Surgical Techniques - Instrument Sterilization Part 2 - 3-A Flashcards
Composed of rigid anodized aluminum, stainless steel, polymer, or a polymer-metal combination which cannot be punctured
sterilization tray and case
thick, protective, plastic wrap used to cover a sterile package
dust cover
adapts to sterilization methods: EtO and pressure steam
Tyvek/plastic sterilization pouch
composed of a synthetic fiber; available in single- or double-layered thicknesses
nonwoven material for envelope and square fold
reusable textile composed of a high-quality cotton or combination of polyester and cotton with a thread count of at least 140
woven wrapping material
composed of two different materials, paper on one side, plastic on the other
paper-plastic peel pack
Select packaging that _____ sterilization, maintains the sterility of the item, and provides easy aseptic delivery of the item.
optimizes
Packaging must allow for adequate removal of _____, adequate penetration of the sterilant, and direct contact with the items.
air
Wrap packages to permit sterilization and ____ of the contents, if needed, while maintaining sterility until the package is opened.
aeration
Imprint or label every in-hospital sterilized package, including package content, the date of sterilization, _____ used, the cycle or load number, the date of sterilization and the initials of the employee who prepared the package.
sterilizer
Package size requirements mandate they do not exceed ______ pounds and are no larger than 12 x 12 x 20 inches.
12
Arrange all packages in the sterilizer in loose contact on a ______ edge (except instruments in perforated pans) to allow free circulation and penetration of steam, and prevent entrapment of air and steam or gas.
vertical
Place nonporous items on the _____ shelves of the rack in combined loads.
bottom
Ensure _____ containers are flat on the shelves of the sterilizer.
rigid
Do not stack containers since it may interfere with air ____ and steam penetration.
removal
high-heat or low-temperature process
temperature
certain types of instruments can be submersed when cleaning without any damage while other instruments will be damaged if water is allowed into the optics
submersible vs. nonsubmersible instruments
ratio of sterilizing agent relative to air or other substance
concentration and purity
high- or low-pressure chambers
pressure
actual or suspected relative number of microorganisms found in an area or on an item
bioburden
how closely other instruments are packed against one another
packaging density
some of these items cannot be steam sterilized because they are heat sensitive
heat sensitive vs. nonheat sensitive instruments
ability to prevent penetration of sterilizing agent
bioshielding or packaging material
amount of sterilizing agent allowed to soak through an item
saturation of the agent
to lessen the expense of the sterilization process
cost
shorter or longer periods
time
pertaining to the level of moisture in the atmosphere, which varies with temperature
humidity
ability to repel without allowing the penetration of the sterilizing agent
bioshedding
spore or vegetative state of organism
biostate
species of microbes are characterized by their nutritional status that is required for growth, such as carbon, oxygen, sulfur, nitrogen, and phosphorus
nutritional status of microbe
durability of the product against heat, pressure, chemicals, etc.
sensitivity
microbial resistance to antimicrobial agents
bioresistance
blood and tissue can present a problem with an instrument that has a lumen. Special care must be taken to slush the lumen until the fluid emerges clear.
presence of lumens
Size and space required vs. size and space available for instruments and equipment.
capacity of autoclave
Water is heated to boiling point of 212 degrees Fahrenheit, additional heat energy evaporates and the water forms steam. Steam is submitted to increasing pressure that increases the temperature. Steam enters at the top of the chamber and drives the heavier air out an escape valve at the bottom of the chamber. The steam must come in contact with the item for a set time to destroy all the microbes including spores. Saturated steam permeates the material within the chamber and transfers its heat to the material.
gravity displacement
smaller version sterilizer used in the OR for unplanned sterilization of urgently needed unwrapped items, such as dropped instruments
flash autoclave
pulls air from sterilizing chamber. Replaces air with steam that immediately penetrates the wrapped items. Assists in the removal of moisture from wrapped items and decreases the drying period. Generally increases shelf life.
pre-vacuum
uses agitated water with neutral detergent cleaning agent to dissolve and loosen blood and debris. Pressurized steam displaces drained water.
washer-sterilizer
This system utilizes peracetic acid and an anticorrosive agent, as a sterilant to destroy microbes by (using cavitation or reacting with various cellular systems).
reacting with various cellular systems
This system is most commonly used to sterilize (endoscopes or stainless steel, or copper instruments).
endoscopes
This system allows the (steam or sterilant) to flow continuously through the lumen of the scope.
sterilant
Items sterilized with peracetic acid (must be or must not be) adequately rinsed with sterile water prior to use.
must be
Operating parameters include low temperatures of 122 degrees to 131 degrees Fahrenheit. The cycle time is (20-30 minutes or 1-2 hours).
