Chap 11 - Decontamination, Sterilisation, & Disinfection Flashcards
(135 cards)
1
Q
Association for the Advancement of Medical Instrumentation (AAMI)
A
An authoritative source of standards for sterilisation and disinfection.
2
Q
Antisepsis.
A
reduction of microorganisms on skin or other tissue.
3
Q
Bactericidal.
A
Able to kill bacteria.
4
Q
Bacteriostatic.
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Inhibiting (Stopping) the growth of bacteria.
5
Q
Biofilms.
A
Dense colonies of bacteria that adhere tightly to surfaces.
6
Q
Biological indicators.
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quality control mechanism used in the process of sterilization. It consists of a closed system containing harmless, spore-forming bacteria that can be rapidly cultured after the sterilization process.
7
Q
Cavitation.
A
A process in which air bubbles are imploded (burst inward), releasing particles of soil or tissue debris
8
Q
Chemical sterilisation.
A
A process that uses chemical agents to achieve sterilisation.
9
Q
Degerming (or degermination).
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Reducing the number of microorganisms on human skin.
10
Q
Mechanical (Degerming).
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Sanitation is a ________ technique that removes some microbes and organic material.
11
Q
How is sterilisation different from disinfection?
A
- Sterilisation is destructin of ALL forms of microbial life (including spores and viruses) on inanimate objects using physical or chemical agents.
- Disinfection is destruction of vegetative pathogens on inert substances - it removes toxins but not bacterial endospores - using physical or chemical agents (disinfectants).
12
Q
Cleaning.
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A process that removes organic or inorganic soil or debris using detergent and washing.
13
Q
What is the minimum alcohol treatment?
A
70% (This concentration dissolves membrane lipis, disrupts cell surface tension and denatures protein).
14
Q
HEPA is a type of sterilisation or decontamination.
A
Sterilisation (more specifically, filtration).
15
Q
Define the type of process used in a quick alcohol swipe before a blood draw vs. a betadine swab before surgery.
A
Alcohol swipe = degerming/degermination of the skin using mostly mechanical processes (scrubbing).
Betadine swab = isodopher (complex of iodine & alchool) using a chemical process to kill germs on skin.
16
Q
Cobalt-60 radiation.
A
A method of institutional bulk sterilisation used by manufacturers to sterilise prepackaged equipment using ionising radiation.
17
Q
Contaminated.
A
Rendered nonsterile and unacceptable for use in critical areas of the body.
18
Q
Decontaminated.
A
A process in which recently used and soiled medical devices, including instruments, are rendered safe for personnel to handle.
19
Q
Detergent.
A
A chemical that breaks down organic debris by emulsification (separation into small particles) to aid in cleaning.
20
Q
Disinfection.
A
Destruction of microorganisms by heat or chemical means. Spores usually are not destroyed by disinfection.
21
Q
Enzymatic cleaner.
A
A specific chemical used in detergents and cleaners to penetrate and break down biological debris, such as blood and tissue.
22
Q
Ethylene Oxide (OD).
A
A highly flammable gas that is capable of sterilising an object.
23
Q
Event-related sterility.
A
- A wrapped sterile item may become contaminated by environmental conditions or events, such as a puncture in the wrapper.
- Event-related sterility refers to sterility based on the absence of such events.
- The shelf life of a sterilised pack is event related, not time related.
24
Q
Evidence-based practice.
A
Methods and procedures proven to be valid by rigorous testing and professional research.
25
Exposure time
- This is the amount of time goods are held at a specific time, temperature, and pressure during a sterilisation process.
- Exposure time varies with the size of the load, type of materials being sterilized, and type of steriliser.
- Exposure time is sometimes called the hold time.
26
Fungicidal
Able to kill fungi.
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Gas plasma sterilisation
A process that uses the form of matter known as plasma (e.g., hydrogen peroxide plasma) to sterilize an item. Also referred to as plasma sterilisation.
