Chapter 7 - Disease Transmission (Disinfection, Decontamination and Sterilization) part 2

High Level Disinfects Compounds are? (2)

1. Glutaraldehyde (Cidex) 2. Sodium Hypochlorite (Bleach)

Intermediate Level Disinfectant Compounds are? (3)

1. Phenol (Carbolic Acid) 2. Quaternary Ammonium Compounds (Quats) 3. Alcohol

Which presoaking solution keeps organic debris moist. 1. Enzyme 2. Sterile Water 3. Detergent

2. Sterile Water

How long is the O.R. closed after a "dirty" case?

48 hours

Which Intermediate Level Disinfectant has Isopropyl/Ethyl in 60-70% solution. Nontoxic to skin -> very drying. Slight odor. Highly corrosive: Stainless Steel, Cement Instruments (Endoscopes).

Alcohol

Which Intermediate Level Disinfectant is non Sporicidal. Highly flammable. Effective against many microbes and HIV.

Alcohol

_______ and _______ forms Chloramine vapor which will kill a human quickly

Ammonia and Bleach

The process in which most, but not all microorganisms located on animate surfaces such as the skin, are destroyed.

Antisepsis

Name used to describe the solutions that are used on the patient for skin preparation of the surgical site.

Antiseptic

Absence of pathogenic microorganisms

Asepsis

Methods practiced by the surgical team to prevent microbial contamination of the surgical environment.

Aseptic Technique

Substance that destroys/kills bacteria

Bacteriocidal

Substance that inhibits growth and reproduction of bacteria.

Bacteriostatic

The number of microbes or amount of organic debris on an object at any given time.

Bioburden

________ (the number of microbes at any given time) is directly proportional to the length of time for disinfecting.

Bioburden

Regulated waste must be placed in leak proof bags that are either clearly marked with the ________ _________ or are Red in color. Only regulated waste should be put into these bags.

Biohazard Symbol

Disinfectants must come in direct contact with ALL surfaces in order to be effective: _______, _______, ______ decrease effectiveness.

Blood, Body fluids, Tissue

After procedures, the case cart is transferred to _____. Instruments cleaned, sterilized and assembled for next case.

CSPD (Central Sterile Processing Department)

The _____ pulls the instruments for the next days schedule and loads the case carts, which are transferred to the surgery department.

CSPD (Central Sterile Processing Department)

What does CSPD stand for?

Central Sterile Processing Department

Contaminated work surfaces should be decontaminated by the _______ with a disinfectant.

Circulator

During surgery, the _________ can clean blood/body fluids from floor ASAP. Change suction containers. Clean and label the outside of specimen container. Retrieve and clean/sterilize (flash) surgical instruments that fall on the floor.

Circulator

The presence of pathogenic materials

Contamination

High concentration of disinfectants increase the level of disinfection, but can be _______ to certain items. Such as rubber

Corrosive

Which Patient Care Items should be sterilized. (High Potential for SSI's) Ex. Surgical instruments/Implants.

Critical Items

The contamination of a person or object by another person or object.

Cross-Contamination

To reduce to an irreducible minimum the presence of pathogenic material.

Decontamination

The __________ room is a separate area where the items are cleaned, disinfected, lubricated, sorted, reassembled, wrapped, sterilized and placed in the sterile storage room for later use.

Decontamination room

Chemical agent that kills most microbes, but usually not spores, and are usually used on inanimate objects, not living tissue.

Disinfectant

DO NOT MIX _________ solutions together! Toxic Fumes, Explosions can occur.

Disinfection

The process in which most, but not all microorganisms located on inanimate surfaces are destroyed. Decontamination is a category of this.

Disinfection

This type of cleaning is the destruction of pathogenic microorganisms or their toxins or vectors by direct exposure to chemical or physical agents.

Disinfection

An inanimate object that harbors microorganisms.

Fomite

Agent that destroys fungus

Fungicide

Which High Level Disinfectant has good shelf-life. Used on items for complete immersion in liquid. Non-corrosive: Metals/Rubber/Plastic/Lensed.

Glutaraldehyde (Cidex)

Which High Level Disinfectant is best on market to date and a Sterilant?