20-30 minutes
The advantage of this system is that the by products: acetic acid, (oxygen or carbon) and water are environmentally safe.
oxygen
Peracetic acid should not be used to sterilize instruments that contain copper, brass, or zinc because (toxic salts or toxic chemicals) may form which can cause injury to patients.
toxic salts
Safely used with (nonmetal instruments or immersible instruments only).
immersible instruments only
Used for (pressure-sensitive and temperature-sensitive or pressure-sensitive and time-sensitive) equipment which cannot withstand steam sterilization, including electric or air-powered instruments.
pressure-sensitive and temperature-sensitive
Kills microorganisms by interfering with the metabolism of proteins and by inactivating the cell’s (molecular structure or reproductive process).
reproductive process
Remove caps, plus, valves, and needle stylets fro instrument to permit the gas to (engulf or circulate through) all items.
circulate through
(Hydrate of Dissolve) highly dried bacterial spores, or the ethylene oxide gas is ineffective.
Hydrate
Be aware that ethylene (glycol or glucose) is a toxic by-product of EtO.
glycol
Aerate all (porous or hardened) items after processing to eliminate the hazard of toxic residues.
porous
(Mechanical or Ambient) aeration (preferred method) - 8 hours to 12 hours at 50 to 55 degrees Celsius or 12 to 16 hours at 38 degrees Celsius.
Mechanical
Biological indicators that contain (Bacillis atrophaeus or pseudomonas bacteria) must be used with every EtO cycle to verify adequacy.
Bacillis atrophaeus
EtO is highly flammable, but it is rendered nonflammable when mixed with (carbon dioxide or carbon monoxide) or fluorinated hydrocarbon (Freon).
carbon dioxide
Activated when an agent is added to make 2% _____ solution
alkaline
2% glutaraldehye or Cidex kills microbes by attacking cell _____.
proteins
Has a broad antimicrobial range; effective against vegetative bacteria, _____ tuberculosis, fungi and viruses.
mycobacterium
Effective against most bacteria in _____ minutes; some species of mycobacteria require longer exposure time.
10
Used for lensed instruments and _____-sensitive items
heat
Relatively _____ to endoscopes, plastic, and rubber items
noncorrosive
Clean and dry items prior to immersion to prevent diluting the _____ concentration.
liquid
Ensure all surfaces come in contact with the agent. Completely fill _____ of instruments or tubing.
lumen
Rinse all instruments thoroughly with sterile _____ _____ following immersion and dry with sterile towel.
distilled water
Requires total immersion of instruments for 10 hours for sterilization; to achieve _____-level disinfection.
high
Minimum exposure time is 20 to _____ minutes.
30
Reusable once activated, since it remains chemically active and stable for a maximum _____-day use period.
14
A new sterilization process, which uses ozone as the sterilant, was cleared by FDA for processing _____ medical devices.
reusable
Ozone gas is a powerful oxidant that destroys microorganisms but is highly _____ (i.e. half-life of 22 minutes at room temperature).
unstable
The duration of the sterilization cycle is about _____ hours and 15 minutes, and it occurs at 30-35 degrees Celsius.
4
Microbial efficacy has been demonstrated against a variety of microorganisms to include the most resistant microorganism, _____ stearothermophilus.
geobacillus
The ozone process is compatible with a wide range of commonly used materials including _____ _____, titanium, anodized aluminum, ceramic, glass, silica, PVC, Teflon, silicon, polypropylene, and acrylic.
stainless steel
The process should be safe for use by the operator because there is no _____ of the sterilant, no toxic emissions, no residue to aerate, and low operating temperature so there is no danger of an accidental burn.
handling
The cycle is monitored using a self-contained biological indicator and a _____ indicator.
chemical
A gaseous chlorine dioxide system for sterilization of health care products was developed in the late (1980s or 1970s).
1980s
Microbial (contamination or destruction) occurs by the interference with the cellular process.
destruction
Chlorine dioxide (is or is not) mutagenic or carcinogenic in humans.
is not
As the chlorine dioxide concentration increases, the time required to achieve sterilization becomes progressively (longer or shorter).
shorter
Currently, (one or no) gaseous chlorine dioxide system has been cleared by the FDA.
no