28
Germicidal.
Able to kill germs (bacteria).
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Gravity displacement steriliser.
A type of steriliser that removes air by gravity.
30
High level disinfection (HLD).
A process that reduces the bioburden to an absolute minimum.
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High-vacuum steriliser
A type of steam steriliser that removes air in the chamber by vacuum and refills it with pressurized steam. Also known as a prevacuum steriliser.
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Inanimate.
Non-living.
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Implant.
Defined by the U.S. Food and Drug Administration (FDA) as "a device that is placed into a surgically or naturally formed cavity of the human body if it is intended to remain there for a period of 30 days or more."
34
Immediate-use sterilisation.
- Items to be sterilised shortly before surgery must be processed so they are ready as close to the time of surgery as possible.
- This is referred to as immediateuse sterilization, previously called flash sterilisation
35
Non-woven.
A fabric or material that is bonded together as opposed to a process of interweaving individual threads.
36
Peracetic acid.
A chemical used in the sterilization of critical items.
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Prion.
- Proteinaceous infectious particle, a unique pathogenic substance that contains no nucleic acid.
- The prion is transmitted by direct contact or ingestion and is resistant to all forms of disinfection and sterilisation normally used in the health care setting.
38
Reprocessing.
Activities or tasks that prepare used medical devices for use on another patient; these activities include cleaning, disinfection, decontamination, and sterilisation.
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Reusable.
A designation used by manufacturers to indicate that a medical device can be reprocessed for use on more than one patient.
40
Sharps.
Any objects capable of penetrating the skin, causing injury.
41
Sanitation.
A method that reduces the number of bacteria in the environment to a safe level.
42
The following sterilisers uses peracetic acid.
Steris.
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Which high level disinfectants could also be used as a sterilising agent?
Glutaraldehyde
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Which type of sterilisation method requires an aeration?
ethylene gas.
45
Instrument trays have a perforated bottom so that:
Steam can circulate up through the tray and adequately cover all surfaces of the instruments.
46
Instruments that have _____________ must be disassembled before sterilisation.
removable parts
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The __________ includes a workroom with ample table space for sorting instruments and assembling instrument sets.
Clean processing area.
48
The washer-steriliser or washer-disinfector is used to process all instruments that can tolerate.
Water turbulence and high pressure steam.
49
The ____________ is used to transport sterile and nonsterile instruments and equipment to and from the main operating room area.
case cart.
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____________ is a skilled, certified profession requiring expertise in the science and practice of materials management, decontamination, and sterilisation.
Central processing.
51
Which body tissues presents a critical risk in the Spaulding system?
Vascular system.
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The system that assigns a device a risk category based on the specific regions of the body where the device is used is the ____________ system.
Spaulding.
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____________ is a chemical used to remove microorganisms on tissue.
An antiseptic
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Organisation that oversees compliance with environmental and patient safety regulations.
TJC
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Agency of the federal government that provides research and protocols in all areas of public health.
CDC.
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Items with a lumen should have a small amount of _________ flushed through them immediately before sterilisation.
Sterile water
57
After the instruments are taken to the clean assembly area, what the next steps for?
Instruments are inspected, assembled, wrapped up or contained for sterilisation, labeled and tracked, and then finally sterilized with one of many sterilisation methods.
58
Before the washer-sterilizer cycle is finished, the instruments are considered ______________.
What is the purpose of the washer-sterilizer?
Nonsterile.
The purpose is to process instruments that can take on water turbulence and high pressure steam.
59
Woven wrappers.
Also called linen or cloth wrappers, these are fabric cloths used to wrap clean, disinfected supplies in preparation for a sterilization process.
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Washer-steriliser/disinfector.
Equipment that washes and decontaminates instruments after an operative procedure.
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Viricidal
Able to kill viruses.
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Ultrasonic cleaner.
Equipment that cleans instruments using ultrasonic waves.