Glutaraldehyde (Cidex)

Disinfectants vary in their ability to kill microbes. 20-30 min is recommended for _____ level disinfection.

High-level

This level of disinfection kills ALL microorganisms except spores and prions.

High-level disinfection

Factors that influence the efficiency of disinfectants include:

-Concentration level -Bioburden -Contact Time -Physical factors of solution: pH close to neutral, Water Hardness, Temperature, Exposure Time

Items that are sterilized or disinfected are placed in one of 3 categories. Name the 3 Patient Care Items.

-Critical Items -Semi critical Items -Non critical Items

The Decontamination room includes:

-Filtered air is exhausted to the outside of the health care facility. -The minimum air exchange rate is 10 times/hour -Temperature should be maintained between 64-70 F with 35-72% Humidity. -Negative air pressure is maintained (Keeps microbes in the room).

There are 3 Levels of Disinfection. They are?

-High level -Intermediate -Low level

There are 3 Levels of "Cleaning". What are they?

-Mechanical Cleaning -Disinfection -Sterilization

In addition to the case-by-case and daily cleaning routines, certain cleaning and disinfection practices are scheduled on a weekly basis. May include:

-Mounted lighting tracks and fixtures -Corridors are cleaned -Air vents and heating ducts grills -Inside and outside supply cabinets -Sterile and Non-sterile supply rooms -Housekeeping supply room

The STSR should soak the instruments in: (3)

-Sterile Water -Enzymatic Solution -Detergent Solution

Terminal cleaning may include:

-Wipe down ceiling and floors with a sponge/mop -Wipe down all furniture -Thoroughly wipe down O.R. table -All other equipment (kick buckets, anesthesia machine) should be cleaned. -All horizontal surfaces are cleaned.

Environmental services personnel involved with O.R. decontamination must follow the guidelines for Standard Precautions and the use of _____ at all times.

PPE

When handling contaminated linens, the ST should wear ___ as deemed necessary.

PPE

Gloves, mask, gown and eyewear are?

PPE (Personal Protective Equipment)

What should be worn when handling disinfectant solutions?

PPE (Personal Protective Equipment)

Any microbe capable of causing disease

Pathogen

What does PPE stand for?

Personal Protective Equipment

Which Intermediate Level Disinfectant is effective in eliminating fecal contamination. Irritating to Respiratory Tract -> needs good ventilation. Highly irritating to skin. Also has noxious odor

Phenol (Carbolic Acid)

Which Intermediate Level Disinfectant is highly concentrated solution that is easily diluted?

Phenol (Carbolic Acid)

Which Intermediate Level Disinfectant is low cost. Easy to mix with water. Odorless. Non-corrosive on metals. Effectiveness limited. Kill limited microbes.

Quaternary Amonium Compounds (Quats)

Which Intermediate Level Disinfectant is non Sporicidal, Virucidal or Tuberculocidal.

Quaternary Amonium Compounds (Quats)

Multiple parts must be disassembled in order for the disinfectant to make direct contact with the item. _______ and _______ must be opened.

Ratchets and Box Locks

Microbes that normally reside below the skin surface or within the body.

Resident Flora

Between procedures, the ____ is responsible for disposing of the sharps. Also for placing all instruments in a covered case cart for decontamination.

STSR

In the Cleaning process, the ____ is responsible for presoaking instruments to prevent the dying of organic matter.

STSR

Which Patient Care Items are high level disinfection. (Lesser Risk) Ex. Cystoscopes/Colonoscopes.

Semi critical Items

Infection, usually accompanied by a fever

Sepsis

DO NOT allow _______ to mix with Formaldehyde. Highly carcinogenic (cancerous) solution is formed.

Sodium Hypochlorite (Bleach)

Which High Level Disinfectant is effective on surfaces, floors and equipment.

Sodium Hypochlorite (Bleach)

Which High Level Disinfectant is recommended for blood or body fluid spills. Corrosive: Metals, Rubber and Plastics. Fast acting. Harmful to skin.

Sodium Hypochlorite (Bleach)

A resident form of certain types of bacteria that are able to survive in adverse conditions.

