Surg 101--Chapter 17 (B&K) Flashcards
Degree of microbial load on an item before sterilization.
bioburden
Microbial load attached to a surface in a fluid environment.
biofilm
Process by which chemical or physical agents are used to clean inanimate, concritical surfaces; a specific contact time is not specified.
decontamination
Water that has been processed through synthetic cation-anion resins to remove the positively or negatively charged ions.
deionized water
Chemical or physical process of destroying most forms of pathogenic microorganisms excepts bacterial endospores; used on inanimate objects but not on tissue.
disinfection
The degree of _____ depends primarily on the strength of the agent, the nature of the contamination, and the purpose for the process.
disinfection
Process that destroys all microorganisms except high numbers of bacterial endospores.
high-level disinfection
Process that inactivates vegetative bacteria, including M. tuberculosis, and most fungi and viruses but does not kill bacterial endospores.
intermediate-level disinfection
Process that kills most bacteria, some viruses, and some fungi but does not destroy resistant microorganisms, such as M. tuberculosis or bacterial endospores.
low-level disinfection
The process of evaporating water and creating condensation from the steam that is collected for future uses.
distilled water
Protective capsule that forms inside specific bacterial species encircles and protects the genetic matter to resist destructive forces, such as disinfection or sterilization.
endospore
Heating process kills many pathogenic microorganisms that are found in biosubstances such as milk or wine.
pateurization
The decontamination process renders soiled instruments safe for _____, but not safe for _____.
handling
patient use
A sterile processing certification program accredited by the National Commission for Certifying Agencies (NCCA).
Certification Board of Sterile Processing and Distribution (CBSPD)
CBSPD offers five levels of certification:
- technician
- supervisor
- manager
- surgical instrument processor
- ambulatory surgery
What can be applied to the instruments to prevent debris from drying during transport to the central service area.
enzymatic foam or solution
True or False: All instruments on the table during a surgical procedure require decontamination before processing to the required level of safety for patient use.
True
Decontamination combines _____ or _____ and a physical or chemical microbial process.
mechanical or manual cleaning
Done in the processing department to render the instrumentation safe for handling by CS personnel.
prerinsing, washing, rinsing, and disinfection/sterilizing
Should be worn at all times while using chemical disinfectant agents.
PPE
What is the purpose of prerinsing or presoaking?
To prevent blood and debris from drying on instruments or to soften and remove dried blood and debris.
_____ or _____ instruments with enzymatic solution in the OR can make further processing more efficient.
Prerinsing or presoaking
What is the purpose of manual cleaning?
To remove residual blood and debris before terminal sterilization or high-level disinfection
Personnel in the processing area wear PPE such as:
- caps
- gloves
- waterproof aprons
- face shields
When cleaning instruments manually, fill the washing sink with clean, _____ to which a concorrosive, _____, low-sudsing, free-rinsing detergent has been added.
warm water
neutral pH
An alkaline detergent (pH more than _____) can stain instruments.
8.5
An acidic detergent (pH less than _____) can corrode or pit instruments.
6
What type of detergents are preferred when manually cleaning instruments?
liquid
When manually cleaning instruments by hand, rinse them thoroughly in _____water at the temperature recommended by the manufacturer.
distilled or deionized
Some enzymes can be inactivated by extreme temeratures, the water should not exceed _____ to prevent burns of the skin.
140 F (60 C)
A washer sterilizer requires instruments to be prewashed by hand in germicidal solution at _____ before being placed in the machine.
110 F (43.3 C)
The temperature of the washer-sterilizer ranges from _____ and would cause coagulation and crusting or protein.
250 - 280 F (121 - 138 C)
A cycle in a washer-sterilizer makes the instruments _____ with the bare hands, but does not render the instrument safe for immediate _____.
safe to handle
patient use or sterile storage
A washer-decontaminator does not reach the same temperature as a washer-sterilizer. It cleans at a maximum temperature of _____, rendering the instrument safe to handle without gloves at the end of the cycle.
140 - 180 F (60 - 82 C)
Using high-frequency sound waves, ultrasonic energy thoroughly cleans by a process of _____.
cavitation
For ultrasonic cleaning the temperature of the water should be between _____ to enhance the effectiveness of the detergent.
100 - 140 F (37.7 - 60 C)
True or False: An ultrasonic cleaner is not a sterilizer like the washer-sterilizer.
True
In an ultrasonic cleaner, rinse instruments thoroughly in _____ after the cleaning cycle to remove any surface debris and detergent residue.
hot deionized water
For lubrication, instruments are immersed in an _____ that is steam penetrable.
antimicrobial water-soluble lubricant
What are not used to lubricate instruments because they leave a residue that interferes with steam or ethylene oxide sterilization.
mineral oil, silicone, and machine oils
To use most lubricants, instruments are completely immersed for _____.
