Test 8 Sterilization And Disinfection Flashcards
What is the purpose of sterilization and disinfection?
Reduce/eliminate microorganisms
Prevent SSI
Protect patients and staff
What is decontamination?
Reduction of microbes by removal or destruction of contaminants
What does the term cleaning mean?
Physical removal of blood, fluids, and gross debris from inanimate objects
What is antisepsis?
Reduction of microorganisms on animate objects (humans)
What does it mean to disinfect?
Destroy most microorganisms on inanimate object
Ex. OR furniture, walls, floors, medical devices
Requires direct exposure to chemical agents
Not effective against spores or prions
What does sterilization mean?
Destroy microorganisms and spores
(Not always prions)
Renders items safe for contact to sterile body tissue and blood
Required for surgical instruments and supplies
What is the sterile processing dept?
CSP or SPD
Responsible for Decon, assembly, and sterilization of equipment
Not usually on same floor as OR
Semi-restricted area
Describe the clean area of SPD
Instrument assembled into sets to be sterilized
Describe the dirty area of SPD.
Surgical instruments are cleaned and decontaminated
Describe the SPD supply area.
Storage of sterilized instruments
Instrument tracking
Where cases are picked and packed onto case carts
What is the cycle of reprocessing instruments and equipment?
Point of use care
Sort and disassemble
Clean
Decontamination
Inspect
Assemble and wrap
Sterilize
Storage
Point of use
What methods are used to clean instruments
Manually
Ultrasonically
Mechanically
May go through more then one method
What does manual cleaning of instruments in the OR area consist of?
Responsibility of surgical tech
Wipe off blood and debris
Use sterile water
NEVER saline
Disassemble items and stack back into sets
Spry with PreKlenz before cart leaves room
What does manual cleaning of instruments in SPD consist of?
Do not soak drills, saws, etc.
Removal of gross debris
Scrub hard to clean areas- serrations, box locks, and lumens
What does ultrasonic cleaning consist of?
Removes debris by cavitation (high frequency sound waves) micro bubbles
Instruments cleaned before using
Only same metals washed in each cycle- do not mix
Thorough rinsing after
What does mechanical cleaning entail?
Washer/dryer/sterilizer
All instruments go through, except cords and scopes, special equipment
Water water and steam
Terminal decontamination
What are some special cleaning considerations in decon?
Box lock hardest to clean
Don’t submerge drills and saws
Lumens need special attention
Endoscopes processed within 1 hour
What are the 3 levels of disinfection?
High
Intermediate
Low level
What is high level disinfection?
Kills ALL microorganisms except spores and prions
What is intermediate level disinfection?
Kills most microorganisms
Bacteria, most viruses, and fungi, but not spores or prions
What is low level disinfection?
Kills some microorganisms
Most bacteria, some viruses and fungi
But not tb, spores, or prions
What are the 3 levels of Spaulding classifications?
Determines level of processing required based on intended use
Critical
Semi-critical
Non-critical
Describe Spaulding classification- critical
Invasive procedures
High potential to cause SSI
Surgical instruments
Enter vascular (needle, catheter)
Enter urinary
Implantable items ( wires, screws, joint replacements, mesh, sutures)
Requires sterilization
Describe Spaulding classification- semi-critical
Items that contact mucous membranes or non-intact skin
Laryngoscopes/ GI endoscopes
Anesthesia equipment
Respiratory equipment
Endoscopes
Requires high level disinfection
Describe Spaulding classification-
non-critical
Equipment and items that contact patients intact skin
Blood pressure cuffs
Pulse oximeter
OR transport stretchers
OR furniture
Requires intermediate or low level disinfection
Ideal characteristics of disinfectant solutions are…
Effective against broad spectrum of microorganisms
Rapid acting
Odorless and nontoxic as possible
Non corrosive
Prolonged shelf life- use test strips
Factors that influence disinfectant solutions are…
What item is to be disinfected
Presence of bioburden
Exposure time
Temperature
What are the two high level disinfectant solutions??
2% glutaraldehyde (cidex)
Sodium hypochlorite (bleach)
Important things to know about 2% glutaraldehyde (cidex)
Effective against bacteria, TB, and viruses
Used on endoscopes/ heat sensitive
14-28 day shelf life
Minimum exposure time 20 minutes
If used as sterilant then 10 hours exposure
Skin, eye, respiratory irritant
Important things to know about sodium hypochlorite (bleach)
Bactericidal, virucidal, tuberculocidal
Fast acting
Clean floors and countertops
Used for blood spills
What are the 2 intermediate level disinfectants?
Phenol (carbolic acid)
Isopropyl or ethyl alcohol
Things to know about phenol
Carbolic acid
Intermediate level disinfectant
General cleaning agent
Used on floors and countertops
Things to know about isopropyl or ethyl alcohol…
Intermediate level disinfectant
60-70% concentration
Highly flammable
Things to know about isopropyl or ethyl alcohol…
Intermediate level disinfectant
60-70% concentration
Highly flammable
What is a low-level disinfectant?
Quaternary ammonium “quats”
Not effective against viruses or TB
Easily neutralized
What are the ways to disinfect the OR rooms?
Uv radiation
Sami-cloth wipes
What are the three sterilization options?
Thermal
Chemical
Radiation
What is used to lubricate instruments?
“Instrument milk” or surgical milk
What is used to lubricate instruments?
“Instrument milk” or surgical milk
What are woven textile material for wrapping?