Spore

A substance that kills/destroys bacteria in the spore stage.

Sporicide

Having been rendered free of ALL living microorganisms, including spores.

Sterile

Specified area, usually around the patient, that is considered free of microorganisms.

Sterile Field

Techniques of creating a sterile field and performing in the sterile field to keep microbes at an irreducible minimum.

Sterile Technique

During surgery, a basin with ______ _______ should be available in the sterile field for the soaking and cleaning instruments.

Sterile Water

The destruction of ALL microorganisms, including spores, on inanimate surfaces.

Sterilization

The destruction of all microorganisms, including spores, on an inanimate surfaces through the use of steam or chemical sterilization, electron bombardment, or irradiation.

Sterilization

This type of cleaning is the destruction of ALL microorganisms, including spores, in or about an object, as by steam, chemical agents, high-velocity electron bombardment, or ultraviolet light.

Sterilization

Contamination of a sterile field that occurs through the passage of fluid through, or a puncture in, a microbial barrier.

Strike-through Contamination

Mechanically cleaned and chemically disinfected, but NOT sterile.

Surgically Clean

Each health care facility designs its own end-of-day or ______ cleaning routine. This entails a more thorough cleaning of rooms and areas outside of the O.R.s after the last case of the day has been completed.

Terminal cleaning

Microbes that reside on the skin surface and are easily removed

Transient Flora

Living carrier that transmits disease

Vector

In a "dirty" case, the floor should be cleaned with a phenolic detergent and all equipment and furniture is wiped with 70% _______ solution. Sometimes dirty cases are scheduled as _____ procedure.

alcohol last

An important part in maintaining _______ is minimizing microbial counts in the O.R. environment itself.

asepsis

A routine schedule should be established for cleaning and _________ of O.R. surfaces, scrub sinks, cabinets, floors, walls and ceilings.

decontamination

Between procedures, Suction containers must be disconnected from the suction unit and ______ according to hospital policy.

disposed

Prior to First Procedure, the ST should clean all surfaces in the O.R. Damp dusting should begin with the _______ surface. When cleaning the O.R. table the pads should be _______ in order to clean both sides of the pads and the surfaces and hinges of the O.R. table.

highest removed

The STSR is responsible for dropping soiled sponges into the ______ _______. If there are several sponges, the circulator and STSR count the sponges, after which they are placed in plastic bags. The circulator should be wearing?

kick bucket PPE

Contaminated _______ must not be rinsed or sorted in the area of use.

linens

Reusable contaminated ________ must be handled as little as possible to prevent airborne contamination.

linens

Expired solutions must be disposed of according to hospital ______, manufacturer's ________ and state ____.

policy, recommendations, law

Effective _______ and ________ techniques and established procedures aid in preventing the intra-operative cross-infection of patients.

sanitation and decontamination

Between procedures, the linen and _____ _____ must be sealed and placed in the designated area.

trash bags

Prior to First Procedure, the O.R. table should be _______ and moved to one side to facilitate mopping the floor under the table. If blood or body fluids are present on the O.R. walls, clean the area. Clean cabinet doors and track. Do not clean the surgical lights if they have not ______ off -> break light bulbs.

unlocked cooled

Solution Containers should be stored in a well _________ area.

ventilated

Which Patient Care Items are intermediate/Low Level Disinfection. (Least Risk) Ex. OR Table/BP Cuff.

Non critical Items

Infection acquired within a health care facility.

Nosocomial

Invasion of the human body by pathogenic microorganisms that reproduce and multiply, causing disease.

Infection

This level of disinfection kills MOST microorganisms including bacteria, most viruses and fungi. Ineffective against spores.

Intermediate disinfection

This level of disinfection kills SOME fungi and viruses and most bacteria, but is not effective against spores and M.Tuberculosis.

Low-level disinfection

Instruments with a _______ should be periodically flushed.

Lumen

What is the MSDS?

Material Safety Data Sheet

This type of cleaning is the physical removal of blood, body fluids, and/or gross debris from an inanimate object. "Muscle Man Power!"

Mechanical Cleaning