30 - 45 seconds
With normal use, good-quality surgical instruments have an expected life of at least _____.
10 years
What are the most common causes of instrument breakage.
misuse and abuse
Disinfection differs from sterilization by its lack of _____.
sporicidal power
Disinfection can be accomplished with _____.
chemical and physical agents
A reconstituted chemical container should be labeled with the _____ and _____.
date of mixing and date of expiration
Spaulding system developed when?
1968
Must be sterile because they enter sterile tissue, break the mucosal barrier, or come into contact with the vascular system.
critical items
Is sterilization required for critical items?
yes
High-level chemical disinfection should not be confused with _____.
chemical sterilization
Come into contact with intact skin and mucous membranes and require high-level disinfection, although that also may be sterilized.
semicritical items
Used in contact only with intact skin. Intermediate or low-level disinfection is adequate.
noncritical items
The process of destroying or inhibiting growth of pathogenic microorganisms on inanimate objects.
disinfection
Disinfection reduces the risk of microbial contamination but does not provide the same level of assurance as _____ because all endospores are not killed.
sterilization
Disinfection levels are classified by the _____.
effectiveness of the process
Disinfection level that kills all bacteria, viruses, and fungi.
high-level disinfection
Disinfection level that may kill endospores if contact time is sufficient and other conditions are met.
high-level disinfection
Disinfection level that should be used is a semicritical item is disinfected rather than sterilized for use in contact with nonintact skin or mucous membranes.
high-level disinfection
Exposure of a clean item to 2% glutaraldehyde for _____ at _____ produces high-level disinfection.
20 minutes at 68 F (20 C)
Disinfection level that kills most bacteria, viruses, and fungi on noncritical items.
intermediate-level disinfection
Disinfection level that does not attack endospores but inactivates M. tuberculosis.
intermediate-level disinfection
Disinfection level that kills most vegetative bacteria, fungi, and the least resistant viruses on noncritical items, including HIV.
low-level disinfection
A record of the agent, concentration, and time of exposure should be maintained for _____ that have undergone high-level disinfection.
semicritical items
The level of disinfection that can be achieved depends on:
- the type and concentration of the agent
- contact time
- bioburden
Chemical agents for disinfection are registered with the _____.
Pesticide Regulation Division of the EPA
Water are some chemicals that are considered hazardous?
- isopropyl alcohol
- sodium hypochlorite
- formaldehyde
- glutaraldehyde
- phenol
To be labeled for hospital use, a chemical disinfectant should be proved effective against:
- Staphylococcus aureus (g-pos)
- Salmonella choleraesuis (g-neg)
- Pseudomonas aeruginosa (g-neg)
The EPA defines a _____ as an agent that kills growing or vegetative forms of bacteria.
disinfectant
Sterile and high-level disinfected items will require the use of _____ as a rinse.
sterile water
Semicritical and noncritical items can be rinsed with _____.
tap water
Isopropyl alcohol
- intermediate level of disinfection
- virucidal (but not enterovisuses)
- Fungicidal
- Tuberculocidal
Cidex activated alkaline 2.4% dialdehyde
- Sterile and high-level of disinfection
- 10 hours at 25 C (sterile)
- 45 minutes at 25 C (high level)
- Virucidal
- Fingicidal
- Sporicidal
- Tuberculocidal
- 30-day use period
Cidex OPA-(0.55%) orthophthalaldehyde:
- high level of disinfection
- 12 minutes at 20 C
- Virucidal
- Fingicidal
- Tuberculocidal
Cidex OPA-(5.75%) orthophthalaldehyde concentrate:
- high level of disinfection
- 5 minutes at 50 C
Chlorine and chlorine compounds:
- Low to high based on concentration
- 10-30 minutes
- Virucidal
- Fingicidal
- Tuberculocidal
Ethyl or isopropyl alcohol, _____ to _____, kills microorganisms by coagulation of cell proteins.
70% to 95%
Alcohol can disinfect _____ instruments.
semicritical
When using alcohol, to prevent corrosion of metal, 0.2% _____ is added.
sodium nitrate
Alcohol loses its microbial activity below a concentration of _____.
50%
Chlorine compounds kill microorganisms by the _____.
oxidation of enzymes
Sodium hypochlorite (household bleach) 1:10 dilution of 5.25%, is a _____ disinfectant.
low-level
Formaldehyde kills microorganisms by _____ of protein in cells.
coagulation
The solution may be _____ formaldehyde in water or _____ formaldehyde in 70% isopropyl alcohol..
37%
8%
