Chapter 18: Sterilization and Disinfection

What is disinfectant?

An agent used to destoy pathogenic microogranims but does not kill bacterial spores. (applied to inanimate objects).

What is an semicritcal item?

An item that comes in contact with nonintact skin or intact mucous membranes, such as flexible fiberoptic sigmoidoscope.

What is important when filling the water reservoir?

Distilled water is used to fill the water reservoir of the autoclave.

What is a spore?

Is a hard, thick-walled capsule formed by some bacteria that contains only the essential parts of the protoplasm of the bacterial cell.

What is ethylene oxide gas sterilization?

Is a more complex & expensive process than steam sterilization. It is frequently used in the medical manufacturing industry for producing prepackaging, presterilized disposable items, such as syringes, sutures, catheters, & surgical packs.

What is high-level disinfection?

Is a process that destroys all microorganisms with the exception of bacterial spores. High-level disinfection is used to disinfect semicritical items.

What is sterilization strips? (refer to book for all info).

Is prepared paper or plastic strips that contain a thermolabile dye & that change color when exposed to steam under pressure for a certain length of time.

What are the guidelines for sanitizing instruments? (refer to my book for all info)

1. Wear gloves during the sanitization process. While following the OSHA Bloodborne Pathogens Standard, the MA should wear disposable gloves during the entire sanitation procedure. This protects MA from bloodborne pathogens & other potentially infectious materials. 3. Follow instructions on labels of chemical agents. Before using a chemical agent such as a chemical disinfectant, an instrument cleaner or an autoclave cleaner, review the products SDS & carefully read the label on the container. 4. Use proper cleaning agent. A low-sudsing detergent with a neutral pH should be used to clean the instruments. 5. Use proper cleaning devices. Proper cleaning devices should be used for the manual cleaning of surgical instruments. (never use steel wool or other abrasives to remove stains because damage to the instrument could occur.) 6. Carefully inspect each instrument for defects & proper working condition. After cleaning, rinsing, & drying the instrument, it is important to check it for defects & proper working condition.

What is biologic indicators?

Biologic indicators are the best means available for determining the effectiveness of sterilization procedure

What is autoclave tape? (refer to book for all info).

Contains a chemical that changes color if it has been exposed to steam. The tape is available in a variety of colors, can be written on, & is useful for closing & identifying the wrapped article.

What is does the abbreviation (GHS) stand for?

Globally Harmonized System of Classification & Labeling of Chemicals.

What is the purpose of the Hazard Communication Standard (HCS)?

HCS is to ensure that employees are informed of the hazards associated with chemicals in their workplace & the precautions to take to protect themselves.

What is product identifier?

Specifies how the hazardous chemical is identified. (chemical name & the code number or batch number).

What is supplier identifier?

Supplier information includes the name, address, and telephone number of the chemical manufacturer.

What is does the abbreviation (HCS) stand for?

The Hazard Communication Standard.

What is timing the load? (refer to Table 18-2 in the book)

The autoclave is operated at approximately 15 psi with a temp. of 250°F (121°C). The length of time required for sterilization varies according to the item that is being sterilized.

What is supplementary information?

The manufacturer may provide additional information that is helpful, such as directions for use and the expiration date of the chemical.

What is health hazard?

The potential of the chemical to cause acute toxicity, skin corrosion, or irritation, serious eye damage or irritation, cancer, etc.

What is sterilization?

The process of destroying all forms of microbial life, including bacterial spores.

What should Labeling of Hazardous Chemicals include?

This label must include the possible hazards of the chemical & the steps that can be taken to protect against those risks.

What's are the guidelines for Procedure Step #3? (refer to book for pictures)

a. Do not overload the chamber. Small packs should be placed 1 to 3 inches apart. & large packs 2 to 4 inches apart. (should not touch chamber walls) b. Ensure that at least 1 in. separates the autoclave trays. c. Place jars & glassware on their sides. d. Place dressings in a vertical position. e. Sterilizing dressings & hard goods: place dressings on top shelf & hard goods on lower shelf. f. Sterilizing pouches: set them on their sides to maximize steam circulation & to facilitate drying.

What is GHS precautionary statements?

•A precautionary statement is a phrase that describes recommended measures to be taken to minimize or prevent effects resulting from exposure to hazardous chemical or improper storage or handling. •Wear protective gloves, protective clothing, eye protection, & face protection.

What is cold sterilization?

