Sterilization, Disinfectant, Cleaning

Question 1

——— removes foreign material that interfere with the sterilization process?

Answer 1

Cleaning.

Question 2

Why should instruments be kept moist after cleaning?

Answer 2

Prevents any materials from drying on the instruments which makes sterilization less effective

Question 3

———— is a classification system for reprocessing contaminated medical devices based on the risk of contamination of a device to a patient

Answer 3

Spaulding classification

Question 4

Critical items:

Answer 4

High risk for infection if contaminated. Any device that enters sterile tissue.
Must be sterilized to reuse

Question 5

Semi critical items

Answer 5

Have contact with mucous membranes or non intact skin.
Vaginal probes, respiratory equipment
Require high level disinfectant for reuse

Question 6

Non-critical items

Answer 6

Contact intact skin
Stethoscope, etc
Require low or intermediate level disinfection for reuse

Question 7

Blank Destroys all microorganisms including spores.

Answer 7

Sterilization

Using steam for heat resistant items, chemicals like ethylene oxide(eto)for heat sensitive

Question 8

Microorganisms they are easy to kill, group A

Answer 8

Lipid or medium size viruses (hep b, hiv, hav)

Vegetative bacteria- staphylococcus, pseudomonas, etc.

Question 9

Microorganisms that had intermediate level resistance - group b resistance

Answer 9

Non-lipid or small viruses (polio, coxsackie) ie hydrophilic viruses
Fungi
Mycobacterium

Question 10

Organisms that are the Hardest to kill- group c - need sterilization

Answer 10

Bacterial spores- bacillus atrophied, c diff, etc
Cryptosporidium
Prions (highest of all)

Question 11

What temp is needed for steam sterilization

Answer 11

250 f - also need constant pressure, adequate time, and mosture

Question 12

The process of preventing contamination with microbes is called

Answer 12

Asepsis

Question 13

Decontamination is the process by which an item is:

Answer 13

Rendered safe for handling without protective attire

Question 14

An increase in bilirubin has been associated with which disinfectant

Answer 14

Phenolic

Question 15

Endoscope processing

Answer 15

Clean
disinfect (using product instructions) by immersing in high level disinfectant into all channels for recommended time
Rinse with water (sterile, filtered, or tap if meets federal clean water standards)
Dry- rinse with alcohol and dry with forced air

Question 16

Ultrasonic cleaners…

Answer 16

Sonic waves make bubbles that expand and implode that dislodge soil from surfaces.

Advantage: can reach in crevices and cavitation

Disadvantages: maintenance, no rinse, can damage delicate studd

Question 17

Washer-sterilizer cleaners

Answer 17

Cleans by vigorous agitation in detergent bath
Adv: Renders items safe to handle and removes gross soil

Dis: lots of criteria needed - time, ph, detergent used, procedure used, etc

Question 18

Antiseptics are regulated by the

Answer 18

food and drug administration (fda)

Question 19

Fed govt Agencies that have most impact on Infection prevention are under which branch of govt?

Answer 19

Executive branch.

Dept of health and human service is main with branches like cdc, niosh, fda, nih, etc)

Question 20

OSHA enforces it standard by

Answer 20

Inspections

Question 21

Enzymatic cleaner should be discarded

Answer 21

After each use as they are not microbicidal and will not stop microbial growth

Question 22

What organism is most likely to be associated with contaminated disinfectants?

Answer 22

Pseudomonas species.

Question 23

Event related storage of sterile items allows them to be used at any time after processing as long as

Answer 23

It was stored in a dry well ventilated dust free insect free and temperature of controlled area. They must be inspected to ensure that the wrapping is still intact no tears punctures or evidence of water intrusion.

Question 24

What is the first action that should be done when a biological indicator from a sterilizer turns positive

Answer 24

Retrieve unused items from the load.

