Surgical Techniques - Instrument Sterilization and Environmental and Equipment Disinfection 3-A Flashcards
Agent capable of killing spore-forming organisms in the free spore state
sporicidal
Protection against wound infection pre-, inter-, and post-operatively through aseptic technique
surgical asepsis
a small glass receptacle for holding liquids or powders
flask
actual or suspected relative number of microorganisms found in an area or on an item
bioburden
a highly resistant, protective covering or casing formed by a bacterium
spore
chemical agent that destroys microorganisms
disinfectant
surface or medium on which an organism grows or is attached
substrate
open inner space of a tube, which can be in an endoscope, a catheter, or a needle; a hollow cavity in an organ or a blood vessel; can also be a unit of invisible, translit light that is generally described as a measure of brightness
lumen
hospital-acquired infection
nonsocomial
substance that kills all forms of living matter including spore-bearing ones
sterilant
non-living or lifeless
inanimate
transmission of microorganisms from patient to patient and from inanimate objects to patients and vice versa
cross contamination
agent that destroys germs
germicide
having the capacity to chemically kill pseudomonas bacteria which commonly causes infections in wounds, burns, and the urinary tract
pseudimonacidal
the process for removing contaminants from an object that has been exposed to hazardous materials, such as infectious material and blood, chemicals, or radioactive substances
decontamination
a chemical agent that inhibits the growth of microorganisms without necessarily killing them
antiseptic
having the capacity to prevent of destroy or inhibit the growth of fungi
fungicidal
causative agent that is spread by persons coming into contact with body fluids or droplets that leave by mans of an infected person’s portals of exit
pathogen
very small mass of liquid carried in a spray from the nose or mouth which falls to surface upon expiration as liquid and which are not readily inhaled
droplet
inanimate objects which are freshly contaminated with secretions or excretions from an infected person or carrier
fomites
an animal, especially an insect, that transmits pathogens from infected to non-infected individuals
vector
having the capacity to or tending to destroy or inactivate viruses
virucidal
having the capacity to prevent or destroy the growth or action of bacteria
bactericidal
any occurrence that compromises the sterility of the package
event-related sterility
sterility is less critical for those items that come in contact with mucous membranes or broken skin. Items are considered clean and require minimal disinfection using a chemical disinfectant, such as glutaraldehyde, hydrogen peroxide, and peracetic acid with hydrogen peroxide to reduce microorganisms before use.
semicritical
Any items introduced to internal body areas or areas with high risk of infection if contaminated with microorganisms, including bacterial spores. These items must be handles with sterile technique to maintain sterility.
critical
Items that come in contact with intact skin but not mucous membranes. Most reusable items may be decontaminated where they are used and do not need to be transported to Central Processing.
noncritical
the immediate disinfection process following discharge of infectious material from the body of an infected person or after contamination of articles by an infectious agent
concurrent disinfection
used on noncritical items such as floors, walls, and anesthesia equipment
Level 3 low-level disinfectant
used to disinfect or sterilize surgical instruments
Level 1 high-level disinfectant
examples of disinfectants include glutaraldehyde, peracetic acid, and chloride compounds
Level 1 high-level disinfectant
accomplished by surface cleaning or disinfection
Level 3 low-level disinfectant
used on semicritical items such as laryngoscopes, bronchoscopes, and respiratory equipment
Level 2 intermediate-level disinfectant
examples of disinfectants include phenolic germicidal solution, iodophor solution, sodium hypochlorite, and quaternary ammonium compounds
Level 3 low-level disinfectant
the action of a disinfecting agent to make substances, such as fats or lipids, dissolve, especially in water
solubilization
the physical action in which fats are mechanically broken up into very small particles which are uniformly suspended in the disinfecting solution
emulsification
the action of organic matter attaching itself to the water hardness particles, principally those of calcium and magnesium, and inactivating them so they will not combine with other material, such as the disinfecting agent in the water and precipitate out
chelation
the action of breaking down or digesting large organic molecules that then interact with and break down a particular molecule and move on and repeat the process
enzymatic
Use protective eye wear and ______ equipment when working with chemical disinfectants to prevent accidental splash to eyes and inhalation of fumes.
respiratory
Use covered containers and adequate _____ to reduce exposure to fumes since vapors can be toxic.
ventilation
Properly _____ liquids.
dilute
Ensure items are clean and free of gross _____ so the disinfectant effectiveness is maximized.
contaminants
Dry materials prior to disinfection to prevent disinfectant ______.
dilution
Completely _____ items in the disinfectant solution.
immerse
Allow adequate time during immersion for disinfectant to _____.
work
_____ disinfectant from items prior to use.
Rinse
Type and number of microorganisms present, including gross contamination or _____.
bioburden
Degree of _____ - This determines the level of disinfectant required and time of exposure.
contamination
Amount of proteinaceous material present - High protein-based materials _____ and neutralize some chemical disinfectants.
absorb
Presence of _____ matter and other compounds - May neutralize some disinfectants.
organic
______ nature of disinfectant - It is important to understand the mode of action in order to select the appropriate disinfectant.
