sterilization and disinfection Flashcards
disinfection
chemical/physical means that kills pathogenic microorganisms but not spores
Spaulding Classification System
- categorized items to be disinfected
- critical, semicritical, noncritical
process controls/indicators/process challenge devices (PCD)
- make sure that physical conditions meet standards in the sterilizers
- CI, BI…
BI
-efficacy of specific sterilization cycle, not sterility of item
Class 1 CI
- external
- processed vs unprocessed distinction: has it been exposed to sterilization?
Class 2 CI
- Bowie Dick/Daily Function Test
- in dynamic air removal only during pre-vaccuum stage
- detect air leaks, presence of noncondensable gas
- in empty sterilizer over drain not pan
class 3 CI
single parameter
class 4 CI
> 2 parameters
class 5 CI
- integrating indicator that includes ALL critical parameters
- sterilant specific
class 6 CI/emulating indicator
-all critical parameters in a specific cycle
which sterilization methods use geobacillus stearothermophilus as BI?
-steam, plasma, vapor, ozone
which sterilization methods use bacillus atropheus
ETO, dry heat
which sterilization methods does not need BI?
peracetic acid-use specific BIs
class I clean wound
- no inflammation, maybe just nonpenetrating blunt trauma
- no entry into resp. alimentary, GU tract/break in sterility
- primarily closed wound, thyroidectomy, masectomy, ganglion excision, herniorrhaphy, laminectomy
- closed drainage system (bulb drain)
class II clean contaminated wound
- controlled/no infected/contaminated entry into resp., alimentary, GU tract
- no major GI spillage/breaks in sterility
- D&C, TAH, cysto, TUR, cholec…, hysterectomy (ab or vag), Csection, tracheostomy, appendectomy
class III contaminated wound
- gross/visible spillage from GI tract
- fresh, open, accidental wounds w/ nonpurluent inflammation
- major break in sterility
- rectal, traumatic (gunshots, fx), acute organ inflammation w/out pus
class IV dirty infected wound
- old wound >4-6 hr, delayed primary wound closure
- retained dead tissues
- infection w/ pus/perforated viscera
- evisceration, amputation, incision/drainage, incision/drainage of abscess
which 2 body systems have the highest rates of infection
GI and resp. tract
critical items
- touch blood/sterile inner body
- lap, implants
- need sterilization, if not possible then high level disinfection
semicritical items
- contact mucous membrane; nonpenetrating
- endoscopes (enter normal orifice GI), resp. instruments
- high level disinfection needed
noncritical items
- touch intact skin
- BP cuffs, bedpan
- low level to intermediate disinfection
what does enzymatic wash in decontamination target?
fat, protein, dried soil
what kind of packaging materials are for items undergoing ETO, plasma, and ozone sterilization?
polyethylene pouches
6 steps of sterilization
- cleaning/decontamination
- assembly
- package
- sterilization
- storage
- transport
4 factors in steam sterilization
time, pressure, temp, steam saturation
how long do items need to be cooled down in steam sterilization
30-60 min
what metal is not suitable for peracetic acid sterilization
Al bc dulls it
can instruments be stored using peracetic acid
NO! used immediately
4 factors in ETO
- time (2-10 hrs)
- temp
- chamber humidity
- gas concentration
how long do items need to be aerated in ETO
12-16 hours
special packaging requirements w/ plasma sterilization
no cellulose (paper), linens, liquids
dimensional requirements in storage of sterile items in rooms
- 8 to 10 inches above floor
- at least 18 in from ceiling
- 2 in. apart
aerosol/bellow effect
risk of contamination whenever sterile packages are compressed (dropped, XS handling)
high level disinfection
- kill vegetative bacteria, TB, some spores/fungi, virus
- 2% glutaraldehyde
intermediate disinfection
do not kill spores
low disinfection
do not kill spores or TB
2% glutaraldehyde high level disinfection’s container requirement
- in covered plastic container w/ well ventilation due to noxious fumes
- use 100%
2% glutaraldehyde high level disinfection’s PPE
100% nitrile rubber/butyl rubber gloves, eye protection
