Sterilization and Disinfection

Question 1

Sanitization

Answer 1

a process that removes organic material and reduces the number of microorganisms to a safe level

Question 2

decontamination

Answer 2

the use of physical or chemical means to remove or destroy pathogens on an item

Question 3

detergent

Answer 3

an agent that cleanses by emulsifying dirt and oil

Question 4

disinfectant

Answer 4

an agent used to destroy pathogenic microorganisms, does not kill spores; generally applied to inanimate objects

Question 5

spore

Answer 5

a hard, thick-walled capsule that some bacteria form by losing moisture and condensing their contents to contain only essential parts of the protoplasm of the cell

Question 6

Examples of bacteria that form spores

Answer 6

clostridium botulinum and clostridium tetani

Question 7

sterilization

Answer 7

the process of destroying all forms of microbial life including spores

Question 8

sterile

Answer 8

free from all microorganisms and spores

Question 9

autoclave

Answer 9

used to sterilize items in the medical office

Question 10

HCS

Answer 10

Hazard Communication Standard

Question 11

Purpose of HCS

Answer 11

-Required by OSHA, to ensure that employees are informed of the hazards of chemicals in the workplace

Question 12

Hazardous chemical

Answer 12

any chemical that presents a threat to the health and safety of an individual that comes into contact with it

Question 13

HCS states that employees have a right to know about

Answer 13

hazardous chemical in their workplace and precautions to protect themselves when working with it

Question 14

HCS consists of the following components:

Answer 14

a. development of a hazardous communication program
b. inventory of hazardous chemicals
c. labelling requirements
d. material and safety data sheet requirements
e. employee information and training

Question 15

Hazard Communication Program

Answer 15

• consists of a written plan: describes what the facility is doing to meet the requirements of HCS
• must be made available to all employees who work with hazardous chemicals

Question 16

Inventory of Hazardous Chemicals

Answer 16

Required by HCS, employer must develop and maintain a list of hazardous chemicals, used and stored in the workplace.
List must include:
name of chemical, manufacturer, hazardous ingredients and health and safety ratings of chemical

• must be updated as new chemicals are acquired

Question 17

Labeling of Hazardous chemicals

Answer 17

• manufacturer must label hazardous chemicals with a warning that it is dangerous
• must include: possible hazards of the chemical, steps to take to protect against risks, warnings to indicate physical and health hazards

Question 18

Container Label requirements

Answer 18

• Name of chemical
• manufacturer/supplier information
• physical hazards of the chemical
• health hazards of the chemical
• safety precautions
• storing, handling and disposal of chemical

Question 19

standards for MSDS

Answer 19

• provides more detailed information than container label on hazards of the chemical and measures to take to prevent injury or illness
• must be kept on file for each hazardous chemical used or stored
• must be readily accessible to employees
• manufacturers must provide MSDS with every hazardous chemical

Question 20

Information that must be on MSDS

Answer 20

a. identification including: generic chemical name, brand name of chemical, manufacturer’s information, date the MSDS was prepared
b. composition of ingredients: list of ingredients in the hazardous chemical, exposure limits of each chemical
c. physical and chemical characteristics, such as: appearance and odor, boiling point, vapor pressure, odor threshold, pH level, melting/freezing point
d. fire and explosion data: the circumstances that may cause a fire or explosion, what to do if it occurs
e. reactivity data: substances and conditions from which the chemical should be kept away from to prevent a dangerous reaction
f. health hazard data: route of entry, skin contact, eye contact, inhalation, ingestion
g. emergency first aid procedures: identifies first aid measures to take if exposed to the chemical

h, precautions for safe handling and use

i. control measures: measures to use to avoid exposure to hazardous chemicals

Question 21

Sanitization

Answer 21

series of steps to remove organic material and to reduce microorganisms to a safe level

Question 22

Ultrasound method

Answer 22

ultrasonic cleaning, vibrations occur that loosen and remove debris

Question 23

Guidelines for sanitizing instruments

Answer 23

1. Wear utility gloves over disposable gloves
2. handle instruments carefully: do not drop or throw into a basin, do not pile in a heap, keep sharp instruments separate
3. follow instructions on labels of chemical agents
4. use proper cleaning agent
5. use proper cleaning devices
6. inspect each instrument for defects and proper working condition
7. lubricate hinged instruments