Chemical
Concentration and _____ of disinfectant - It is important to choose the proper concentration and _____ of disinfectant that is best suited for the level of disinfection needed.
quantity
quantity
Contact time, ______ level, and temperature - Sufficient time and appropriate temperature must be allowed for action of the disinfectant and may depend on the degree of contamination and organic matter load.
pH
Widely used high-level disinfecting agent, especially for semicritical instruments, that destroys microbes by denaturation of cellular proteins
2% glutaraldehyde
Is a nonglutaraldehyde based high-level disinfecting agent used to destroy microbes by denaturation of cellular proteins
Ortho-Phthaldehyde 0,55% (Cidex OPA)
Destroys microbes by coagulating cellular proteins
alcohol - Isolpropyl and ethyl
Disrupts the cellular metabolism of the microbes by oxidizing enzymes
chlorine compounds/sodium hypochlorite (bleach)
reacts through oxidation with the organic material and microbes in the water to kill them
chlorinated lime
penetrate the cell wall of microorganisms quickly, and the lethal effects are believed to result from disruption of protein and nucleic acid structure and synthesis
iodine-based compounds (iodophor)
destroy microorganisms through denaturation and coagulation of proteins
phenois and derivatives
Keep _____ in and out of the operating room to an absolute minimum.
traffic
Immediately apply a _____ spectrum detergent-germicide to areas contaminated with organic debris such as blood.
broad
Dispose of sponges in a ____ biohazard bag.
red
Do not place soiled sponges on a _____ sterile table.
draped
Use glove or _____ or both when counting and collecting soiled sponges.
instruments
Place all disposable sharps in a ______-resistant biohazard container as infectious waste.
puncture
Clean the exterior surfaces of _____ containers before removal from OR.
specimen
Keep all trash and _____ off the floor.
linen
begins with the removal of the initial gross contaminants by wiping the instrument as it is used on the sterile field
decontamination
initial immersion in a basin of enzymatic detergent, distilled water, or water with a low sudsing detergent helps to loosen gross contaminants from instruments
pre-rinse or soaking
the hand washing of instruments in the processing area to remove any residual blood or debris before high-level disinfection or terminal sterilization
manual cleaning
uses high frequency sound waves to generate tiny bubbles that clean the serrations, crevices, and lock boxes of instruments that are difficult to clean with other methods
ultrasonic cleaning
this process must be completed on any instrument with moving parts; involves completely immersing the instrument in a manufacturer-approved lubricant for 30-45 seconds, then dipping and allowing to drip dry in a draining tray
lubrication
involves the inspection, assembling, and packaging of instruments and supplies prior to terminal sterilization of disinfection
preparation, assembly, and packaging
critical verification of instruments must be done after cleaning to ensure there is no damage, stiffness of hinged joints, etc.
inspecting and testing
distribution of instruments into instrument sets or procedure trays for packaging and placement in sterilizer racks
assembly
to be effective, the appropriate instrument container must allow the sterilizing agent to come in contact with all surfaces of the instrumnts
packaging
the physical or chemical sterilization process that renders an item free of all living microorganisms, including spores
terminal and final sterilization
concerned with event-related sterility and the shelf-life of items
storage
concerned with the probability of contamination increasing as supplies are touched and moved around
handling
concerned with systems, delivery, patient charging methods, record keeping, and safety practices
distribution
The _____ cleaner provides a cleaning process, not a thermal or chemical disinfection or sterilization process.
ultrasonic
The washer-sterilizer method cleans items to at least an ______ disinfected level.
intermediate
The manual or hand-wash method requires a _____ in its first stage to prevent excessive drying of soil.
soaking time
During hand wash, _____ must be brushed internally to remove residue.
endoscopes
_____ is the final step before milking the instruments.
Rinsing
Milking the instruments is designed for instruments that require _____.
lubrication
After cleaning, completely _____ the instruments.
dry
When using a washer-decontaminator, instruments are placed in a mesh or perforated bottom ______
basket
When using the manual method, completely immerse instruments in a deep basin with _____ cleaning detergent in warm water.
non-corrosive
It is important to keep dissimilar metals separate to prevent _____ through electrolysis.
etching