Question 25

Nearest alcohol swabs that are placed on top of a dialysis machine in an active dialysis unit

Answer 25

Should be discarded. Any medication or patient care supplies that come in contact with the dialysis machine should be discarded

Question 26

Blank Destroys All micro organisms except for high numbers of bacterial spores

Answer 26

High-level disinfectant

Question 27

Blank destroys Vegetative bacteria, mycobacterium, Most viruses, most fungi, but not bacterial spores

Answer 27

Mid-level disinfection

Question 28

Destroys vegetative bacteria, some fungi, some viruses, But not mycobacterium or spores

Answer 28

Low level disinfection

Question 29

The use of blank may result in Endotoxin contamination Of surgical instruments

Answer 29

Ultrasonic cleaners

Question 30

Washer pasteurizer’s are typically use to clean what type of instrument

Answer 30

Respiratory instruments. They use hot water 70°C for 30 minutes. It is at 70°C to not damage plastics

Question 31

Blank is the preferred method of Sterilization

Answer 31

Steam sterilization. 250° for 90 minutes

Question 32

What are some limitations of liquid chemical sterilants? Etheline oxide, Hydrogen peroxide Gas plasma, ozone, etc

Answer 32

The time it takes 3 to 12 hours Device cannot be wrapped during processing- (so harder to stay sterile in storage) They need to be rinsed following sterilization according to the manufacturers instructions Should only be used on items that cannot be steam sterilized– Heat sensitive items

Question 33

Blank are microbial masses Attached to surfaces that are immersed in liquid.

Answer 33

Biofilms. Bacteria in biofilms are up to 1000 times more resistant To antimicrobials.

Question 34

Blank is an acute noninfectious Inflammatory reaction To the anterior segment of the eye Typically occurring 12 to 48 After uneventful cataract surgery

Answer 34

TASS Toxic anterior segment syndrome. Associated with improper instrument cleaning and or powder from gloves

Question 35

High risk tissues for prion disease like Cruzfelt Jacobs disease are

Answer 35

Brain, spine, and Iete

Question 36

Advantages to OPA (ortho phthalaldehyde)

Answer 36

Fast acting No activation required Odor not significant

Question 37

Disadvantages to OPA (ortho phthalaldehyde)

Answer 37

``` Stains proteins gray Eye irritation with contact Expense Slow sporocital activity Anaphylactic reactions in bladder cancer patients ```

Question 38

Advantages of glutaraldehyde

Answer 38

Numerous use studies published Inexpensive Excellent material coverage

Question 39

Disadvantages of glutaraldehyde

Answer 39

Respiratory irritation from vapor Pungent odor Coagulations blood and fixes tissue to surfaces Slow mycobactericidal activity

Question 40

Advantages to hydrogen peroxide

Answer 40

``` No activation required- fast acting No odor or irritation Low toxicity - lowest of all in fact Does not coagulate blood or fix tissue No disposal issues Inactivates crypto ```

Question 41

Disadvantages to hydrogen peroxide

Answer 41

Material compatibility concerns-brass, copper, zinc-both cosmetic and functional Serious eye damage with contact

Question 42

List of semi-critical equipment

Answer 42

``` Cystoscopes Laryngoscopes Vaginal/rectal probes Gi endoscopes Bronchoscopes Diaphragm fitting rings Respiratory therapy devices ```

Question 43

Examples of critical medical equipment

Answer 43

Surgical instruments Cardiac and urinary catheters Implants Ultrasound probes for sterile body cavities

Question 44

When must floors in the operating room be cleaned and disinfected?

Answer 44

After each case. It is only necessary to clean a 3-4 foot perimeter around the operating table unless wider perimeter of contamination identified Reusable string or microfiber mops may be used and changed after each use. If cotton mop- clean mop head and fresh disinfectant after each case

Question 45

What should you look for when inspecting a 3rd party reprocessing site?

Answer 45

Their cleaning and decontamination process and Sterilizing load preparation process. Also review their quality control records

Question 46

What disinfectant can inactivate cryptosporidium

Answer 46

Hydrogen peroxide

Question 47

Chlorhexidine should be used on PICCs because

Answer 47

Effectiveness 30 second dry time Low incidence of allergic reaction No need to be rinsed. Not approved for infants under 2 months of age

Question 48

Endoscope carrying cases should…

Answer 48

Be discarded if used to carry an unprocessed endoscope Also should Not be used to store clean or dirty endoscopes in a healthcare facility

Question 49

What govt agency has a key focus on reprocessing of reusable medical devices (like endoscopes) and single use devices

Answer 49

Food and drug administration FDA

Question 50

Bleach solutions stored in a closed container, spray bottle, etc will remain stable for how long

Answer 50

30 days. If open contain it is stable for 24 hours

Question 51

Low and intermediate level disinfection is regulated by

Answer 51

The EPA

Question 52

High level disinfectant, sterilants and antiseptic are regulated by the

Answer 52

FDA