Question 24

Disinfection

Answer 24

process of using chemical agents in destroying pathogenic microorganisms, does not kill spores

Question 25

High level disinfection

Answer 25

- destroys all microorganisms with the exception of bacterial spores - used for semicritical items such as sigmoidoscope - ie. 2% gluteraldehyde or cidex

Question 26

semicritical

Answer 26

comes in contact with nonintact skin, or intact mucous membranes

Question 27

Cidex

Answer 27

a high level disinfectant that does not contain gluteraldehyde, less toxic and safer to handle

Question 28

intermediate-level disinfection

Answer 28

inactivates tubercle bacilli, all vegetative bacteria, most viruses and fungi - does not kill bacterial spores - used for noncritical items such as stethoscopes, blood pressure cuffs ie. isopropyl alcohol

Question 29

noncritical item

Answer 29

an item that comes in contact with intact skin but not mucous membranes

Question 30

low-level disinfectant

Answer 30

- kills most bacteria, some viruses, does not kill resistant microorganisms or spores - commonly used to disinfect work surfaces ie. sodium hydrochloride, phenolics

Question 31

alcohol

Answer 31

frequently used in medical office, intermediate to low level disinfectant ie. ethyl alcohol and isopropyl alcohol

Question 32

Phenolics

Answer 32

used on walls, furniture, floors and laboratory work surfaces

Question 33

Guidelines for disinfection

Answer 33

1. sanitize articles before disinfecting them 2. observe safety precautions 3. properly prepare and use the disinfectant 4. properly store the disinfectant

Question 34

Sterilization

Answer 34

process of destroying all forms of microbial life including bacterial spores -used to process critical items

Question 35

critical items

Answer 35

an item that comes in contact with sterile tissue or the vascular system

Question 36

Physical sterilization methods

Answer 36

1. steam under pressure (autoclave) 2. hot air (dry heat oven) 3. radiation

Question 37

Chemical sterilization methods

Answer 37

ethylene oxide gas and cold sterilization

Question 38

Autoclave

Answer 38

uses steam under pressure to sterilize semicritical items

Question 39

At what temperature does the autoclave begin to sterilize?

Answer 39

250 degrees Fahrenheit or 121 degrees Celsius

Question 40

What is the measurement of pressure an autoclave operates at?

Answer 40

15 pounds per square inch

Question 41

Sterilization in an autoclave consists of:

Answer 41

a. monitoring program b. sanitizing articles c. wrapping articles d. operating the autoclave e. handling and storing packs f. maintaining the autoclave

Question 42

Monitoring program of an autoclave

Answer 42

1. recommended by CDC 2. Consists of written policies for each step of the sterilization process b. sterilization indicators to ensure minimum sterilization conditions have been achieved c. records for each cycle are maintained in an autoclave log: date and time of cycle, description of load, exposure time, exposure temperature, results of sterilization indicator and initials of operator

Question 43

Sterilization indicator

Answer 43

1. purpose is to determine effectiveness of the sterilization procedure - checks against: improper wrapping of articles, improper loading of autoclave, faulty operation of autoclave 2. an article is not sterile unless steam has penetrated to its center 3. most reliable indicators check for attainment of proper temperature b. duration of temperature 4. if indicator does not change properly a. may be a problem in: sterilization technique or working condition of autoclave ie. autoclave tape and chemical indicator

Question 44

biological indicator

Answer 44

best means to determine effectiveness of sterilization, CDC recommends to use at least once a week - each indicator contains 3 tests; each containing living bacterial spores in a small envelope - placed in area least accessible to steam - after exposure to steam indicators are processed

Question 45

Wrapping articles for autoclave

Answer 45

purpose: to protect sterile articles from recontamination during handling and storage -articles must be sanitized first -wrapping material should allow steam to penetrate, prevent dust and microorganisms from reentering, does not tear or puncture easily Different types of wrapping: sterilization paper, sterilization pouches, muslin