Muslin
Cotton material
Reusable
Eventually discarded
Not used often anymore
What are woven textile material for wrapping?
Muslin
Cotton material
Reusable
Eventually discarded
Not used often anymore
What is a non-woven material for wrapping items?
Kimguard
Single use
2 layers
What are the 2 wrapping techniques?
Envelope
Square fold
What are the two types of peel pack materials?
Paper and plastic- steam
Tyvek and plastic- sterrad
What are the 2 thermal sterilization methods?
Steam
Dry heat
What does steam sterilization destroy?
Coagulation of nucleic acids, protein, and cell wall
What are factors affecting steam sterilization?
Time
Temperature
Pressure
Moisture/humidity
Contact
What are the three types of autoclaves?
Gravity displacement
Dynamic air removal/prevac
Immediate use steam sterilizer (IUSS)/ flash sterilization
What are components of a steam sterilizer?
Outer jacket
Inner chamber
Control panel
What is the gravity displacement cycle?
Conditioning- steam into inner chamber
Exposure- pressure and temp met
Exhaust- steam removed
Drying- moisture evaporated
What are the parameters for a gravity displacement sterilizer?
250F (121C) for 30 min or
279F (132C) for 15 min
15-17 psi
15-30 minute dry time
Must be tested with biological I dicators
What are the cycles of dynamic air removal (prevac)
Air removal
Conditioning
Second air removal vacuum pump
Exposure
Exhaust
Drying
What are the parameters for dynamic air removal sterilizer?
270F (132C) for 4 min
27-30 psi
20-30 minutes drying
Use biological to test sterilization
What is some info about immediate use steam sterilization (IUSS)
Flash sterilization
Gravity or prevac system
Time of essence
Implants never done
Infection risk when used
What are IUSS parameters
Nonporous/ no lumens
3 minutes 270F
Porous / with lumens
4 minutes at 270F (prevac) or
10 minutes at 270F (gravity)
What is dry heat sterilization?
No steam or moisture
High temp retired
Anhydrous oils
Petroleum products
Bulk powders (medications)
What is dry heat sterilization?
No steam or moisture
High temp retired
Anhydrous oils
Petroleum products
Bulk powders (medications)
What are ethylene oxide (ETO) sterilizers?
Destroys microbes through alkylation
Carcinogenic
Sterilization:
16 hours/ 85F to 145F/ 30-80% humidity
Must be dry
Aeration cycle:
8 hrs at 140F or 12 hrs at 120F
What is sterrad sterilization?
Hydrogen peroxide gas plasma
Used on heat/moisture sensitive
28-38 minute cycles
No paper!
What is steris sterilization?
Peracetic acid
New every load
Used for heat sensitive
Sterility cannot be maintained
Semi-critical
3 important things to know about 2% glutaraldehyde?
High level disinfectant
Sterilization- 10 hours
Disinfectant- 20 minute
What is ionizing radiation?
Cobalt-60 gamma
Commercial production or single-use supplies
What bacterial species is in a steam and steris biological indicator?
Geobacillus stearothermophilus
What bacterial species is in ethylene oxide (ETO) and sterrad sterilization?
Bacillus atrophaeus
Aeration
The act of airing out
Animate
Living
Inanimate
Non-living
Antiseptic
An agent that destroys microorganisms on animate surfaces
Asepsis
Absence of pathogenic microorganisms of disease
Autoclave
Machine used to sterilize items
Bactericidal
An agent that kills bacteria
Bacteriostatic
An agent that inhibits or prevents bacterial growth
Bioburden
Contaminating microbes on an object such as blood, body fluids, and gross debris
Bowie-dick test
Test that identifies air leaks and ineffective air removal in the steam sterilization process
Contamination
Rendering nonsterile and unacceptable for use in critical areas of the body
Cross-contamination
The contamination of a person, object, or environment by contact with contaminants from another source
Cross-contamination
The contamination of a person, object, or environment by contact with contaminants from another source
Decontamination
A process in which recently used and soiled medical devices are made safe for personnel to handle, removal/destruction of gross contaminants and other potentially Infectious materials
Denaturation
To change the vital functions, forces, and activities of an organism
Disinfectant
Chemical agent that kills most microbes, but usually not spores or prions.
Usually used on inanimate objects due to potential for toxicity in living tissue
Disinfection
Chemical process by which most, but not all, microorganisms on a surface are destroyed
Efficacy
The ability to produce a desired or intended result
Exposure time
The amount of time an item is held in a condition
Aka hold time
Event-related sterility
Item becomes contaminated by conditions or events
Fomite
Inanimate object that harbors microorganisms, including dust and environmental surfaces
Germicide
A chemical agent that kills germs
High-level disinfection (HLD)
Process that reduces the bioburden to a minimum
Immediate-use steam sterilization (IUSS)
Rapid sterilization of items to be used immediately, previously called flash sterilization
Implant
FDA defines as a device that is placed into a surgically or naturally formed cavity of the human body.
30 days or more
Lumen
Space within a tube
Shelf-life
Length of time that a wrapped package remains sterile while in storage
Sporicidal
An agent capable of killing spore- forming organisms
Sterile
Having been rendered free of all living microorganisms, including spores
Sterilization
A process that kills all forms of living matter including spore-forming organisms
Sterilizer
Equipment or chamber used to attain physical or chemical sterilization
Terminal cleaning
A daily process in which surfaces of the operating room are cleaned and disinfected
Terminal decontamination
The process in which instruments and supplies are processed and made safe for staff to handle in succeeding stages of reprocessing
