies to equipment that comes in contact with _____ or _______ ______ _______ penetrating body or cavity. This includes (6).

skin, mucous, membranes, without

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In terms of semicritical sterility and disinfection, items must be _____ and ______ to reduce microorganisms but since sterility is ___ maintained during procedure sterility isn’t _____. _____
sterilization is common though.

cleaned, disinfected, not, required, Terminal

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“Non-critical” level of sterility and disinfection applies to equipment that comes in contact with _____ skin or mucous membranes but not _____ associated with surgery. This includes (7).

intact, directly

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In terms of non-critical sterility and disinfection, equipment should be _______ but do not require
specific handling ________ patients. Should be _______ cleaned when done for the day.

disinfected, between, terminally

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Common disinfectants

Do not memorize this slide
Just know the compounds

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What microbes does Isopropyl Alcohol (IPA) kill?

Bacteria, fungi, viruses, NOT spore.

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What microbes does Povidone-iodine (PVI) kill?

Bacteria (fast), fungi, viruses, spores

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What microbes does Chlorhexidine Gluconate
(CHG) kill?

Bacteria (fast), fungi (poor), viruses (poor), NOT spores

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What microbes does Alcohol-based solutions kill?

Bacteria, +/- = fungi, viruses, spores

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Isoprpyl Alcohol is considered to be both a _______ and an _______.

disinfectant, antiseptic

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IPA is _________ ( _________ at lower
concentrations) and kills many _____ and _____

bactericidal, bacteriostatic, fungi, viruses

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Describe IPA’s residual activity?

Minimal (evaporates)

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IPA is less effective than ?

PVI or CHG

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IPA is not typically used as a ______ _______ agent.

cold sterilization

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IPA is helpful in removing excess ____ on the ____ prior to surgery

lipids, skin

Povidone-iodine (PVI) is considered to be both a _______ and ______.

disinfectant, antiseptic

Describe the activity of PVI?

• Bactericidal • Fungicidal • Effective against viruses • Sporocidal (15 min contact time)

Describe the residual activity of PVI.

Minimal; Effectiveness decreased in presence of organic material

The concentration of PVI varies in accordance to its ____. • For wound management: ___ to ___% solution • For surgical prep: ___% scrub/solution

use, 0.1, 1, 10

Chlorhexidine Gluconate (CHG) is an ______.

Antiseptic

Describe Chlorhexidine Gluconate (CHG) activity.

• Bactericidal (rapid; quicker with GM + > GM-) • Minimal activity against viruses and fungi • Not sporicidal

Describe CHG's residual activity • Residual activity due to _____ binding • Not inactivated by organic _____, _______, or _____ (so even if you have a dirty patient, it will still be actively working)

keratin, debris, alcohol, or soaps

For CHG, concentration varies according to its use: • For wound management: _____% solution • For surgical prep: ___% scrub/solution

0.05, 4

Alcohol based solutions are considered to be _______.

antiseptics

Alcohol based solutions have a superior ________ activity than PVI, CHG, or IPA alone

antimicrobial

The residual activity of alcohol based solutions is ?

More than alcohol alone

The usage of alcohol based solutions is a ____-step process (“_____”, single application and let dry) • ChloraPrep (2% CHG + 70% IPA) • ACTIPREP (83% Ethanol + Zinc Pyrithione) • DuraPrep (PVI + 74% IPA

one, scrubless

Sterilization is an ______ state, there is no such thing as almost or sort of sterile. It either is or isn’t.

absolute

What are the different types of sterilization?

• Steam Sterilization • Chemical (Gas) Sterilization • Ethylene oxide • Plasma sterilization (hydrogen peroxide gas) • Gas plasma • Peracetic acid sterilization • Ionizing radiation (gamma) • Cold chemical sterilization

Steam Sterilization is when ______ steam destroys microorganisms by ______ and cellular protein _______

saturated, coagulation, denaturation

What machine is used for steam sterilization?

Cylindrical machine

Is steam sterilization common?

It is very common

What are the pros of steam sterilization?

It is cheap, non-toxic, safe, and simple to use. It is effective, can be used for wrapped and unwrapped items, and has a quick turnaround time.

What are the cons of steam sterilization?

Not suitable for heat sensitive items, potential for injury if not maintained or used correctly, requires care and maintenance.

A gravity displacement sterilizer works on principle that air is ______ than steam. The machine uses ________ steam that goes from the _____ to _____ chamber.

heavier, pressurized, outer, inner

With steam sterilizer machines, microbial death is dependent on, _______ time (minimum __-__ mins based on _____ is being sterilized), _______ (____° F- ____° F), ______ __- ___PSI

exposure, 10-30, what, temperature, 250, 275, Pressure, 15, 18

Steam sterilizers are

• Dependable, simple design, affordable

Notes from this slide

Creates steam, works its way up untilthe ambietn gas is being pushed out.

A prevaccum sterilizer allows sterilization in ______ items with ______ to reach spaces through a _______ mechanism. Usually runs for about ___-___ minutes at _____ °F to ___°F

porous, harder, vacuum, 3, 4, 270, 275

A flash sterilizer should only be used in _______ when no alternative is available.

emergencies

Flash sterilizers use a gravity _______ sterilizer with a _____ tray.

displacement, metal

Flash sterilizers should be used on metal nonporous items (items ______ lumen) for __ minutes at ____° F to ____° F and metal items _____ lumen and ______ items (3) for ____ minutes at ___° F to ____° F

without, 3, 270, 275, with, porous, rubber, plastic, autoclavable power tools, 10, 270, 275

Notes on this slide don't need to know this

When would a steam sterilizer fail?