•Cold sterilization involves the use of a chemical agent for an extended length of time. •Only chemicals that are designated sterilants by the U.S. Environmental Protection Agency (EPA) can be used for sterilizing articles. If a chemical agent holds this status, the word sterilant is printed on the front of the container. •Submerged in the chemical for a long time (6 to 24 hours depending on the manufacturer's instructions). Prolonged immersion of instruments can damage them. •Each time an instrument is added to the instrument container, the clock has to be restarted for the entire amount of time.

What is sterilization pouches? (refer to book for pictures)

•Consist of a combination of paper and plastic; paper makes up one side of the pouch, & plastic film makes up the other side. •Sterilization pouches are available in different sizes; the most common sizes (in inches) are 3 x 9 , 5 x 10 , 7 x 12. •Sterilization pouches provide good visibility on the plastic side. Most manufacturers include a sterilization indicator on the outside of the pouch. •Sterilization pouches can be paper or plastic (you can write on the paper side)

What is important about the dry heat oven?

•Dry heat is less corrosive than moist heat for instruments with sharp edges; it does not dull their sharp edges. •The most commonly used temp. for dry heat sterilization is 320°F (160 °C) for 1 to 2 hours, depending on the article being sterilized.

What is GHS revisions to the HCS?

•Enables employees to quickly obtain & more easily understand information regarding the safe handling & use of hazardous chemicals. •Preventing injury & illness associated with exposure to hazardous chemicals.

What is important about sterilization indicators?

•If an indicator does not change properly, a problem may be present in the sterilization technique or in the working condition of the autoclave. •The manufacturer's guidelines for proper sterilization techniques should be reviewed. •If indicator still does not change properly, the autoclave is in need of repair & should not be used until it has been serviced.

What is autoclave? (refer to book for all info).

•Is a dependable, efficient, and economical and can be used to sterilize items that are not harmed by moisture or high temperature. •Is usually operated at approximately 15 pounds of pressure per square in. at a temperature of 250 °F (121 °C). •Most Microorganisms are killed in a few minutes at temperatures ranging from 130 °F to 150 °F (54 °C to 65 °C).

What is the GHS hazard statement?

•Is a phrase that describes the types of hazardous chemical, including the degree of the hazard. •Causes damage to kidneys through prolonged or repeated exposure when absorbed through the skin.

What is GHS signal word? & what are 2 signal words?

•Is used to indicate the relative degree of the hazardous chemical & to alert the user to potential hazard on the label. •Danger: denotes a more severe hazard possible. •Warning: denotes a less serious hazard possible but (potentially harmful.)

What is the GHS hazard pictograms?

•Pictograms consists of standardized graphic symbols that allow employees to quickly identify the types of hazards associated with a hazardous chemical. •There are eight different pictograms representing the health & physical hazards covered in the GHS.

What is safety data sheet (SDS)?

•Provides more detailed information than the container label regarding the chemical, it's hazards, & measures to take to prevent injury & illness when handling the chemical. •HCS requires that a current SDS be kept on file for each hazardous chemical used or stored in the workplace. • SDS must be accessible to employees & the MA should always review the safety data sheet before working with a hazardous chemical. •Companies that manufacture & distribute hazardous chemicals must provide an SDS with every product.

What happened in 2012 to The Hazard Communication Standard? (HCS)

•Revised to incorporate the Globally Harmonized System of Classification & Labeling of Chemicals (GHS). •The GHS is an international standard that provides classification & labeling of chemicals through the use of pictograms, signal words & hazard warnings. •The GHS requires the use of a standardized format for labeling containers & the development of safety data sheets (SDSs).

What is important about handling & storing packs?

•Sterilization wrapped articles should be handled carefully and as little as possible. •If a wrapped article is crushed, compressed, or dropped, the sterility of the contents cannot be assumed, & the pack must be resterilized. (also called event-related sterility) •Sterilization packs should be stored in clean, dry areas that are free from dust, insects & other sources of contamination (stored in the back). •MA should check each sterilized pack at least twice: before storing it & before using it. •If pack is torn, opened, or wet it much be rewrapped & resterilized.

What is the purpose of wrapping articles? (refer to book for more

•The purpose of wrapping articles is to protect them from recontamination during handling and storage. •The wrapping material should be made of a substance that is no affected by the sterilization process & should allow stem to penetrate while preventing contaminants, such as dust, insects, & microorganisms, from entering during handling & storage. •Examples of wrapping materials used for autoclaving are sterilization paper, sterilization pouches, & muslin. •It should not tear or puncture easily, & should not be used if it is torn or has a hole. (opened w/o contamination of the contents).

What is drying the load?

•The sterilized articles are moist & must be allowed to dry before they are removed from the autoclave. •Microorganisms can move quickly through the moisture on a wet wrap & onto the sterile article inside, resulting in contamination.