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Terminal decontamination.
- Thorough cleaning and disinfection of supplies or an environment such as the operating room suite after patient use.
- Specific protocols and procedures are used during terminal decontamination.
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Soricidal
Able to kill spores.
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Spaulding system
- A system used to determine the level of microbial destruction required for medical devices and supplies based on the risk of infection associated with the area of the body where the device is used.
- Categories include
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Single-use items
Instruments and devices intended for use on one patient only; sometimes called disposable items.
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Shelf life.
The length of time a wrapped item remains sterile after it has been subjected to a sterilisation process.
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An antiseptic
A chemical used to remove microorganisms on skin or other tissue.
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Bioburden.
Is the number of live bacterial colonies on a surface before it is sterilised.
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Critical items for Spaulding system.
Come in contact with sterile body tissues and internal organ system; include vascular system (e.g., hypodermic needles, surgical instruments, all medical devices).
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Semi critical devices
Used on the mucous membrane or non-intact skin, that requires high-level disinfection (bronchoscope, thermometer, or otoscope).
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noncritical items
Used only on intact skin, items that have been exposed to body fluids or patient skin may be treated by low-level disinfection (blood pressure cuffs, and examination tables).
73
Nearly all instruments used in surgery are transferred to.
Central processing for reprocessing.
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Central processing
Must make sure that equipment is safe and ready for scheduled surgery and that thousands of instruments are organised and processed according to strict standards.
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Monitoring means
checking, recording, and reporting.
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The preparation of equipment and instrument for patient usually begin________.
At the point of use in surgery.
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Saline.
Never used for cleaning or soaking instruments because it causes pitting, rusting and corrosion.
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During surgery, instruments and equipment exposed to blood and body tissue are periodically.
wiped free of blood and debris to prevent caking and drying.
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Dried blood and tissue must not be reintroduced ___.
into the surgical wound.
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1st phase of reprocessing is _____.
Sorting.
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Instruments and equipment must be cleaned before they are ________ .
Disinfected or sterilised.
82
Ultrasonic cleaner.
Removes debris form instruments by a process called cavitation.
83
After instruments have been sorted,
Selected instruments are soaked and hand cleaned using cold water and enzymatic detergent.
84
Ophthalmic instruments
Require special handling in order to prevent toxic anterior segment syndrome also know as TASS.
85
Regardless of the type of packaging or wrapping system used, each package ______.
Must be properly labeled, with the name of the item, a lot control number, batch number, and employee initials
86
Woven wrappers
Sufficiently dense to protect goods from contamination, yet porous enough to allow penetration of steam or gas.
87
instruments and equipment used in critical areas of the body must be _______ .
sterile before use.
88
Sterilisation include.
High temperature steam, Ethylen oxide, gas plasma sterilization, peracetic acid processing, ozone, dry heat, and Ionizing radiation.
89
Steam sterilisation is the most efficient method of ______ .
Sterilisation.
90
Saturation and surface exposure.
All parts of the item must be exposed to the sterilisation process.
91
Parameters must be regularly tested for all sterilisation methods, the fact tat items have been subjected to a sterilisation process does not ensure that there was no mechanical or human error prevented this is called _______.
Challenge or challenge test.
92
Time.
items must be exposed to the process long enough to destroy microorganisms.
93
Patient safety.
Can't be ensured unless devices are handled according to the manufactures recommendations.
94
Microbial destruction.
Depends on the individual phases of the process itself and on the biroburden, and resistance of the microorganism.
95
Power driven equipment and cords are never
Sterilised
96
Immediate use sterilisers.
Must be located in an area where unwrapped sterile items can be transported directly from the sterilizer to the sterile field.
97
To remove items in the steriliser chamber.
Circulator dons sterile gloves and grasps the edges of the tray using sterile transfer handles. than the tray if offered to the scrub, who removes the sterile items from the tray to prevent contamination.