• Inappropriate packing or loading • Poor steam quality (not enough water, etc.). • Vacuum failure • Inadequate temperature

________ ______ is used for chemical (gas) sterilization (gas __________), which is a _______ gas.

Ethylene Oxide, diffusion (through instrument packs), flammable.

What are the pros of chemical (gas) sterilization?

Sterilizes heat sensitive equipment, sterilizes moisture sensitive equipment.

What are the cons of chemical (gas) sterilization?

Expensive, lengthy time cycle, hazardous

Efficacy of chemical (gas) sterilization depends on

Gas used, temperature, humidity, exposure time.

_______ _______ (____) is used for plasma sterilization. It is a ____ temp sterilization, is completed in ______ time because no _______ is needed

Hydrogen Peroxide (H2O2), low, rapid, drying.

Plasma sterilization uses _____ photons and _______ to kill _________ by ________.

UV, radicals, microorganisms, oxidation.

What are the pros of plasma sterilization?

Sterilizes heat and moisture intolerant items (#1 option), quick turnaround, no harmful emissions

What are the cons of plasma sterilization?

Gas cannot penetrate linen, gauze, wood products, endoscopes, and some plastics Requires specific synthetic packaging Sterilization chamber is relatively smaller than that of an EtO sterilizer.

Ionizing Gamma Radiation is a ____ temperature sterilization process and is useful for ___ sensitive equipment. Only used ________ since its so expensive. Uses _______ __ gamma rays

low, heat, commercially, cobalt 60

What are the pros of ionizing gamma radiation?

high penetrating power, rapidity of action, low temperature, flexibility

What are the cons of ionizing radiation?

expensive, dangerous, can cause breakdown of packing material or product

Peracetic acid sterilization uses ____ temperature ______ immersion sterilization on _____ sensitive items. This is used on items that will be used _______, not ____ term.

low, liquid, heat, immediately, long

What are the pros of peracetic acid sterilization?

Sterilizes heat intolerant items, rapid sterilization cycle, low temperature, safe.

What are the cons of peracetic acid sterilization?

Only applicable for immersible instruments, can be expensive, no sterile storage.

Cold sterilization uses _____, _______ chemicals to sterilize instruments. The effect depends on _______ (______) time • Disinfection = ____ ____ • Sterilization = ____ ______

liquid, noncorrosive, contact, immersion, 10, minutes, 10 hrs

What chemicals can be used for cold sterilization?

• Glutaraldehyde 2% • Ortho-phthalaldehyde (OPA) (Cidex OPA) • Hydrogen peroxide 7.5% (Sporox II)

When using cold sterilization, instruments should be rinsed with sterile _____ and dried with sterile _____.

water, towels

Components needed for surgery in one sterile pack include:

• Gown + towel • Instruments + gauze • Miscellaneous items

Wrapping material for surgical packs depends on the ?

method of sterilization

Paper bags are used to wrap?

Small light, non- sharp items such as Cotton balls and Gauze

What are the pros of wrapping material?

Cheap, easily obtained

What are the cons of wrapping material

easily perforated when wet, items can't be visualized, heavy items can break through

What type of linen material can be used for surgical packs?

Linen material = Usually cotton blend (muslin or linen) OR Synthetic material

Laminated sleeves/packs/pouches are a combination of _______, _____ stable _____ film laminated to ________ paper

transparent, heat, plastic, treated

What are the pros of laminated sleeves/packs/pouches?

Cheap and easily obtained, pre-cut sizes or rolls in various widths, several small items can fit, instruments can be identified.

What are the cons of using laminated sleeves/packs/pouches?

Easily perforated when wet, heavy items can break through.

Instrument containers are made up of?

Aluminum and stainless steel

Instrument containers store ?

a wide range of surgical instruments

List the steps of the surgical pack procedure

Cleaning and sonicating instruments • Pre clean rinse • Instrument soak • Cleaning • Manually • Ultrasonic cleaning equipment • Post clean rinse • Instrument drying

How do you prep the surgical pack?

Place and organize instruments Add drape and gauze Add sterile indicator Wrap (2x) Secure with autoclave tape Sign and initial

What are the purpose of sterilization indicators?

Monitors effectiveness of the sterilization process

Chemical indicators: chemical change occurs in response to _____, _____ and/or _______ but NOT _______ ______. • Does not confirm ______

heat, pressure, humidity, exposure time, sterility

Biological indicators: • Only means of ensuring ______ following sterilization • Sterility is assessed using ______ maintained in a _____ or on a ____

sterility, bacteria, broth, strip

How should all surgical items be wrapped?

All surgical items should be wrapped so they can be easily unwrapped without breaking sterile technique

Wrapped Surgical Packs

Folding and wrapping gown

Folding Surgical Gown

When folding the huck towel, you should use _____ hands. This towel is used as a ___.

dry, drape

Folding and wrapping drapes

Opening wrapped pack

Opening sterile instruments and equipment