Chapter 18: Sterilization and Disinfection Study Guide

What guidelines must be followed when using cold sterilization?

- Completely submerged for a long time. - Chemical must be designated at the sterile by the EPA.

What information does the Centers for Disease Control and Prevention (CDC) recommend be recorded in an autoclave log regarding each cycle?

- Date and time of the cycle - Description of the load - Exposure time - Exposure temperature - Results of the sterilization indicator - Initial of the operator

List two properties of a good wrapper for use in autoclaving.

- Not affected by the sterilization process - Allow steam to penetrate while preventing contaminants from entering during handling and storage

List three examples of wrapping materials used for the autoclave and identify an advantage of each type.

- Sterilization paper-disposable and inexpensive - Sterilization pouches provide good visibility of the contents - Muslin-flexible and easy to handle, can be reused and is durable

Describe the care an autoclave should receive on a daily basis.

- Wipe the outside of the autoclave with a damp cloth and mild detergent. - Wipe interior of the autoclave and trays with damp cloth. (Distilled water) - Clean the rubber gasket on the door of the autoclave with a damp cloth. (Distilled water) - Inspect the rubber door gasket for damage that could prevent a good seal.

List four examples of hazardous chemicals that maybe used in the medical office.

- clean products - chemicals used for laboratory testing - products for sanitization, disinfection and sterilization. - front office products

What type of brush should be used to clean the following parts of an instrument?

- stiff nylon brush - stainless steel wire brush - commercial instrument stain remover

What is the purpose of a GHS signal word?

A word used to indicate the relative degree of severity of the hazardous chemical and to alert the user to a potential hazard on the label.

What is a GHS hazard pictogram and what is its purpose?

Allow employees to quickly identify the types of hazard associate with a hazardous chemical.

What is a critical item? List examples of critical items.

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

How often should a biological indicator be used to monitor an autoclave?

At lease once a week.

What is the purpose of the Hazard Communication Standard?

Ensure that employees are informed of the hazards associated with chemicals in their workplace and the precautions to take to protect themselves when working with hazardous chemicals.

What is the purpose of the Globally Harmonized System of Classification and Labeling of Chemicals (GHS)?

International standard that provides consistency in the classification and labeling of chemicals through the use of pictograms, signal words, and hazard warnings.

How should a sterilization strip be placed in a wrapped pack?

In the center, with the end containing the placed area of the packer considered to be the hardest for steam to penetrate.

Why should instruments be handled carefully?

Instruments are expensive and delicate, yet durable. Can last for many years when handled and maintained properly. (to prevent damage and harm)

What is the advantage of using the ultrasound method to clean instruments?

Instruments do not have to be handled during the cleaning process.

Why should a chemical not be used past its expiration date?

It can lose its potency.

Why shouldn't tap water be used to fill the water reservoir of an autoclave?

It contains minerals, such as chlorine, which have corrosive effects on the stainless-steel chamber of the autoclave.

List two examples of items that can be disinfected through intermediate-level disinfection. List one example of an intermediate-level disinfectant.

Items that come in contact with intact skin, but not mucous membrane and surgical instruments.

What is the purpose of lubricating an instrument?

Makes the instrument function better and last long.

Why is a longer exposure period needed to ensure sterilization when using the dry-heat oven?

Microorganisms and spore are more resistant to dry heat than moist hear and because dry heat penetrates more slowly and unevenly than moist heat.

Why must a sterilized load be allowed to dry before it is removed from the autoclave?

Microorganisms can move quickly through the moisture on a wet wrap and onto the sterile article inside, resulting in contamination. (Needs to be 100% dry)

Why is more time needed to autoclave a large minor office surgery pack?

More time needed to penetrate the center of the pack.

How does one determine what type of physcial or chemical agent to use to destroy microorganisms on an article?

On the intended use of the article.

What is the definition of high-level disinfection?

Process that destroys all micro-organisms with the expectation of bacterial spores.

What is the purpose of wrapping articles to be autoclaved?

Protect them from re-contamination during handling and storage.

Why should gloves be worn during the sanitization procedure?

Protects the medical assistant from blood borne pathogens and other potentially infectious materials.

What are the characteristics of bacterial spores?

Representing a resting and protective stage of the bacterial cell and are more resistant to drying, sunlight, heat, and disinfectants.

What should be done if a sterilization indicator does not change properly?

Review manufacturer's guidelines for proper sterilization techniques, the articles should be re-sterilized following these guidelines. If the indicator still doesn't change, the autoclave is in need of repair and should not be used until then.

Glutaraldehyde (Cidex) is a high-level disinfectant.

True

High-level disinfection kills all microorganisms but not spores.

True

The Hazard Communications Standard requires that the label of a hazardous chemical include GHS hazard pictograms.

True

The best means of determining the effectiveness of the sterilization process are biologic indicators.

True

The inside of the autoclave should be wiped everyday with a damp cloth.

True

The most common temperature and pressure for autoclaving is 212F at 15 Ibs of pressire per square inch.