98
Creutzfeldt jakob disease prions.
Are fatal diseased called by prions. a prion is a protein particle that is not a cell and that is not related to bacteria or viruses.
99
Ionising radiation.
Destroys all microorganism through destruction of the DNA.
100
Ozone sterilisation.
Utilises a molecular form of oxygen, at low heat for sterilisation of moisture.
101
Many disinfectants are unsafe for use
| on _________ .
Human tissue, including skin.
102
Terminal Decontamination.
Thorough cleaning and disinfection of all equipment and soiled surfaces int he operating room; follows every surgical case.
103
Low Level Disinfection.
Operating table and accessories; furniture; floors and walls; intravenous stands; stretchers; blood pressure cuffs; stethoscopes (hypochlorite).
104
Purpose of wrapping instruments
To protect them from contamination after the sterilisation process.
105
Loaner Instruments.
The sterility of these items must not be assumed.
106
Why are sterile packages given a lot number?
ID the items that have been included in the sterilisation load that may have yielded a + biological or mechanical control test.
107
Why are instruments processed in the washer - decontaminator steriliser?
Used to process instruments that can tolerate water & turbulence and high-pressure steam.
108
Single use items
Used on one patient only, and must never be reprocessed or resterilises again.
109
all staff members who work in the decontaminated area must wear
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PPE.
Protective eyewear.
Gloves.
Face shield.
Waterproof shoes and covers.
Full protective body suit or gown.
```
110
Monitoring means
Checking, Recording, and Reporting.
111
All instruments and equipment used on one patient must be ________ .
Cleaned, disinfected, sterilised, and protected form contamination for the next patient.
112
Name the types of detergents.
- enzymatic.
- organic acid.
- high alkaline.
- non abrasive cleaning.
- soaps.
113
Name the steps in the cleaning process.
```
sorting the items to be cleaned
preringsing or presoaking the item
washing
rinsing
drying
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114
What the ph level for neutral.
7
115
A solution having a pH below 7 is
Acidic
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Detergent solutions must be changed ___ to reduce the bioburdent and prevent the recontamination of cleaned items and the environment
Frequent
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Contain organic substances that assist in the breakdown of protein soils and blood
Enzymatic detergents
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Can be used to remove severe stains on stainless steel instruments. these detergents should not be used routinely because they are very corrosive.
Organic acid detergents
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Are used in some mechanical washers, followed by a neutralizing acid rinse to clean surgical instrumentation
High alkaline detergents
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Are available for removing stubborn soils and stains, however these specially formulated agents can be difficault to remove and must be thoroughly rinsed
Non abrasive cleaning agents
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Breakdown blood, mucus, feces, and albumin, lipase, carbohydrates
Enzymatic detergens
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TWO ways of cleaning
manual and mechanical
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A type of automated cleaning equipment transmit sound waves through cleaning soulution. transducers located in the bottome of the unit emit sound waves and create bubbles that implode burst inward as they contact the instrument drawing soil away from the surface
Ultrasonic cleaner
124
Lumen means tube
True.
125
Sonic irrigator is specifically designed for lumend
True
126
Name the two types of mechanical washers
washer sterilizer and washer decontaminator
127
Which detergent is used to reduce the potential for corrosion
Alkaline
128
There are four types of detergent used in mechanical washers all are usually in the liquid form and are low suds foam producers
False.
129
Flexible endoscopes must always be leak tested before any manual precleaning is performed
True
130
Two types of endoscope
flexible and rigid
131
Critical processing method is
Sterilization
132
Semicritical processing method
High Level Disinfection
133
Noncritical processing method
Sanitization
134
Include chlorine and iodine based compounds. the most commonly recgnized chlorine formulation is sodium hpochiorite (bleach) which is used in the processing of linen and which is considered a low to medium level disinfectant.
Halogens
135
Is the new high level disinfectant is 0.55%
Ortho phthaldehyde