True

The proper time for sterilizing an article in the autoclave depends on what is being autoclaved.

True

The wrapper used to autoclave articles should prevent contaminants from getting in during handling and storage.

True

How should each of the following be checked for defects and proper working condition?

a. Blades of an instrument: blades should be straight. (not bent) b. Tips of an instrument: tips should approximate tightly and evenly when the instrument is closed. c. Instrument with a box lock: instrument with box lock should move freely but must not be too lose. d. Cutting edge of a sharp instrument: cutting edge of sharp instrument should be smooth and devoid of nicks. e. Scissors: scissors should cut cleanly and smoothly.

A bacterial spore consists of a hard, thick-walled capsule that can resist adverse conditions.

True

A sterilization strip should be positioned in the center of a wrapped pack.

True

Ethylene oxide gas is used by medical manufacturers to sterilize disposable items.

True

What temperature and pressure are the most commonly used to sterilize materials with the autoclave?

250F (121C) 15 pounds of pressure per square inch.

List two diseases that are caused by bacteria that produce spores.

Botulinum and tetani.

How should sterilized packs be stored?

Clean, dry areas that are free from dust, insects, and other sources of contamination.

What are the advantages and disadvantages of autoclave tape?

Contains a chemical that changes color if it has been exposed to steam. It is placed outside the packaging it cannot ensure that steam has penetrated to the center of the pack. It also does not ensure that the item has been sterilized.

How should sterilization indicators be stored?

Cool, dry area.

What effect does moist heat have on instruments with sharp cutting edges?

Corrosive and dulls them.

Why must a cleaning agent with a neutral pH be used to sanitize instruments?

Could leave an orange stain looking like rust.

What is the meaning of the following GHS signal words?

Danger denotes a more sever hazard possible. Warning denotes a less serious hazard possible but potentially harmful.

What is the purpose of sterilization?

Destroy all forms of microbial life, including bacterial spores.

List two examples of items that are disinfected by low-level disinfection.

Examining tables, laboratory counter tops and walls.

According to OSHA, gloves do not need to be worn during the sanitization process.

False

Autoclave tape indicates whether an autoclaved item is sterile.

False

Sterilization is the process of destroying all forms of microbial life expect for bacterial spores.

False

Stethoscopes must be decontaminated using a high-level disinfectant.

False

Tap water should be used in the autoclave.

False

The agent used to destroy microorganism on an article depends on the size of the article.

False

The purpose of sanitzation is to remove all microorganisms and spores from a contaminated article.

False

The purpose of the Hazard Communications Standard is to ensure that employees do not use hazardous chemicals in the workplace.

False

A pack that has been in the storage cupboard for 4 weeks should be resterilized.

False.

List one example of an item that requires high-level disinfection. List one example of a high-level disinfectant.

Flexible fiberoptic sigmoidoscope.

What is the difference between a GHS hazard statement and a GHS precautionary statement?

GHS hazard statement is a phrase that describes the types of hazards associate with a hazardous chemical, including, when appropriate, the degree of the hazard. GHS precautionary statements phrases that describes recommended measures to be taken to minimize or prevent adverse effect resulting from exposure to the hazardous chemical or from improper storage or handling.

What is the difference between a health hazard and a physical hazard?

Health hazard includes the potential of chemical to cause acute toxicity, skin corrosion or irritation, serious eye damage or irritation, respiratory or skin sensitization germ cell mutagenicity cancer or reproductive toxicity or is an aspiration hazard. Physical hazard includes the potential of the chemical to catch fire, explode, or react with other chemicals or materials.

List and briefly describe the information that must be included in a Safety Data Sheet.

Identification, lists of ingredient hazardness chemicals, and firefighting measures.

What is event-related sterility?

Sterile pack is considered sterile indefinitely unless an event occurs that interferes with the sterility of the article.

How does the medical manufacturing industry use ethylene oxide gas sterilization?

Sterilize heat-sensitive items that cannot by sterilized in an autoclave.

What is the purpose of the pressure used in the autoclaving process?

Sterilized items that are not harmed by moisture or high temperature.

What is the purpose to sanitizing an article?

To remove organic material from an article and to reduce to a safe level the number of microorganisms on the article.

What information must be included on a hazardous chemical label?

Supply identification, GHS signal word, GHS Hazard statement, and any supplementary information.

Why is it important that all air be removed from the autoclave during the sterilization process?

The temperature that is adequate for sterilization is not reached. The temperature is reduced.

What is the purpose of a sterilization indicator?

To determine the effectiveness of the procedure and to check against improper wrapping articles, improper loading the autoclave, and faulty operation of the autoclave.

What determines the amount of time required to sterilize articles in the autoclave?

When the desired temperature is reached.

How should the following be positioned in the autoclave?

a. Small packs: 1-4 inches b. Large packs: 2-4 inches c. Jars and glassware: placed on their sides in the autoclave with their lids removed. d. Sterilization pouches: positioned on their sides to maximize steam circulation and facilitate the drying process.